Cardiovasc Diabetol:TyG指数变化轨迹与高血压患者卒中风险的相关性

2022-08-09 MedSci原创 MedSci原创

定期监测 TyG 指数可能有助于及时识别高血压患者中卒中风险较高的个体

有理论提出,基线甘油三酯-葡萄糖 (TyG) 指数是胰岛素抵抗的简单替代指标,与卒中的发生密切相关。但是,TyG 纵向模式对高血压患者卒中风险的影响仍不清楚。本研究旨在调查 TyG 指数轨迹与高血压患者卒中风险之间的关系。

这是一项前瞻性研究,纳入了来自Kailuan研究在2010年之前或期间接受了三次调查且没有心肌梗塞、癌症和卒中的19924位高血压患者。TyG指数计算为In[空腹甘油三酯(mg/dL)×?空腹血糖(mg/dL)/2],利用潜在混合模型识别暴露期间 (2006–2010) 的TyG轨迹。此外,应用 Cox 比例风险模型来估计不同轨迹组的卒中事件的风险比 (HR) 和 95% 置信区间 (CI)。

2006-2010年期间确定了五种不同的 TyG 轨迹:低水平-稳定(n=2483;范围 8.03-8.06)、中低水平-稳定(n=9666;范围 8.58-8.57)、中高水平-稳定(n=5759;范围 9.16-9.09)、高水平-稳定(n=1741;范围 9.79-9.75)和高水平-升高(n=275;范围 10.38-10.81)。


不同TyG 轨迹组患者的累积卒中发生率

在中位随访9.97年期间,共发生了1519例卒中事件,包括1351例缺血性卒中和215例出血性卒中。根据混杂变量校正后,与低水平-稳定组相比,高水平-升高组卒中的风险比(HR)是2.21(95% CI 1.49-3.28),高水平-稳定组、中高水平-稳定组和中低水平-稳定组的分别是1.43(1.13-1.83)、1.35(1.10-1.64)和1.26(1.06-1.52)。在缺血性卒中中也观察到了类似的结果,但未发现 TyG 轨迹与出血性卒中风险之间存在显著关联。

综上,高血压患者的 TyG 指数长期升高与卒中风险增加有关,尤其是缺血性卒中。该研究发现表明,定期监测 TyG 指数可能有助于及时识别高血压患者中卒中风险较高的个体。

 

原始出处:

Huang, Z., Ding, X., Yue, Q. et al. Triglyceride-glucose index trajectory and stroke incidence in patients with hypertension: a prospective cohort study. Cardiovasc Diabetol 21, 141 (2022). https://doi.org/10.1186/s12933-022-01577-7.

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    2022-12-05 docwu2019
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