非糖尿病腹膜透析患者基线血清三酰甘油葡萄糖乘积指数与首次心血管事件的相关性分析  

Relationship between baseline serum triglyceride-glucose index and primary cardiovascular event in nondiabetic peritoneal dialysis patients

作　　者：闫奇奇 刘桂凌[1] 王瑞峰[1] 李丹丹[1] Yan Qi-qi;Liu Gui-ling;Wang Rui-feng;Li Dan-dan(Department of Nephrology,the Second Affiliated Hospital of Anhui Medical University,Hefei 230601,China)

机构地区：[1]安徽医科大学第二附属医院肾脏内科,合肥230601

出　　处：《临床肾脏病杂志》2024年第1期8-12,共5页Journal Of Clinical Nephrology

基　　金：安徽医科大学第二附属医院临床研究培育计划重点项目(2021LCZD16)。

摘　　要：目的探讨非糖尿病腹膜透析(peritoneal dialysis,PD)患者基线三酰甘油葡萄糖乘积(triglyceride-glucose,TyG)指数与首次心血管事件(cardiovascular event,CVE)的关系。方法收集2014年1月至2020年6月在安徽医科大学第二附属医院行PD置管术、术后长期透析并规律随访的非糖尿病患者为研究对象,根据基线TyG指数的中位数分为低TyG组(TyG<8.47)和高TyG组(TyG≥8.47)。对患者进行5~95个月的随访,记录首次CVE。结果共纳入119例患者,其中高TyG组女性(37例比21例)、体重指数[(22.54±3.50)kg/m^(2)比(21.29±3.04)kg/m^(2)]、白蛋白[(35.7±5.8)g/L比(33.0±5.8)g/L]、三酰甘油[1.55(1.32,1.98)mmol/L比0.90(0.73,1.03)mmol/L]、空腹血糖[4.97(4.58,5.47)mmol/L比4.49(4.19,4.95)mmol/L]均明显高于低TyG组(P均<0.05)。Spearman相关分析显示,TyG指数与体重指数、白蛋白呈正相关(P均<0.05)。随访期间共40例(33.61%)患者发生首次CVE。低TyG组13例(22.03%),高TyG组27例(45%)。Kaplan-Meier分析显示,高TyG组患者首次CVE的发生率明显高于低TyG组患者(χ^(2)=4.858,P=0.028)。多因素COX回归分析显示TyG≥8.47(HR=2.418,95%CI:1.105~5.294,P=0.027)是PD患者发生首次CVE的独立危险因素,总胆固醇(HR=1.686,95%CI:1.133~2.509,P=0.010)是PD患者发生CVE的独立影响因素。结论基线高TyG指数(TyG≥8.47)是PD患者发生CVE的独立危险因素。对于基线高TyG指数的PD患者,早期干预或许有望降低发生首次CVE的风险。Objective To explore the relationship between baseline serum triglyceride-glucose(TyG)index and primary cardiovascular event(CVE)in nondiabetic peritoneal dialysis(PD)patients.Methods From January 2014 to June 2020,119 nondiabetic patients undergoing PD catheterization with regular postoperative dialysis and follow-ups were enrolled.According to the median baseline TyG index,they were assigned into two groups of low TyG(TyG<8.47)and high TyG(TyG≥8.47).During a median follow-up period of 36(5-95)months,primary CVE was recorded.Results Female(37 vs 21),body mass index(BMI)[(22.54±3.50)kg/m^(2) vs(21.29±3.04)kg/m^(2)],albumin[(35.7±5.8)g/L vs(33.0±5.8)g/L],triacylglycerol[1.55(1.32,1.98)mmol/L vs 0.90(0.73,1.03)mmol/L]and fasting plasma glucose[4.97(4.58,5.47)mmol/L vs 4.49(4.19,4.95)mmol/L]were significantly higher in high TyG group than those in low TyG group(all P<0.05).Spearman’s correlation analysis indicated that TyG index was correlated positively with BMI and albumin(all P<0.05).And 13 patients(22.03%)in low TyG group and 27(45%)in high TyG group developed primary CVE during follow-ups.Kaplan-Meier analysis revealed that high TyG group had a significantly higher incidence of primary CVE than low TyG group(χ^(2)=4.858,P=0.028).Multivariate Cox regression analysis indicated that TyG≥8.47(HR=2.418,95%CI:1.105-5.294,P=0.027)was an independent risk factor for an initial occurrence of primary CVE while total cholesterol(HR=1.686,95%CI:1.133-2.509,P=0.010)an independent influencing fac-tor for the occurrence of primary CVE.Conclusions High baseline TyG index(TyG≥8.47)is an inde-pendent risk factor for the occurrence of primary CVE.Early intervention may lower the risk of develop-ing a primary CVE in PD patients with a high baseline TyG index.

关 键 词：腹膜透析 三酰甘油 葡萄糖 心血管疾病 

分 类 号：R692.5[医药卫生—泌尿科学]