北京社区居民甘油三酯葡萄糖乘积指数与新发颈动脉斑块风险的研究  

Analysis of the association between triglyceride glucose index and new-onset carotid plaque

作　　者：骆星谕 范芳芳[1] 贾佳[1] 孙蓬飞 刘博 陈楚云 杨颖[1] 李建平[1] 郑博[1] 张岩[1] LUO Xing-yu;FAN Fang-fang;JIA Jia;SUN Peng-fei;LIU Bo;CHEN Chu-yu;YANG Ying;LI Jian-ping;ZHENGBo;ZHANG Yan(Department of Cardiology,Peking University First Hospital,Beijing 100034,China)

机构地区：[1]北京大学第一医院心血管内科,北京市100034

出　　处：《中国心血管病研究》2023年第1期18-24,共7页Chinese Journal of Cardiovascular Research

基　　金：国家重点研发计划(2021YFC2500600、2021YFC2500601、2021YFC2500500、2021YFC2500503);中央高水平医院临床科研业务费资助(北京大学第一医院高质量临床研究专项)(2022CR71)。

摘　　要：目的探讨北京社区人群中甘油三酯葡萄糖乘积(TyG)指数与新发颈动脉斑块之间的关系。方法研究对象来源于一项2011年12月至2012年4月在北京市石景山区首钢开展的横断面调查研究,使用颈动脉超声对研究对象进行随访评估新发颈动脉斑块情况。筛选队列中基线无颈动脉斑块、冠心病及卒中病史,未服用降脂药、降糖药,甘油三酯(TG)、空腹血糖(FBG)无缺失,且包涵随访颈动脉斑块数据的参与者纳入本研究。使用多普勒超声评估颈动脉斑块,颈动脉斑块定义为颈动脉内膜中层厚度(IMT)值≥1.5mm,或>周围IMT值至少0.5 mm或50%以上,且凸向管腔的局部结构变化。采用多因素logistic回归分析探讨TyG指数与新发颈动脉斑块之间的关系,根据所有重要的临床变量特征进行亚组分析和交互作用检验,观察主要结果在不同人群中的差异。结果本研究总共纳入909例研究对象,平均随访时间(6.77±0.13)年,平均年龄为(51.53±5.02)岁,男性248例(27.28%),94例(10.34%)患有糖尿病。其中新发颈动脉斑块患者为219例(24.09%)。多因素分析中调整可能的混杂因素,包括年龄、性别、双侧收缩期颈动脉远端IMT平均值、体重指数(BMI)、当前吸烟、当前饮酒、高血压、降压药、肾功能(eGFR)以及总胆固醇(TC),结果显示TyG指数升高与颈动脉斑块发病风险增加相关(OR=1.36,95%CI 1.00-1.85,P=0.050)。TyG指数最高四分位数的参与者的OR(95%CI)为1.92(1.16-3.20),明显高于最低四分位数的参与者。分层交互检验结果显示在饮酒人群中TyG指数与颈动脉斑块发病之间的相关性更强。结论北京社区人群中TyG指数升高与颈动脉斑块发病风险增加相关,提示TyG指数是颈动脉斑块的独立危险因素。未来需要更大规模研究进一步验证TyG指数对颈动脉斑块的预测价值。Objective The present study aimed to investigate the association between TyG index and new-onset carotid plaque in a Chinese community-based population.Methods The community-based cohort was set up in Shougang,Shijingshan District,Beijing from December 2011 to April 2012.Participants diagnosed with coronary heart disease,stroke or carotid plaque or with any use of antidiabetic or lipid-lowering medication were excluded.Participants who lacked information about triglyceride(TG),fasting blood-glucose(FBG)and carotid plaque were further excluded.Doppler ultrasonography examinations of the carotid artery were performed at baseline and during follow-up.Carotid plaque was defined as a carotid intima-media thickness(IMT)value of≥1.5 mm,or greater than the surrounding IMT value by at least 0.5 mm or more than 50%,and local structural changes that were convex to the lumen.The multivariate logistic regression models were used to analyze the association between TyG index and new-onset carotid plaque.Subgroup analysis and interaction test were performed according to the characteristics of important clinical variables to investigate differences in the primary outcome among different populations.Results Of the 909 participants in the cohort,the mean age was(51.53±5.02)years,248(27.28%)were men,and 94(10.34%)was diagnosed with diabetes.The incidence of carotid plaque was 219(24.09%)after a mean follow-up of(6.77±0.13)years.Adjusting for potential confounding factors including age,gender,mean bilateral systolic distal carotid IMT,BMI,current smoking,current drinking,hypertension,antihypertensive drugs prescription,renal function and total cholesterol(TC),the adjusted odds ratio(OR)of the continuous TyG index was 1.36(95%CI 1.00-1.85,P=0.050).Participants in the highest quartile of the TyG index were associated with an increased risk of carotid plaque compared with those in the lowest quartile(OR=1.92;95%CI 1.16-3.20).The interaction test showed that the association between TyG index and the risk of carotid plaque incidence w

关 键 词：甘油三酯葡萄糖乘积指数 颈动脉斑块 

分 类 号：R541.4[医药卫生—心血管疾病]