50岁及以上人群三酰甘油葡萄糖指数与心血管代谢性共病关系的研究  

A Study on the Relationship between the Triglyceride-Glucose Index and Cardiometabolic Multimorbidity in Individuals Aged 50 and Above

作　　者：韩正 孙梦 傅方琳 潘姚佳 王为强[1] HAN Zheng;SUN Meng;FU Fanglin;PAN Yaojia;WANG Weiqiang(Department of General Medicine,Suzhou Hospital Affiliated to Anhui Medical University(Suzhou Municipal Hospital of Anhui Province),Suzhou 234000,China;Anhui Medical University,Hefei 230000,China)

机构地区：[1]安徽医科大学附属宿州医院(安徽省宿州市立医院)全科医学科,安徽省宿州市234000 [2]安徽医科大学,安徽省合肥市230000

出　　处：《中国全科医学》2025年第18期2278-2284,共7页Chinese General Practice

基　　金：安徽省科技创新战略与软科学研究专项计划项目(202106f01050042)。

摘　　要：背景 随着中国老龄化进程加快及多病共存人群的增加,心血管代谢性共病(CMM)的高风险性使其成为研究重点。目前,大部分研究集中于单个心血管代谢性疾病,缺乏对CMM整体相关性的探讨。目的 探讨我国中老年人群三酰甘油葡萄糖指数(TyG)与CMM发生风险之间的关系,并评估TyG在CMM防治中的作用。方法 研究对象来源于2017—2021年安徽省心血管病高危人群早期筛查与综合干预项目人群,依据纳入与排除标准最终纳入94 455例研究对象。收集研究对象一般资料和实验室检查指标,计算TyG。采用多因素Logistic逐步回归分析分别探究TyG连续变量和不同四分位数对CMM的影响因素,采用Z检验比较组间的OR值差异。采用限制性立方样条(RCS)分析评估潜在的非线性联系,绘制RCS曲线并计算OR=1的分界点。结果 纳入研究对象中CMM组共1 456例(男664例,女792例),非CMM组共92 999例(男38 313例,女54 686例)。男性群体中CMM患者年龄、BMI、平均动脉压(MAP)、空腹血糖(FPG)、三酰甘油(TG)、高中及以上学历、糖尿病、缺血性心脏病、卒中、高血压比例、TyG高于非CMM组,吸烟、饮酒、农民比例、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)低于非CMM组(P<0.05);女性群体中CMM组年龄、BMI、MAP、FPG、TG、糖尿病、缺血性心脏病、卒中、高血压比例高于非CMM组,在婚、农民比例、TC、LDL-C、HDL-C低于非CMM组(P<0.05)。分别将男性人群和女性人群按照TyG四分位间距进行分组,男性T1组(TyG 6.90~8.33,n=9 745)、T2组(TyG 8.34~8.67,n=9 744),T3组(TyG 8.68~9.08,n=9 744),T4组(TyG 9.09~11.6,n=9 744);女性F1组(TyG 7.07~8.49,n=13 870),F2组(TyG 8.50~8.82,n=13 870),F3组(TyG 8.83~9.21,n=13 869),F4组(TyG 9.22~11.6,n=13 869)。多因素Logistic逐步回归分析结果显示,在调整了年龄、婚姻、吸烟、饮酒、高中及以上学历、农民、TC、HDL-C、LDL-C、BMI、高血压和Background With the progression of aging in China and the increase in the population with multiple coexisting diseases,the high risk associated with cardiovascular-metabolic multimorbidity(CMM)has made it a focal point for research.However,most studies have concentrated on individual cardiovascular metabolic diseases rather than exploring the comprehensive correlations within CMM.Objective To investigate the relationship between the triglyceride-glucose(TyG)index and the risk of CMM in middle-aged and elderly Chinese populations,and to evaluate the role of TyG in the prevention and control of CMM.Methods Participants were derived from the Anhui Province High-Risk Population Early Screening and Comprehensive Intervention Project for Cardiovascular Diseases conducted between 2017 and 2021.A total of 94455 subjects were included based on inclusion and exclusion criteria.Baseline characteristics and laboratory examination indices were collected,and the TyG index was calculated.Multivariate logistic stepwise regression analysis was used to explore the impact factors of CMM by TyG as both a continuous variable and different quartiles.Z-tests were applied to compare odds ratio(OR)between groups.Restricted cubic spline(RCS)analysis was employed to assess potential non-linear associations,RCS curves were plotted,and the cutoff point where OR=1 was calculated.Results Among the participants,1456 cases(664 males,792 females)were identified with CMM,while 92999 cases(38313 males,54686 females)did not have CMM.In males,patients with CMM had higher age,BMI,mean arterial pressure(MAP),fasting plasma glucose(FPG),triglycerides(TG),proportion of individuals with high school education or above,diabetes,ischemic heart disease,stroke,hypertension,and TyG index compared to those without CMM(P<0.05);they also had lower rates of smoking,drinking,farmer occupation,total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),and high-density lipoprotein cholesterol(HDL-C)(P<0.05).Men and women were stratified into quartiles based on t

关 键 词：心血管疾病 慢性病共病 心血管代谢性共病 三酰甘油葡萄糖指数 胰岛素抵抗 安徽省 横截面研究 

分 类 号：R54[医药卫生—心血管疾病]