三酰甘油葡萄糖乘积和血浆致动脉粥样硬化指数与老年冠心病伴2型糖尿病冠状动脉重构关系  

Relationship of TyG index and atherogenic index of plasma with coronary artery remodeling in elderly patients with CHD and T2DM

作　　者：韩延辉[1] 张恒亮 赵劲东[1] 李炳强 陈瑞晓[1] 普照坤 张辉锋[1] 王丽平[1] Han Yanhui;Zhang Hengliang;Zhao Jindong;Li Bingqiang;Chen Ruixiao;Pu Zhaokun;Zhang Huifeng;Wang Liping(Department of Cardiovascular Diseases,First Affiliated Hospital·College of Clinical Medicine of Henan University of Science and Technology,Luoyang 471003,Henan Province,China)

机构地区：[1]河南科技大学第一附属医院(河南科技大学临床医学院)心血管内科,洛阳471003

出　　处：《中华老年心脑血管病杂志》2025年第4期463-467,共5页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：2023年度河南省医学科技攻关计划项目(LHGJ20230458)。

摘　　要：目的探讨三酰甘油葡萄糖乘积(triglyceride-glucose index,TyG)指数和血浆致动脉粥样硬化指数(atherogenic index of plasma,AIP)与老年冠心病(coronary heart disease,CHD)合并2型糖尿病(type 2 diabetes mellitus,T2DM)患者冠状动脉正性重构的关系。方法按照住院先后顺序选取2022年1月至2023年6月河南科技大学第一附属医院心血管内科收治的老年CHD合并T2DM患者120例,根据重构指数分为正性重构组47例和非正性重构组73例。比较2组临床资料;采用多因素logistic回归分析冠状动脉正性重构的危险因素;采用Spearman相关性分析TyG和AIP与冠状动脉正性重构的相关性;采用ROC曲线分析TyG和AIP对冠状动脉正性重构的预测价值。结果正性重构组吸烟、三酰甘油、糖化血红蛋白、TyG、AIP显著高于非正性重构组,高密度脂蛋白胆固醇、血钙水平显著低于非正性重构组(P<0.05,P<0.01)。单因素logistic回归分析显示,吸烟、三酰甘油、高密度脂蛋白胆固醇、糖化血红蛋白、血钙、TyG、AIP是老年CHD合并T2DM患者冠状动脉正性重构的危险因素(P<0.05,P<0.01)。多因素logistic回归分析显示,TyG(OR=7.253,95%CI:2.458~13.364,P=0.035)、AIP(OR=6.017,95%CI:2.205~12.025,P=0.030)是老年CHD合并T2DM患者冠状动脉正性重构的独立危险因素(P<0.05)。TyG、AIP预测老年CHD合并T2DM患者冠状动脉正性重构的曲线下面积分别为0.783、0.766,联合预测老年CHD合并T2DM患者冠状动脉正性重构的曲线下面积为0.868,显著优于单独预测(P<0.05)。结论TyG和AIP与老年CHD合并T2DM患者冠状动脉正性重构密切相关,可作为预测冠状动脉正性重构的有效指标,对临床早期识别高危患者及制定个体化干预策略具有重要意义。Objective To investigate the relationship of triglyceride-glucose(TyG)index and atherogenic index of plasma(AIP)with positive remodeling of coronary arteries in elderly coronary heart disease(CHD)patients with concomitant type 2 diabetes mellitus(T2DM).Methods A total of 120 elderly CHD patients with concomitant T2DM admitted to our department from January 2022 to June 2023 were continuously recruited,and according to the remodeling index,they were divided into positive remodeling group(47 cases)and non-positive remodeling group(73 cases).The clinical data were compared between the two groups.Multivariate logistic analysis was used to identify the risk factors for positive remodeling of coronary artery.Spearman correlation analysis was employed to analyze the correlation of TyG and AIP with positive remodeling.ROC curve was plotted to analyze the predictive value of TyG and AIP for the remodeling.ResultsThe positive remodeling group had larger ratio of smoking,higher TG and HbA1c levels,and increased TyG index and AIP,but lower HDL-C and blood calcium levels than the non-positive remodeling group(P<0.05,P<0.01).Univariate logistic regression analysis showed that smoking,TG,HDL-C,HbA1c,blood calcium,TyG and AIP were risk factors for positive coronary artery remodeling in elderly patients with CHD and T2DM(P<0.05,P<0.01).Multivariate logistic regression analysis showed that TyG index(OR=7.253,95%CI:2.458-13.364,P=0.035)and AIP(OR=6.017,95%CI:2.205-12.025,P=0.030)were independent risk factors for positive coronary artery remodeling in elderly patients with CHD and T2DM(P<0.05).The AUC value of TyG index and AIP in predicting positive coronary artery remodeling in elderly CHD patients with T2DM was 0.783 and 0.766,respectively,and the value of their combination in the prediction was 0.868,which was significantly better than the indicator alone(P<0.05).Conclusion TyG index and AIP are closely associated with positive coronary artery remodeling in elderly CHD patients with T2DM,and can be used as effective indicators i

关 键 词：冠心病 糖尿病 2型 冠状血管 LOGISTIC模型 

分 类 号：R54[医药卫生—心血管疾病]