脂质蓄积指数和甘油三酯葡萄糖指数与冠心病风险的相关性研究  

Association of lipid accumulation product,triglyceride glucose index with the risk of coronary heart disease

作　　者：张凌晓 田志静 孙亚召 ZHANG Ling-xiao;TIAN Zhi-jing;SUN Ya-zhao(Department of Cardiology,Cangzhou People's Hospital,Cangzhou,Hebei,061000,China)

机构地区：[1]沧州市人民医院心内科,河北沧州061000

出　　处：《心血管康复医学杂志》2025年第2期226-231,共6页Chinese Journal of Cardiovascular Rehabilitation Medicine

基　　金：沧州市科技计划项目(23244102020)。

摘　　要：目的:探讨脂质蓄积指数(LAP)和甘油三酯葡萄糖指数(TyG)与冠心病(CHD)患病风险的关联。方法:纳入2021年2月至2021年12月因胸痛于沧州市人民医院心内科住院的433例患者,根据冠状动脉造影结果分为病例组(n=236)和对照组(n=197)。比较两组患者一般资料、LAP、TyG以及其他生化指标。根据LAP、TyG四分位数将研究对象进行分组(L1组、L2组、L3组、L4组;T1组、T2组、T3组、T4组),分别以L1组、T1组为参考,构建不同的Logistic回归模型分析不同LAP、TyG水平与CHD患病风险的关系,绘制LAP、TyG预测CHD发生风险的受试者工作特征(ROC)曲线。结果:与对照组比较,病例组吸烟(27.60%比19.80%)、糖尿病(21.61%比14.21%)、高血压(38.14%比28.43%)、血脂异常比例(36.86%比24.87%)以及人体质量指数(BMI)[(25.97±3.90)kg/m^(2)比(25.11±3.56)kg/m^(2)]、腰围[(85.44±5.39)cm比(83.59±5.39)cm]、尿酸[325.50(270.25,378.25)μmol/L比300.00(245.00,365.00)μmol/L]、同型半胱氨酸[13.34(10.90,16.46)μmol/L比12.27(10.26,15.00)μmol/L]、白细胞[(6.07±1.52)×10^(9)/L比(5.75±1.43)×10^(9)/L]、LAP[39.84(30.06,59.02)比30.06(21.85,44.78)]、TyG[(8.86±0.57)比(8.56±0.60)]显著升高(P<0.05或<0.01)。多因素Logistic回归分析结果显示,在调整各危险因素后,L3组、L4组CHD发生风险显著高于L1组,T3组、T4组CHD发生风险显著高于T1组(P<0.05或<0.01)。ROC曲线分析结果显示,LAP、TyG预测CHD发生风险的曲线下面积(AUC)分别为0.656(95%CI 0.609~0.701)、0.665(95%CI 0.618~0.709),临界值分别为30.21、8.73。结论:LAP、TyG是CHD的危险因素,随着二者水平的升高,CHD风险逐渐增加。Objective:To investigate the association of lipid accumulation product(LAP),triglyceride glucose index(TyG)with the risk of coronary heart disease(CHD).Methods:A total of 433 patients admitted to Department of Cardiology,Cangzhou People's Hospital for chest pain between February 2021 and December 2021 were included and divided into case group(n=236)and control group(n=197)according to the results of coronary angiography.General data,LAP,TyG and other biochemical indexes were compared between two groups.The subjects were grouped according to LAP and TyG quartiles(L1,L2,L3,L4;T1,T2,T3,T4),and different Logistic regression models were constructed to analyze the association of different LAP,TyG levels with the risk of CHD using the L1 group and the T1 group as references,respectively,and receiver operating characteristic(ROC)curve of LAP and TyG predicting risk of CHD were drawn.Results:Compared with participants in control group,those in case group had significant higher proportions of smoking(27.60%vs.19.80%),diabetes(21.61%vs.14.21%),hypertension(38.14%vs.28.43%),dyslipidemia(36.86%vs.24.87%)and body mass index(BMI)[(25.97±3.90)kg/m^(2)vs.(25.11±3.56)kg/m^(2)],waist circumference[(85.44±5.39)cm vs.(83.59±5.39)cm],uric acid[325.50(270.25,378.25)μmol/L vs.300.00(245.00,365.00)μmol/L],homocysteine[13.34(10.90,16.46)μmol/L vs.12.27(10.26,15.00)μmol/L],leucocytes[(6.07±1.52)×10^(9)/Lvs.(5.75±1.43)×10^(9)/L],LAP[39.84(30.06,59.02)vs.30.06(21.85,44.78)],and TyG[(8.86±0.57)vs.(8.56±0.60)](P<0.05 or<0.01).Multifactorial Logistic regression analysis showed that after adjusting for each risk factor,risk of CHD in L3 and L4 groups were significantly higher than that of L1 group,and risk of CHD in T3 and T4 groups were significantly higher than that of T1 group(P<0.05 or<0.01).ROC curve analysis showed that the area under curve(AUC)of LAP and TyG predicting the risk of CHD was 0.656(95%CI 0.609~0.701),0.665(95%CI 0.618~0.709)respectively,and the critical value was 30.21 and 8.73 respectively.Conclusion:LAP and Ty

关 键 词：冠心病 脂质蓄积指数 甘油三酯葡萄糖指数 

分 类 号：R541.4[医药卫生—心血管疾病]