甘油三酯葡萄糖指数联合不同肥胖指标与糖尿病前期人群10年新发缺血性脑卒中的相关性  

Correlation between triglyceride glucose index combined with different obesity indexes and new-onset ischemic stroke in 10 years among prediabetes individuals

作　　者：缪莹 汪宇 晏丕军 白雪 陈攀 万沁 MIAO Ying;WANG Yu;YAN Pijun;BAI Xue;CHEN Pan;WAN Qin(Department of Endocrinology and Metabolism,The Affiliated Hospital of Southwest Medical University,Luzhou 646000,Sichuan,China;Department of Cardiology,Luzhou People’s Hospital,Luzhou 646000,Sichuan,China)

机构地区：[1]西南医科大学附属医院内分泌与代谢内科,泸州646000 [2]泸州市人民医院心内科,泸州646000

出　　处：《海军军医大学学报》2024年第9期1113-1119,共7页Academic Journal of Naval Medical University

基　　金：国家重点研发计划(2016YFC0901200);西南医科大学校级课题(2019SQN013)。

摘　　要：目的通过队列研究分析甘油三酯葡萄糖指数(TyG)联合不同肥胖指标与四川省泸州地区糖尿病前期人群10年新发缺血性脑卒中(IS)的相关性。方法选择2011年参与泸州地区流行病学调查并且符合糖尿病前期诊断的普通居民2551例,分别按基线TyG-腰围(WC)、TyG-腰围身高比(WtHR)、TyG-BMI、TyG-腰臀比(WHR)的四分位数分为第1、第2、第3、第4四分位组(Q1、Q2、Q3、Q4组),观察各组10年新发IS情况。通过多因素logistic回归分析探索TyG-WC、TyG-WtHR、TyG-WHR与新发IS的关系。结果纳入研究的2551例糖尿病前期个体在非干预性随访至第10年时,因各种原因死亡123例,死亡率为4.8%;新发IS 142例,发生率为5.6%;新发糖尿病224例,其中22例同时新发IS,占新发糖尿病患者的9.8%。按照TyG-WC、TyG-WtHR四分位数分组,糖尿病前期人群10年新发IS的发生率均为Q4组>Q3组>Q2组>Q1组,差异有统计学意义(P<0.05);按照TyG-BMI四分位数分组,新发IS的发生率差异无统计学意义(P>0.05);按照TyG-WHR四分位数分组,新发IS的发生率为Q3组>Q4组>Q2组>Q1组,差异有统计学意义(P<0.05)。多因素logistic回归分析显示,无论在未调整任何变量的情况下还是调整多因素后,TyG-WtHR均与糖尿病前期人群新发IS相关。结论TyG-WtHR是糖尿病前期人群发生IS的危险因素,加强对高TyG-WtHR的糖尿病前期人群的分级管理或可降低IS的发生风险。Objective To analyze the correlation between triglyceride glucose index(TyG)combined with different obesity indexes and new-onset ischemic stroke(IS)in 10 years in prediabetes population in Luzhou,Sichuan through cohort study.Methods A total of 2551 residents who participated in the epidemiological survey in Luzhou in 2011 and were diagnosed as having prediabetes were enrolled.According to the quartiles of baseline TyG-waist circumference(WC),TyG-waist to height ratio(WtHR),TyG-body mass index(BMI),and TyG-waist to hip ratio(WHR),they were divided into the 1st,2nd,3rd,and 4th quartiles groups(Q1,Q2,Q3,and Q4 groups).The incidence of new-onset IS in each group in 10 years was analyzed.The relationships between TyG-WC,TyG-WtHR,TyG-WHR and new-onset IS were analyzed by multivariate logistic regression.Results Among the 2551 prediabetes subjects enrolled in the study,123 died of various causes during the 10 years of non-intervention follow-up,with a mortality of 4.8%;142 had new-onset IS,with an incidence of 5.6%;and 224 had new-onset diabetes mellitus,including 22 also had new-onset IS,accounting for 9.8%.The quartile grouping analyses of TyG-WC and TyG-WtHR showed that the incidence of new-onset IS in prediabetes subjects over 10 years was Q4 group>Q3 group>Q2 group>Q1 group,with significant differences(P<0.05).The quartile grouping analysis of TyG-BMI showed that there was no significant difference in the incidence of new-onset IS(P>0.05).The quartile grouping analysis of TyG-WHR showed that the incidence of new-onset IS was Q3 group>Q4 group>Q2 group>Q1 group,with significant difference(P<0.05).Multivariate logistic regression analysis showed that TyG-WtHR was associated with new-onset IS in prediabetes subjects,either without adjusting any variable or after adjusting multiple factors.Conclusion TyG-WtHR is a risk factor of IS in prediabetes individuals.Enhancing management of prediabetes patients with high TyG-WtHR may reduce the risk of IS.

关 键 词：甘油三酯葡萄糖指数 腰围身高比 缺血性脑卒中 糖尿病前期 

分 类 号：R587.1[医药卫生—内分泌] R743.3[医药卫生—内科学]