TyG指数与稳定性冠心病患者冠状动脉病变支数的关联分析  

The association between the TyG index and the number of coronary artery lesions in patients with stable coronary artery disease

作　　者：刘茹 张皓楠 许雅鑫 王启哲 戴维[2] 刘明[2] 江孙芳 邹健[1] Liu Ru;Zhang Haonan;Xu Yaxin;Wang Qizhe;Dai Wei;Liu Ming;Jiang Sunfang;Zou Jian(Department of Family Medicine,Zhongshan Hospital,Fudan University,Shanghai 200032,China;Health Management Center,Zhongshan Hospital,Fudan University,Shanghai 200032,China)

机构地区：[1]复旦大学附属中山医院全科医学科,上海200032 [2]复旦大学附属中山医院健康管理中心,上海200032

出　　处：《中华全科医师杂志》2023年第7期715-721,共7页Chinese Journal of General Practitioners

基　　金：上海市医学领军人才培养计划(2019LJ15)。

摘　　要：目的分析甘油三酯葡萄糖(TyG)指数与稳定性冠心病患者冠状动脉病变支数的关联。方法该研究为横断面研究。纳入2019年1月1日至2020年4月30日在复旦大学附属中山医院住院进行冠状动脉造影的稳定性冠心病患者,根据TyG指数是否高于均值将入选者分为高TyG指数组和低TyG指数组。收集入选患者的一般临床资料、实验室检查结果,并计算TyG指数。通过冠状动脉造影评估患者冠状动脉病变情况。采用logistic回归模型分析冠状动脉病变支数的关联因素。结果共入选患者832例,其中男性641例(77.0%),年龄(64.6±11.5)岁,TyG指数均值为8.78,将TyG指数≥8.78的患者纳入高TyG指数组(411例),TyG指数<8.78的患者纳入低TyG指数组(421例)。与低TyG指数组比较,高TyG指数组患者的体重指数、舒张压更高(均P<0.05),吸烟及合并糖尿病的患者更多(均P<0.05),冠心病的发病年龄更小(P<0.001),使用他汀类药物的患者比例较低(P=0.027)。与低TyG指数组比较,高TyG指数组患者血红细胞计数、血红蛋白、白细胞计数、白蛋白、尿素氮、尿酸、空腹血糖、糖化血红蛋白、甘油三酯、低密度脂蛋白胆固醇、非高密度脂蛋白胆固醇、载脂蛋白B、载脂蛋白E、C反应蛋白水平均更高(均P<0.05),而高密度脂蛋白胆固醇、载脂蛋白A1、脂蛋白(a)水平均较低(均P<0.05)。高TyG指数组患者冠状动脉病变支数为2.35±0.91,多于低TyG指数组的2.10±0.95(P<0.001)。校正了混杂因素后,多因素logistic回归分析结果显示男性、吸烟史(戒烟或吸烟)、TyG指数及肌钙蛋白T水平与冠状动脉病变支数呈独立正向关联(均OR值>1,均P<0.05),载脂蛋白A1则与冠状动脉病变支数呈独立负向关联(OR=0.140,P=0.007)。结论TyG指数与稳定性冠心病患者冠状动脉病变支数呈正向关联,或许可用于评估稳定性冠心病患者冠状动脉病变情况。ObjectiveTo analyse the association between triglyceride glucose(TyG)index and the number of coronary artery lesions in patients with stable coronary artery disease.MethodsIt was a cross-sectional study.Patients with stable coronary artery disease who were admitted to Zhongshan Hospital,Fudan University from 1st January 2019 to 30th April 2020 for percutaneous coronary intervention(PCI)were selected.We collected general clinical information and laboratory results from the enrolled patients,then calculated the TyG index.We evaluated coronary artery lesions by coronary angiography and analysed the factors associated with the number of coronary artery lesion branches by the logistic regression model.ResultsA total of 832 patients were included in this study,641(77.0%)were male,the age was(64.6±11.5)years.The mean TyG index was 8.78.Patients with the TyG index≥8.78 were included in the high TyG index group(411 patients),and those with the TyG index<8.78 were included in the low TyG index group(421 patients).Compared with the low TyG index group,the high TyG index group had the higher body mass index and diastolic blood pressure,more smokers and diabetes mellitus,younger age of onset of coronary heart disease(allP<0.05),and a lower proportion of patients using statins(P=0.027).Compared with the low TyG index group,the high TyG index group had the higher levels of erythrocyte count,hemoglobin,white blood cell count,albumin,urea nitrogen,uric acid,fasting blood glucose,HbA1c,triglyceride,low-density lipoprotein cholesterol,non-high-density lipoprotein cholesterol,apolipoprotein B,apolipoprotein E,and C-reactive protein(all P<0.05).However,the levels of high density lipoprotein,apolipoprotein A1 and apolipoprotein A were lower in the high TyG index group than those in the low TyG index group(allP<0.05).The number of coronary artery lesions in patients in the high TyG index group was 2.35±0.91,more than the low TyG index group 2.10±0.95(P<0.001).After adjusting for the other factors,multivariate logistic regression a

关 键 词：冠心病 冠状动脉病变 甘油三酯葡萄糖指数 

分 类 号：R541.4[医药卫生—心血管疾病]