基于LASSO回归探讨TyG及联合指标与中青年男性体检人群颈动脉粥样硬化的相关性  

LASSO Regression Analysis of Triglyceride-Glucose Index and Combined Indicators for Predicting Carotid Atherosclerosis in Middle-Aged and Young Men

作　　者：纪岩松 陈桂莲[1] 夏磊[2] 李红[1] 夏静静 JI Yansong;CHEN Guilian;XIA Lei;LI Hong;XIA Jingjing(Health Management Center,The Affiliated Huai'an NO.1 People's Hospital of Nanjing Medical University,Huai'an,Jiangsu 223300,China;Department of Neurology,The Affiliated Huai'an NO.1 People's Hospital of Nanjing Medical University,Huai'an,Jiangsu 223300,China)

机构地区：[1]南京医科大学附属淮安第一医院健康管理中心,江苏淮安223300 [2]南京医科大学附属淮安第一医院神经内科,江苏淮安223300

出　　处：《转化医学杂志》2025年第3期77-82,共6页Translational Medicine Journal

基　　金：江苏省卫生健康委科研课题项目(BJ24045);淮安市卫生健康科研项目(HAWJ202001)。

摘　　要：目的探讨Ty G及联合指标与中青年男性体检人群颈动脉粥样硬化的相关性。方法选取2022年12月至2023年12月南京医科大学附属淮安第一医院参加健康体检的870例中青年男性受检者为研究对象,依据颈动脉超声结果分为颈动脉粥样硬化(CAS组,456例)与非CAS组(414例),比较其年龄、收缩压(SBP)、舒张压(DBP)、体质量指数(BMI)、空腹血糖(FBG)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、脂蛋白a[Lp(a)]、脉压(PP)、脉压指数(PPI)、甘油三酯-葡萄糖指数(Ty G)及血浆致动脉粥样硬化指数(AIP)组间差异。通过单因素分析、最小绝对收缩与选择算子(LASSO)回归筛选变量及多因素Logistic回归分析,获得显著相关指标,绘制受试者工作特征(ROC)曲线分析其评估效能。结果单因素分析显示CAS组和非CAS组年龄、BMI、DBP、SBP、FBG、TG、TC、HDL-C、PP、PPI、TyG及AIP比较,差异有统计学意义(P<0.05);LASSO回归筛选变量获得FBG、TyG、年龄、SBP、BMI;多因素Logistic回归分析显示TyG、FBG、年龄、BMI是中青年男性体检人群颈动脉粥样硬化发生的独立危险因素(P<0.05),其中TyG的OR为2.199(95%CI:1.586~3.050);ROC曲线显示,TyG的曲线下面积为0.688(95%CI:0.653~0.724),最佳截断值8.71,敏感度68.20%,特异度63.29%;联合指标(Ty G+FBG+BMI+年龄)的曲线下面积为0.842(95%CI:0.816~0.868),最佳截断值0.46,敏感度85.53%,特异度70.05%。结论TyG对中青年男性体检人群是否存在颈动脉粥样硬化具有一定判断价值,联合指标可作为推荐颈动脉超声进一步筛查的初步评估工具。Objective To investigate the correlation between the Triglyceride-Glucose Index(TyG)and its combined indicators with carotid atherosclerosis(CAS)in middle-aged and young men undergoing health checkups.Methods A total of 870 middle-aged and young male participants from health checkups(December 2022 to December 2023)were enrolled and divided into carotid atherosclerosis(CAS)and non-CAS groups based on carotid ultrasound results.Differences in age,diastolic blood pressure(DBP),systolic blood pressure(SBP),body mass index(BMI),fasting blood glucose(FBG),triglycerides(TG),total cholesterol(TC),lipoprotein(a)[Lp(a)],high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),pulse pressure(PP),pulse pressure index(PPI),TyG,and atherogenic index of plasma(AIP)were compared.Univariate analysis,LASSO regression,and multivariate logistic regression were used to identify significant predictors.Receiver operating characteristic(ROC)curves were plotted to evaluate their diagnostic efficacy for CAS.Results Univariate analysis revealed statistically significant differences in age,BMI,DBP,SBP,FBG,TG,TC,HDL-C,PP,PPI,TyG,and AIP between groups(P<0.05).LASSO regression selected FBG,TyG,age,SBP,and BMI as key variables.Multivariate logistic regression identified TyG,FBG,age,and BMI as independent risk factors for CAS(P<0.05),with TyG showing an odds ratio(OR)of 2.199(95%CI:1.586-3.050).ROC analysis demonstrated that TyG alone had an AUC of 0.688(95%CI:0.653-0.724),with 68.20%sensitivity and 63.29%specificity at a cutoff of 8.71.The combined model(TyG,FBG,BMI,and age)achieved an AUC of 0.842(95%CI:0.816-0.868),with 85.53%sensitivity and 70.05%specificity at a cutoff 0.46.Conclusion TyG shows moderate diagnostic value for CAS in middle-aged and young men.The combined model may serve as a preliminary screening tool to identify high-risk individuals for further carotid ultrasound evaluation.

关 键 词：LASSO回归 甘油三酯-葡萄糖指数 颈动脉粥样硬化 健康体检 颈动脉超声 中青年男性 脑卒中 

分 类 号：R543.4[医药卫生—心血管疾病]