TyG和TyG-BMI与冠心病患者颈动脉粥样硬化的相关性  

Correlation between TyG index,TyG-BMI and carotid atherosclerosis in patients with coronary artery disease

作　　者：李琦[1] 李娇 陈雅芳 李思 齐新[1] 魏丽萍[1] LI Qi;LI Jiao;CHEN Ya-fang;LI Si;Qi Xin;WEI Li-ping(Department of Cardiology,Tianjin Union Medical Center,Nankai University Affiliated Hospital,Tianjin 300121,China;School of Graduate Studies,Tianjin University of Traditional Chinese Medicine,Tianjin 301677,China)

机构地区：[1]天津市人民医院心内科,天津300121 [2]天津中医药大学研究生院,天津301677

出　　处：《心脏杂志》2024年第3期277-282,共6页Chinese Heart Journal

基　　金：国家自然科学基金项目(52173285);天津市卫生健康科技项目(TJWJ2022QN037);天津市中医药管理局项目(2021028)。

摘　　要：目的分析冠心病患者颈动脉粥样硬化与TyG及TyG-BMI的关系。方法选取2021年1月~2022年12月天津市人民医院心内科收治并进行冠脉造影和颈动脉超声检查患者592例为研究对象。依据冠脉造影结果分为正常对照组(n=103)及CAD组(n=489)。收集患者临床资料,计算TyG指数和TyG-BMI水平。分析TyG和TyG-BMI与冠心病患者颈动脉病变程度的相关性。结果与正常对照组比较,CAD组TyG指数和TyGBMI水平明显升高(均P<0.01)。按照Gensini评分三分位数将患者分为三组,中分组(均P<0.05)和高分组(均P<0.01)TyG指数和TyG-BMI水平显著高于低分组。高分组TyG指数和TyG-BMI水平显著高于中分组(均P<0.01)。Spearman相关性分析显示TyG与TyG-BMI和Gensini评分呈现正相关,且TyG指数关联性更强(均P<0.01)。与颈动脉正常组相比,颈动脉粥样硬化组TyG指数更高(P<0.01),TyG-BMI更高(P<0.05)。二元Logistic回归分析发现年龄(OR=1.114,95%CI:1.05~1.18,P<0.01)与高血压(OR=2.913,95%CI:1.27~6.70,P<0.05)是颈动脉粥样硬化的独立危险因素),HDL-C(OR=0.108,95%CI:0.03~0.43,P<0.01)是保护因素。多元Logistic回归分析结果提示高水平TyG和TyG-BMI是颈动脉斑块形成的危险因素。以颈动脉正常为参照,排除混杂因素(如性别、年龄、BMI、收缩压、吸烟史、高血压病史、糖尿病史、药物服用情况)后,高TyG指数组CAD患者发生颈动脉斑块形成的风险是低TyG组的2.56倍,高TyG-BMI组发生颈动脉斑块的风险是低水平TyG-BMI组的4.35倍。Spearman相关性分析发现,TyG指数和颈动脉斑块厚度呈显著正相关(P<0.05),而TyGBMI和斑块厚度无相关。ROC曲线分析结果显示,TyG指数对冠心病患者合并颈动脉斑块形成具有较好的预测价值。结论TyG指数和TyG-BMI是冠心病患者颈动脉斑块形成的危险因素,且TyG指数对颈动脉斑块的预测价值优于TyG-BMI。AIM To demonstrate that TyG index and TyG-BMI had association with carotid atherosclerosis in coronary artery disease(CAD)patients.METHODS This study included 592 patients who underwent both coronary artery angiography and carotid Doppler ultrasound in the Department of Cardiology at Tianjin Union Medical Center from January 2021 to December 2022.TyG index and TyG-BMI were determined and Gensini score and carotid intima-media thickness were calculated or measured.The CAD patients were divided into two groups according to carotid intima-media thickness(IMT).RESULTS Compared with the normal control group,the TyG index and TyG-BMI levels in the CAD group were significantly increased(both P<0.01).The patients were divided into three groups according to the three Quantile of Gensini score.The TyG index and TyG BMI levels in the middle group(all P<0.05)and the high group(all P<0.01)were significantly higher than those in the low group.The TyG index and TyG-BMI levels in the high group were significantly higher than those in the middle group(both P<0.01).Spearman correlation analysis showed a positive correlation between TyG,TyG-BMI,and Gensini score,with a stronger correlation between TyG index(all P<0.01).Compared with the normal carotid artery group,the TyG index and TyG BMI of the carotid atherosclerosis group were higher(P<0.01)and higher(P<0.05).The binary Logistic regression analysis found that age(OR=1.114,95%CI:1.05~1.18,P<0.01)and hypertension(OR=2.913,95%CI:1.27~6.70,P<0.05)were independent risk factors for carotid atherosclerosis,and HDL-C(OR=0.108,95%CI:0.03~0.43,P<0.01)were protective factors.The results of multiple Logistic regression analysis suggest that high levels of TyG and TyG-BMI are risk factors for the formation of carotid artery plaques.With the normal carotid artery as the reference,after excluding the confounding factors(such as gender,age,BMI,systolic blood pressure,smoking history,hypertension history,diabetes history,drug use),the risk of carotid plaque formation in CAD patients in the high

关 键 词：TyG指数 TyG-BMI 冠心病 颈动脉粥样硬化 颈动脉内中膜厚度 

分 类 号：R543[医药卫生—心血管疾病]