甘油三酯葡萄糖乘积指数和心源性猝死风险关联的社区队列研究  

Associations between the triglyceride-glucose index and the risk of sudden cardiac death in a community cohort study

作　　者：郭媛 张天清 刘怡[3] 唐欣 俞静[3] 李东泽[3] 万智[2] 贾丹 GUO Yuan;ZHANG Tian-qing;LIU Yi;TANG Xin;YU Jing;LI Dong-ze;WAN Zhi;JIA Dan(Outpatient Department,West China Hospital,Sichuan University and West China Nursing School of Sichuan University,Chengdu,Sichuan 610041,China;不详)

机构地区：[1]四川大学华西医院门诊部/四川大学华西护理学院,四川成都610041 [2]四川大学华西医院门诊部 [3]四川大学华西医院急诊科

出　　处：《现代预防医学》2023年第16期3067-3072,共6页Modern Preventive Medicine

基　　金：四川省科学技术项目(2022YFS0279,2021YFQ0062)。

摘　　要：目的研究甘油三酯葡萄糖乘积指数(TyG)和社区人群心源性猝死风险的相关性。方法本研究为社区自然人群前瞻性队列研究,选择美国社区动脉粥样硬化风险(ARIC)研究中社区自然人群作为研究对象,收集人群人口学特征、心血管危险因素、心血管病史、血常规、血脂、肝肾功等变量。利用TyG指数四分位进行分组,采用Cox回归模型分析不同TyG指数和社区人群心源性猝死风向的相关性。结果本研究最终纳入14684名社区居民,随访36年期间,2188(14.9%)居民发生心源性猝死。TyG指数越高人群的心源性猝死发生率越高(Q1组发生率10.3%,Q2组11.9%,Q3组15.0%,Q4组22.5%,补充统计量值P<0.001)。限制性曲线分线显示,TyG指数越高,社区人群心源性风险越高。Kaplan-Meier生存分析显示:TyG指数越高,社区人群无心源性猝死的累计生存率越低(log rank χ^(2)=362.55;P<0.001)。多因素Cox回归分析显示,TyG指数是心源性猝死的独立影响因素[风险比(HR):1.161;95%置信区间(CI):1.073~1.256,P<0.001]。亚组分析显示,在不同年龄、性别、BMI、吸烟史、饮酒史、高血压史、糖尿病史、心血管疾病史和高脂血症亚组中,TyG指数与心源性猝死风险均呈独立相关趋势,但在女性和心血管疾病史人群中,对TyG指数与心源性猝死风险无相关性。中介效应分析显示,TyG指数对心血管疾病介导心源性猝死具有中介效应。结论TyG指数和社区人群心源性猝死风险独立相关。Objective To investigate the correlation between the triglyceride-glucose index(TyG)and the risk of sudden cardiac death in community populations.Methods This study was a prospective cohort study of the community’s natural population.The community natural population in the American Community Atherosclerosis Risk(ARIC)Study was selected as the research object.The demographic characteristics,cardiovascular risk factors,cardiovascular history,blood routine test,blood lipids,liver and kidney functions and other population variables were collected.Using the TyG index quartile for grouping,aCox regression model was used to analyze the correlation between different TyG indices and the direction of sudden cardiac death in the community population.Results 14684 community residents were ultimately included in this study,and during a 36-year follow-up period,2188(14.9%)residents experienced sudden cardiac death.The higher the TyG index,the higher the incidence of sudden cardiac death in the population(Q110.3%,Q211.9%,Q315.0%,Q422.5%,P<0.001).The restrictive curve line showed that the higher the TyG index,the higher the cardiogenic risk of the community population.Kaplan Meier survival analysis showed that the higher the TyG index,the lower the cumulative survival rate without sudden cardiac death in the community population(log-rank χ^(2)=362.55;P<0.001).Multivariate Cox regression analysis showed that the TyG index is an independent influencing factor for sudden cardiac death[hazard ratio(HR):1.161;95%CI:1.073-1.256,P<0.01].Subgroup analysis showed that in different ages,gender,BMI,smoking history,drinking history,hypertension history,diabetes history,cardiovascular disease history,and hyperlipidemia subgroups,the TyG index was independently related to the risk of sudden cardiac death,but in women and people with cardiovascular disease history,there was no correlation between TyG index and the risk of cardiac death.Mesomeric effect analysis showed that the TyG index had a mesomeric effect on sudden cardiac death mediate

关 键 词：心源性猝死 甘油三酯 葡萄糖 社区队列 

分 类 号：R541.78[医药卫生—心血管疾病]