TyG指数联合HbA1c对2型糖尿病老年患者左心室收缩功能障碍的预测价值  

Predictive value of TyG index combined with HbA1c for left ventricular systolic dysfunction in elderly patients with type 2 diabetes mellitus

作　　者：雷琳 王刚 赵鑫扬 徐琦 LEI Lin;WANG Gang;ZHAO Xin-yang;XU Qi(Department of Ultrasound,Wuhan Fourth Hospital,Wuhan 430033,China)

机构地区：[1]武汉市第四医院超声科,湖北武汉430033

出　　处：《中国临床医学影像杂志》2024年第3期169-173,共5页Journal of China Clinic Medical Imaging

摘　　要：目的:探究甘油三酯葡萄糖(TyG)指数联合糖化血红蛋白(HbA1c)对2型糖尿病(T2DM)老年患者左心室收缩功能障碍的预测价值。方法:回顾性分析2018年12月—2022年12月武汉市第四医院就诊的166例T2DM老年患者的临床资料。根据TyG指数的四分位数值将患者分为TyG-1组(TyG≤8.89)、TyG-2组(TyG>8.89~9.44)、TyG-3组(TyG>9.44~9.83)、TyG-4组(TyG>9.83)。比较不同TyG指数T2DM老年患者超声特征的差异,分析TyG指数联合HbA1c对T2DM老年患者左心室收缩功能障碍的预测价值。结果:TyG-2组、TyG-3组、TyG-4组患者空腹血糖、总胆固醇、甘油三酯、载脂蛋白A1、载脂蛋白B及高血压比例较TyG-1组升高(P<0.05)。TyG-3组、TyG-4组患者空腹血糖、HbA1c、低密度脂蛋白、甘油三酯、载脂蛋白B较TyG-2组升高(P<0.05)。TyG-4组患者空腹血糖、HbA1c、总胆固醇、甘油三酯、载脂蛋白A1较TyG-3组升高(P<0.05)。TyG-3组、TyG-4组患者整体纵向峰值应变(GLS)值较TyG-1组、TyG-2组降低(P<0.05)。Logistic回归分析结果显示,HbA1c、TyG指数是T2DM老年患者左心室收缩功能障碍的独立影响因子。TyG指数、HbA1c预测T2DM老年患者左心室收缩功能障碍的ROC曲线下面积分别为0.775(P<0.05,95%CI:0.705~0.844)、0.758(P<0.05,95%CI:0.684~0.831)。TyG指数联合HbA1c预测T2DM老年患者左心室收缩功能障碍的ROC曲线下面积为0.801(P<0.05,95%CI:0.733~0.869),当预测概率值取最佳截断值0.506时,预测的灵敏度为73.17%、特异度为77.38%。结论:TyG指数联合HbA1c对T2DM老年患者左心室收缩功能障碍具有较好的预测价值。Objective:To investigate the predictive value of triglyceride glucose(TyG)index combined with glycated hemoglobin(HbA1c)on left ventricular systolic dysfunction in elderly patients with type 2 diabetes mellitus(T2DM).Methods:The clinical data of 166 elderly patients with T2DM attending Wuhan Fourth Hospital from December 2018 to December 2022 were retrospectively analyzed.The patients were divided into TyG-1 group(TyG≤8.89),TyG-2 group(TyG>8.89~9.44),TyG-3 group(TyG>9.44~9.83)and TyG-4 group(TyG>9.83)according to the quartile values of TyG index.Then we compared the differences in clinical ultrasound characteristics of T2DM patients with different TyG indices and analyzed the predictive value of TyG index combined with HbA1c on left ventricular systolic dysfunction in elderly patients with T2DM.Results:Fasting blood glucose,total cholesterol,triglycerides,apolipoprotein A1,apolipoprotein B(ApoB)and the proportion of hypertension were higher in the TyG-2,TyG-3 and TyG-4 groups compared with the TyG-1 group(P<0.05).Fasting blood glucose,HbA1c,low-density lipoprotein(LDL),triglycerides and ApoB were elevated in patients in the TyG-3 and TyG-4 groups compared with the TyG-2 group(P<0.05).Fasting blood glucose,HbA1c,total cholesterol,triglycerides and apolipoprotein A1 were elevated in patients in the TyG-4 group compared with the TyG-3 group(P<0.05).The overall longitudinal peak strain(GLS)values were lower in patients in the TyG-3 and TyG-4 groups compared with the TyG-1 and TyG-2 groups(P<0.05).The results of Logistic regression analysis showed that HbA1c and TyG index were independent risk factors for left ventricular systolic dysfunction in elderly patients with T2DM.The areas under the ROC curves for TyG index and HbA1c predicting left ventricular systolic dysfunction in elderly patients with T2DM was 0.775(P<0.05,95%CI:0.705~0.844),0.758(P<0.05,95%CI:0.684~0.831),respectively.The area under the ROC curve of TyG index combined with HbA1c to predict left ventricular systolic dysfunction in elderly patients with

关 键 词：糖尿病 心室功能障碍 左 超声心动描记术 

分 类 号：R587.1[医药卫生—内分泌] R541[医药卫生—内科学] R540.45[医药卫生—临床医学]