胰岛素抵抗替代指标在非糖尿病早发冠心病患者中的临床研究  

Clinical Study of Insulin Resistance Substitute Indexes in Non Diabetes Patients with Premature Coronary Heart Disease

作　　者：甄旭东 刘克坚 邵明明 王素文 刘家琦 周良 ZHEN Xudong;LIU Kejian;SHAO Mingming(School of Medicine,Shihezi University,Shihezi City,Xinjiang 832000;不详)

机构地区：[1]石河子大学医学院,新疆石河子市832000 [2]石河子大学第一附属医院

出　　处：《医学理论与实践》2024年第16期2706-2710,2735,共6页The Journal of Medical Theory and Practice

基　　金：石河子大学第一附属医院博士基金项目(BS202205);兵团科技计划项目:重点领域科技攻关计划(S2022AB2002)。

摘　　要：目的:探究甘油三酯葡萄糖乘积指数(TyG指数)、甘油三酯与高密度脂蛋白胆固醇比值(TG/HDL-C比值)、胰岛素抵抗代谢评分(METS-IR评分)与非糖尿病早发冠心病(PCAD)患者的相关性及其预测价值,并探究其与冠脉病变严重程度(Gensini评分)的关系。方法:收集2017年1月—2023年8月于石河子大学第一附属医院心内科住院并符合纳入标准的790例患者作为研究对象,依据冠状动脉造影(CAG)结果分为PCAD组和对照组。记录两组患者的基线资料、血常规、肝肾功能,并计算胰岛素抵抗(IR)替代指标:TyG指数、TG/HDL-C比值、METS-IR评分。采用校正多因素logistic回归分析TyG指数、TG/HDL-C比值、METS-IR评分对PCAD组的发病影响情况;分析TyG指数、TG/HDL-C比值、METS-IR评分与PCAD组Gensini评分的相关性;采用受试者工作特征(ROC)曲线预测TyG指数、TG/HDL-C比值、METS-IR评分对PCAD组发病的预测价值。结果:PCAD患者TyG指数、TG/HDL-C比值、METS-IR评分高于对照组,差异有统计学意义(P<0.001)。校正多因素logistic回归分析结果显示TyG指数(OR=3.375,95%CI:2.179~5.228,P<0.001)、TG/HDL-C比值(OR=1.489,95%CI:1.309~1.695,P<0.001)和METS-IR评分(OR=1.040,95%CI:1.007~1.074,P<0.05)是PCAD组的危险因素。PCAD组TyG指数、METS-IR评分与Gensini评分之间存在较弱正相关性(r均为0.100,P<0.05)。ROC曲线显示,TyG指数、TG/HDL-C比值、METS-IR评分预测PCAD组发病的曲线下面积分别为0.700、0.699、0.623(P<0.001)。结论:在非糖尿病患者中,TyG指数、TG/HDL-C比值、METS-IR评分与PCAD发病呈正相关,TyG指数、METS-IR评分与PCAD的冠脉病变严重程度有关,为其诊断提供一定依据。Objective:To explore the correlation and predictive value of triglyceride glucose product index(TyG index),triglyceride to high-density lipoprotein cholesterol ratio(TG/HDL-C ratio),insulin resistance metabolic score(METS-IR score)and non diabetes patients with premature coronary heart disease(PCAD),and explore the relationship between them and the severity of coronary artery disease(Gensini score).Methods:790 patients who were hospitalized in the Department of Cardiology at the First Affiliated Hospital of Shihezi University from January 2017 to August 2023 and met the inclusion criteria were collected as the study subjects.They were divided into PCAD group and control group based on coronary angiography(CAG)results.Record baseline data,blood routine,liver and kidney function of two groups of patients,and calculate insulin resistance(IR)substitute indicators:TyG index,TG/HDL-C ratio,METS-IR score.Using adjusted multivariate logistic regression analysis to assess the incidence of PCAD in the TyG index,TG/HDL-C ratio,and METS-IR score.Analyze the correlation between TyG index,TG/HDL-C ratio,METS-IR score,and Gensini score in PCAD group.The predictive value of using receiver operating characteristic(ROC)curves to predict TyG index,TG/HDL-C ratio,and METS-IR score for the onset of PCAD group.Results:The TyG index,TG/HDL-C ratio,and METS-IR score of PCAD patients were higher than those of the control group,and the differences were statistically significant(P<0.001).The results of the adjusted multivariate logistic regression analysis showed that TyG index(OR=3.375,95%CI:2.179~5.228,P<0.001),TG/HDL-C ratio(OR=1.489,95%CI:1.309~1.695,P<0.001),and METS-IR score(OR=1.040,95%CI:1.007~1.074,P<0.05)were risk factors for the PCAD group.There is a weak positive correlation(r=0.100,P<0.05)between the TyG index,METS-IR score,and Gensini score in the PCAD group.The ROC curve showed that the areas under the curve for predicting the incidence of PCAD in the TyG index,TG/HDL-C ratio,and METS-IR score were 0.700,0.699,and 0.623,resp

关 键 词：TyG指数 TG/HDL-C比值 METS-IR评分 PCAD患者 非糖尿病 

分 类 号：R541.4[医药卫生—心血管疾病]