甘油三酯-葡萄糖指数与老年高血压合并冠心病患者全因死亡的关联研究  

Association between triglyceride glucose index and all-cause mortality in elderly patients with hypertension and coronary artery disease

作　　者：田露 汪驰 赵茂翔 李雁洁 冯泽锟 兰丽花 孙艺祯 侯紫微 薛浩[1] Tian Lu;Wang Chi;Zhao Maoxiang;Li Yanjie;Feng Zekun;Lan Lihua;Sun Yizhen;Hou Ziwei;Xue Hao(Department of Hypertension,the Sixth Medical Center of Chinese People′s Liberation Army General Hospital,Beijing 100048,China)

机构地区：[1]解放军总医院第六医学中心高血压病科,北京100048

出　　处：《中华检验医学杂志》2024年第5期506-513,共8页Chinese Journal of Laboratory Medicine

基　　金：首都卫生发展科研专项(2020-2-5013),(22BJZ38)

摘　　要：目的:探讨甘油三酯-葡萄糖(TyG)指数与老年高血压合并冠心病患者全因死亡的相关性。方法:纳入2008年8月至2018年7月就诊于解放军总医院心血管内科的5640例老年(≥65岁)高血压合并冠心病住院患者进行回顾性队列研究。收集患者基线临床资料,并计算TyG指数。根据TyG指数四分位数值将患者分为4组:TyG指数<8.31(Q1组,n=1392),8.31≤TyG指数<8.67(Q2组,n=1417),8.67≤TyG指数<9.07(Q3组,n=1427)和TyG指数≥9.07(Q4组,n=1404)。通过获取门诊、再入院记录或电话随访对所有患者进行随访,主要随访终点为全因死亡。Log-rank检验比较各组累积全因死亡率差异;调整混杂因素后,Cox比例风险回归模型对各组全因死亡风险进行分析(以全因死亡率最低的Q2组作为参照),限制性立方样条(RCS)曲线分析TyG指数与全因死亡风险的关系。结果:患者随访时间为6.44(4.70,8.85)年,其中1037例(18.39%)患者发生全因死亡。Q1~Q4组的累积全因死亡率分别为16.52%、16.51%、17.59%和22.93%,差异有统计学意义(χ^(2)=26.49,P<0.01)。Cox回归模型校正多种混杂因素后,以Q2组为参照,Q1、Q3、Q4组的HR值(95%CI)分别为1.06(0.88~1.28)、1.23(1.02~1.48)、1.48(1.23~1.77)(趋势P<0.01)。RCS曲线分析显示当TyG指数>8.67时,全因死亡风险随TyG指数增加而升高,二者之间呈线性关联(非线性趋势检验P=0.31)。结论:TyG指数升高与老年高血压合并冠心病患者全因死亡风险增加具有相关性。Objective To investigate the association between triglyceride-glucose(TyG)index and all-cause mortality in elderly patients with hypertension and coronary artery disease.Methods This was a retrospective cohort study,a total of 5640 elderly inpatients(≥65 years)with hypertension and coronary artery disease who were admitted to the Department of Cardiology,Liberation Army General Hospital from August 2008 to July 2018 were enrolled in this study.The baseline clinical data of the patients were collected and the TyG index was calculated.Patients were divided into four groups according to their TyG index quartiles:TyG index<8.31(Q1 group,n=1392),8.31≤TyG index<8.67(Q2 group,n=1417),8.67≤TyG index<9.07(Q3 group,n=1427),and TyG index≥9.07(Q4 group,n=1404).All patients were followed up by obtaining outpatient/rehospitalization records or by telephone.The primary endpoint was all-cause mortality.Log-rank test was used to compare the cumulative all-cause mortality among groups.Cox proportional hazard regression model was used to analyze the risk of all-cause mortality in each group(the Q2 group with the lowest all-cause mortality was used as a reference),after adjusting for confounding factors,Restricted cubic spline analysis(RCS)was used to determine the association between TyG index and risk of all-cause mortality.Results During a follow-up of 6.44(4.70,8.85)years,1037 all-cause deaths(18.39%)were documented.The cumulative all-cause mortality in Q1-Q4 groups was 16.52%,16.51%,17.59%and 22.93%,respectively,and the difference was statistically significant(χ^(2)=26.49,P<0.01).In the Cox regression model,compared with Q2 group(reference),the HR(95%CI)for all-cause mortality was 1.06(0.88-1.28)in the Q1 group,1.23(1.02-1.48)in the Q3 group and 1.48(1.23-1.77)in the Q4 group,respectively(P for trend<0.01).RCS curve analysis showed that when the TyG index was greater than 8.67,the risk of all-cause mortality increased with the TyG index,and there was a linear relationship between TyG index and all-cause mortality in th

关 键 词：高血压 冠心病 甘油三酯类 葡萄糖 指数 老年人 

分 类 号：R544.1[医药卫生—心血管疾病] R541.4[医药卫生—内科学]