甘油三酯葡萄糖指数和胰岛素抵抗代谢评分与携带载脂蛋白Eε4等位基因人群冠心病严重程度的相关性  

Correlation of triglyceride and glucose index and metabolic score for insulin resistance with coronary heart disease severity in ApoEε4 allele carriers

作　　者：刘文韬 高萌 米蕊 孙跃 杨荣礼 Liu Wentao;Gao Meng;Mi Rui;Sun Yue;Yang Rongli(Graduate School of Xuzhou Medical University,Xuzhou 221000,Jiangsu Province,China;Department of Geriatrics,Affiliated Hospital of Xuzhou Medical University,Xuzhou 221004,Jiangsu Province,China)

机构地区：[1]徐州医科大学研究生院,江苏徐州221000 [2]徐州医科大学附属医院老年医学科,江苏徐州221004

出　　处：《中华老年多器官疾病杂志》2024年第9期650-654,共5页Chinese Journal of Multiple Organ Diseases in the Elderly

基　　金：江苏省老年健康科研项目(LD2021023,LR2022007)。

摘　　要：目的分析冠状动脉粥样硬化性心脏病(CAD)患者胰岛素抵抗代谢评分(METS-IR)和甘油三酯葡萄糖指数(TyG)与携带载脂蛋白E(ApoE)ε4等位基因的CAD人群冠状动脉狭窄程度的相关性。方法回顾性分析2021年1月至2022年12月于徐州医科大学附属医院经冠状动脉造影确诊为冠心病,且ApoE基因检测结果为ApoE4(ε3ε4,ε4ε4)的308例冠心病患者的临床资料,计算TyG与METS-IR。采用2019年改良Gensini评分(GS)评价CAD狭窄程度,并将患者分为低GS组(106例)、中间GS组(100例)与高GS组(102例)。采用SPSS 27.0统计软件进行数据分析。根据数据类型分别采用单因素方差分析、Kruskal-Wallis H检验或χ^(2)检验进行比较。采用logistic回归分析评估ApoE4冠心病患者冠状动脉狭窄程度的影响因素。采用Spearman相关性分析评估METS-IR和TyG与Gensini评分的相关性。绘制受试者工作特征(ROC)曲线,采用Delong检验比较METS-IR和TyG对冠状动脉狭窄程度的预测价值。结果高GS组METS-IR明显高于非高GS组;高GS组TyG明显高于低GS组,差异有统计学意义(P<0.05)。Spearman相关性分析显示,METS-IR和TyG与Gensini评分呈正相关(r=0.210,0.658;P<0.001)。logistic回归分析显示,METS-IR是携带ApoEε4等位基因冠心病患者狭窄程度的独立预测因子(OR=1.147,95%CI 1.077~1.221;P<0.001)。ROC曲线显示,METS-IR与TyG预测携带ApoEε4等位基因的冠心病人群冠状动脉狭窄程度曲线下面积分别为0.824和0.608,METS-IR预测效能明显更高。结论METS-IR相比于TyG对携带ApoEε4等位基因的CAD患者冠状动脉狭窄程度有更高预测价值。Objective To analyze the correlation of metabolic score for insulin resistance(METS-IR)and triglyceride and glucose(TyG)index with the severity of coronary stenosis in patients with coronary artery disease(CAD)who carry theε4 allele of apolipoprotein E(ApoE).Methods A retrospective analysis was conducted on 308 patients with coronary heart disease identified by coronary angiography carrying ApoE4 genotypesε3ε4 andε4ε4 admitted in Affiliated Hospital of Xuzhou Medical University from January 2021 to December 2022.Their clinical data were collected,and TyG index and METS-IR were calculated.According to the results of modified Gensini score(GS)of 2019 for CAD stenosis,they were divided into low(n=106),intermediate(n=100),and high GS(n=102)groups.SPSS statistics 27.0 was used for statistical analysis.One-way analysis of variance,Kruskal-Wallis H test,or Chi-square test was employed for intergroup comparison depending on data type.Logistic regression analysis was applied to explore the influencing factors for severity of CAD stenosis in patients carrying the ApoEε4 allele.Spearman correlation analysis was performed to analyze the correlation of METS-IR and TyG index with GS.Receiver operating characteristic(ROC)curve was plotted and Delong test was conducted to compare the predictive value of METS-IR and TyG index for the severity.Results METS-IR were significantly higher in the high GS group than in the other two GS groups,and TyG in high GS group was significantly higher than that in low GS group(P<0.05).Spearman correlation analysis indicated a positive correlation of METS-IR and TyG index with GS(r=0.210,0.658;P<0.001).Logistic regression analysis showed that METS-IR was an independent predictor of stenosis severity in CAD patients carrying ApoEε4 allele(OR=1.147,95%CI 1.077-1.221;P<0.001).ROC curve analysis revealed that the area under the curve of METS-IR and TyG index in prediction for coronary stenosis in the CAD population with ApoEε4 allele was 0.824 and 0.608,respectively,and METS-IR had better perf

关 键 词：冠心病 载脂蛋白Eε4等位基因 胰岛素抵抗代谢评分 甘油三酯葡萄糖指数 

分 类 号：R541.4[医药卫生—心血管疾病]