甘油三酯-葡萄糖指数和残余胆固醇与非糖尿病人群颈动脉内膜-中膜厚度的相关性  

Associations of triglyceride-glucose index and remnant cholesterol with carotid intima-media thickness in non-diabetic population

作　　者：沈韵致 杜小琼 马荣超 何轩 沙杜鹃[1,3,4] Shen Yunzhi;Du Xiaoqiong;Ma Rongchao;He Xuan;Sha Dujuan(Medical School of Nanjing University,Nanjing 210008,China;Zhetang Central Health Center,Lishui District,Nanjing 211215,China;Department of General Medicine,Nanjing Drum Tower Hospital,Affiliated Hospital of Medical School,Nanjing University,Nanjing 210008,China;Department of General Medicine,Drum Tower School of Clinical Medicine,Nanjing Medical University,Nanjing 210008,China)

机构地区：[1]南京大学医学院,南京210008 [2]南京市溧水区柘塘中心卫生院,南京211215 [3]南京大学医学院附属鼓楼医院全科医学科,南京210008 [4]南京医科大学鼓楼临床医学院全科医学科,南京210008

出　　处：《国际脑血管病杂志》2024年第9期674-680,共7页International Journal of Cerebrovascular Diseases

基　　金：南京大学医学院附属鼓楼医院临床研究项目(2022-LCYJ-ZX-05)。

摘　　要：目的探讨非糖尿病人群甘油三酯-葡萄糖(triglyceride-glucose,TyG)指数和残余胆固醇(remnant cholesterol,RC)与颈动脉内膜-中膜厚度(carotid intima-media thickness,cIMT)的相关性,评价TyG联合RC对cIMT增厚的预测价值。方法回顾性纳入2021年1月至2021年12月在南京大学医学院附属鼓楼医院进行健康体检的非糖尿病成年受试者。根据颈动脉超声检查结果,将受试者分为cIMT增厚组(cIMT≥1 mm)和非cIMT增厚组。应用多变量logistic回归分析确定cIMT增厚的独立危险因素。采用受试者工作特征(receiver operating characteristic,ROC)曲线评价TyG指数联合RC对cIMT增厚的预测价值。结果共纳入1109例受试者,男性640例(57.7%),年龄(56.44±14.58)岁,626例(56.4%)存在cIMT增厚。cIMT增厚组年龄和男性的构成比显著高于非cIMT增厚组,且2组间RC和TyG指数四分位数分布差异有统计学意义(P均<0.001)。多变量logistic回归分析显示,RC(优势比1.601,95%置信区间1.162~2.207;P=0.004)和TyG指数(优势比1.807,95%置信区间1.302~2.508;P<0.001)较高是cIMT增厚的独立危险因素。ROC曲线分析显示,TyG指数联合RC预测cIMT增厚的曲线下面积为0.717(95%置信区间0.687~0.747),其诊断效能高于TyG指数和RC。结论TyG指数和RC与非糖尿病人群cIMT增厚相关,且两者联合对cIMT增厚具有良好的预测价值。Objectives To investigate associations of triglyceride glucose(TyG)index and remnant cholesterol(RC)with carotid intima-media thickness(cIMT)in non-diabetes population,and to evaluate the predictive value of TyG combined with RC for cIMT.Methods Non-diabetes adult subjects underwent physical examination in Nanjing Drum Tower Hospital,Affiliated Hospital of Medical School,Nanjing University from January 2021 to December 2021 were included retrospectively.According to the findings of carotid ultrasound examination,they were divided into cIMT thickening group(≥1 mm)and non-cIMT thickening group.Multivariate logistic regression analysis was used to identify the independent risk factors for cIMT thickening.The receiver operating characteristic(ROC)curve was used to evaluate the predictive value of TyG index combined with RC for cIMT thickening.Results A total of 1109 subjects were enrolled,including 640 males(57.7%),aged 56.44±14.58 years,and 626(56.4%)had cIMT thickening.The age and male proportion of the cIMT thickening group were significantly higher than those of the non-cIMT thickening group,and there were significant differences in the quartiles distribution of RC and TyG index between the two groups(all P<0.001).Multivariate logistic regression analysis showed that RC(odds ratio 1.601,95%confidence interval 1.162-2.207;P=0.004)and TyG index(odds ratio 1.807,95%confidence interval 1.302-2.508;P<0.001)were the independent risk factors for cIMT thickening.ROC curve analysis showed that the area under the curve of TyG index combined with RC to predict cIMT thickening was 0.717(95%confidence interval,0.687-0.747),indicating higher diagnostic efficacy than TyG index and RC alone.Conclusion TyG index and RC are associated with cIMT thickening in the non-diabetes population,and the combination of them had good predictive value for cIMT thickening.

关 键 词：颈动脉内膜中层厚度 动脉粥样硬化 甘油三酯 血糖 胆固醇 危险因素 

分 类 号：R194.3[医药卫生—卫生事业管理]