甘油三酯-血糖指数和甘油三酯-血糖-体质指数指数在冠心病预测和评估中的应用价值  

Application value of triglyceride-glucose index and index of triglyceride-glucose-body mass index to prediction and review of coronary heart disease

作　　者：宋晚美 刘曦峰 马小峰[1] Song Wanmei;Liu Xifeng;Ma Xiaofeng(Department of Cardiology,Nanhua Hospital,University of South China,Hengyang 421002,China;不详)

机构地区：[1]南华大学附属南华医院心内科,衡阳421002 [2]南华大学附属第一医院心内科,衡阳421001

出　　处：《中国循证心血管医学杂志》2021年第6期680-683,691,共5页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：湖南省卫生计生委科研基金(B2016139)。

摘　　要：目的探讨甘油三酯-血糖(TyG)指数和甘油三酯-血糖-体质指数(TyG-BMI)在冠状动脉粥样硬化性心脏病(冠心病,CHD)预测和评估中的应用价值。方法收集2018年6月至2019年6月因不明原因胸痛于南华大学附属南华医院行冠状动脉造影(CAG)的调查者210例,其中126例为确诊CHD,另84例为非CHD患者。检测入组人群血脂和血糖水平,计算TyG指数和TyG-BMI指数,并分析其与Gensini评分和SYNTAXⅡ评分的关系。采用受试者工作特征(ROC)曲线和多因素Logistic回归分析确定TyG指数和TyG-BMI指数对冠心病的诊断价值。结果冠心病患者TyG指数、TyG-BMI高于非冠心病人群(P<0.05);且经多因素Logistic回归分析,两者是冠心病发生的独立影响因素。采用ROC曲线分析,TyG指数和TyG-BMI指数对冠心病诊断的ROC曲线下面积分别为0.71(95%CI:0.64~0.79)和0.68(95%CI:0.61~0.76)。Gensini评分中度病变和重度病变者TyG指数和TyG-BMI高于轻度病变者(P<0.05);同时SYNTAXⅡ评分高危患者TyG指数和TyG-BMI高于低危患者(P<0.05)。经多元线性回归分析,TyG指数和TyG-BMI指数与Gensini评分或SYNTAXⅡ评分均呈正相关性(P<0.05)。结论TyG指数和TyG-BMI指数可综合反映血脂和血糖信息,在预测冠心病发生风险及冠状动脉病变严重程度方面具有更好的应用价值。Objective To investigate the application value of triglyceride-glucose index(TyG index)and index of triglyceride-glucose-body mass index(TyG-BMI index)to prediction and review of coronary heart disease(CHD).Methods The patients(n=210)received coronary angiography(CAG)due to unexplained chest pain were chosen from Nanhua Hospital affiliated to University of South China from June 2018 to June 2019,and divided into CHD group(n=126)and non-CHD group(n=84).The levels of blood fat and blood sugar were detected,TyG index and TyG-BMI index were calculated,and relationship among TyG index,TyG-BMI index,Gensini scores and SYNTAX II scores was analyzed.The diagnostic value of TyG index and TyG-BMI index to CHD was determined by using ROC curve and multi-factor Logistic regression analysis.Results TyG index and TyG-BMI index were higher in CHD group than those in non-CHD group(P<0.05),and the results of multi-factor Logistic regression analysis showed that they were independent influence factors of CHD.The results of ROC curve analysis showed that AUC of ROC of TyG index was 0.71(95%CI:0.64~0.79)and that of TyG-BMI index was 0.68(95%CI:0.61~0.76).The results of Gensini scoring showed that TyG index and TyG-BMI index were higher in moderate CHD patients and severe CHD patients than those in mile CHD patients(P<0.05),results of SYNTAXⅡshowed that TyG index and TyG-BMI index were higher in high-risk CHD patients than those in low-risk CHD patients(P<0.05).The results of multi-factor Logistic regression analysis showed that TyG index and TyG-BMI index were positively correlated to Gensini scores and SYNTAX II scores(P<0.05).Conclusion TyG index and TyG-BMI index can reflect information of blood fat and blood sugar,and they have higher application value in predicting CHD risk and severity of coronary artery lesions.

关 键 词：冠心病 甘油三酯-血糖指数 甘油三酯-血糖-体质指数 冠状动脉病变 危险因素 

分 类 号：R541.4[医药卫生—心血管疾病]