甘油三酯葡萄糖指数预测脑小血管病患者的脑小血管病总体负担  

Triglyceride glucose index predicts total burden of cerebral small vessel disease in patients with cerebral small vessel disease

作　　者：周旭游 胡进 曲娟 Zhou Xuyou;Hu Jin;Qu Juan(Department of Neurology,Jiaxing First Hospital,Jiaxing 314000,China)

机构地区：[1]嘉兴市第一医院神经内科,嘉兴314000

出　　处：《国际脑血管病杂志》2022年第12期912-916,共5页International Journal of Cerebrovascular Diseases

基　　金：嘉兴市科技计划项目(2020AD30068,2019AD32179)。

摘　　要：目的探讨甘油三酯葡萄糖(triglyceride-glucose,TyG)指数对脑小血管病(cerebral small vessel disease,CSVD)CSVD总体负担的预测价值。方法连续纳入2019年7月至2021年1月在嘉兴市第一医院住院治疗的CSVD患者,利用MRI进行CSVD影像学总体负担评分。分析高负担组(3~4分)与低负担组(0~2分)TyG指数及其他危险因素的差异。通过多变量logistic回归分析确定CSVD高负担的独立预测因素,并应用受试者工作特征(receiver operating characteristic,ROC)曲线评估TyG指数对CSVD高负担的预测价值。结果共纳入165例CSVD患者,其中低负担组103例(62.4%),高负担组62例(37.6%)。高负担组既往卒中或短暂性脑缺血发作史患者构成比以及年龄、空腹血糖、糖化血红蛋白和TyG指数均显著高于低负担组(P均<0.05)。多变量logtistic回归分析显示,TyG指数(优势比4.584,95%置信区间2.180~8.887;P=0.001)和年龄(优势比1.075,95%置信区间1.025~1.128;P=0.003)为CSVD高负担的独立预测因素。ROC曲线显示,TyG指数预测CSVD高负担的曲线下面积为0.69(95%置信区间0.60~0.77);最佳截断值为8.5,其预测CSVD高负担的敏感性和特异性分别为72.6%和64.1%。结论TyG指数与CSVD总体负担相关,且对CSVD高负担有一定的预测价值。Objective To investigate the predictive value of triglyceride-glucose(TyG)index for the overall burden of cerebral small vessel disease(CSVD).Methods Consecutive patients with CSVD admitted to Jiaxing First Hospital from July 2019 to January 2021 were enrolled.MRI was used to conduct the overall burden score of CSVD.The difference of TyG index and other risk factors between high burden group(3-4 points)and low burden group(0-2 points)was analyzed.The independent predictors of the high burden of CSVD were determined by the multivariate logistic regression analysis,and the predictive value of TyG index for the high burden of CSVD was evaluated by the receiver operating characteristic(ROC)curve.Results A total of 165 patients with CSVD were enrolled,including 103 patients(62.4%)in the low burden group and 62(37.6%)in the high burden group.The proportion of patients with previous stroke or transient ischemic attack,as well as age,fasting blood glucose,glycosylated hemoglobin and TyG index in the high burden group were significantly higher than those in the low burden group(P<0.05).Multivariate logistic regression analysis showed that TyG index(odds ratio[OR]4.584,95%confidence interval[CI]2.180-8.887;P=0.001)and age(OR 1.075,95%CI 1.025-1.128;P=0.003)were the independent predictors of high burden of CSVD.The ROC curve showed that the area under the curve of TyG index for predicting the high burden of CSVD was 0.69(95%CI 0.60-0.77).The optimal cutoff value was 8.5,and its sensitivity and specificity for predicting the high burden of CSVD were 72.6%and 64.1%,respectively.Conclusion TyG index is associated with the overall burden of CSVD and has certain predictive value for the high burden of CSVD.

关 键 词：脑小血管疾病 甘油三酯 血糖 胰岛素抗药性 危险因素 

分 类 号：R743[医药卫生—神经病学与精神病学]