甘油三酯-葡萄糖指数及其与脂肪相关指数的组合与心肌梗死发病率的关系:英国生物库队列研究。

IF 4.2 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM International Journal of Obesity Pub Date : 2024-08-14 DOI:10.1038/s41366-024-01612-5
Jie Zhou, Hui Huang, Hao Huang, Jing Peng, Wenjuan Chen, Fuli Chen, Yijia Tang, Qiyong Li, Yan Xiong, Long Zhou
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引用次数: 0

摘要

背景:甘油三酯-葡萄糖(TyG)指数与腰围(WC)、体重指数(BMI)和腰围-身高比(WHtR)相结合时,比单独使用时更能反映胰岛素抵抗。本研究旨在前瞻性地检测TyG、TyG-BMI、TyG-WC和TyG-WHtR与心肌梗死(MI)发病率及其亚型之间的关系:这项队列研究包括英国生物库中的 370,390 名参与者。采用Cox比例危险模型和限制性立方样条回归模型评估TyG、TyG-BMI、TyG-WC和TyG-WHtR与心肌梗死、ST段抬高型心肌梗死(STEMI)和非ST段抬高型心肌梗死(NSTEMI)的关系。采用接收者操作特征曲线(ROC)和曲线下面积(AUC)来检验四项指标的预测价值:在完全调整模型中,TyG、TyG-BMI、TyG-WC 和 TyG-WHtR 在最高四分位数的心肌梗死危险比 (HR) 和 95% 置信区间 (CI) 分别为 1.36 (1.28-1.44)、1.47 (1.39-1.56)、1.53 (1.43-1.64) 和 1.58 (1.48-1.68)。当结果被重新分类为 STEMI 或 NSTEMI 时,也观察到了类似的结果。然而,TyG-BMI、TyG-WC 和 TyG-WHtR 与 STEMI 风险的相关性弱于 MI 和 NSTEMI。TyG与MI和NSTEMI风险之间呈线性剂量反应关系。TyG-BMI、TyG-WC和TyG-WHtR与心肌梗死、STEMI和NSTEMI风险的关系均呈非线性模式。TyG-WC在诊断MI(AUC:0.648,95% CI:0.644-0.653)、STEMI(AUC:0.631,95% CI:0.622-0.639)和NSTEMI(AUC:0.647,95% CI:0.641-0.654)方面最为有效:结论:TyG指数与心肌梗死和NSTEMI风险增加呈线性相关,而TyG-BMI、TyG-WC和TyG-WHtR与心肌梗死和NSTEMI风险增加呈非线性相关。这些指标与 STEMI 的关系有明显的模式。TyG-WC对MI、STEMI和NSTEMI的诊断效果最佳。
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Association of triglyceride-glucose index and its combination with adiposity-related indices with the incidence of myocardial infarction: a cohort study from the UK Biobank.

Background: The triglyceride-glucose (TyG) index performs better at reflecting insulin resistance when combined with waist circumference (WC), body mass index (BMI), and waist-to-height ratio (WHtR) than when used alone. This study aimed to prospectively examine the relationships between TyG, TyG-BMI, TyG-WC, and TyG-WHtR with the incidence of myocardial infarction (MI) and its subtypes.

Methods: This cohort study included 370,390 participants from the UK Biobank. The Cox proportional hazards model and restricted cubic spline regression model were used to assess the associations of TyG, TyG-BMI, TyG-WC, and TyG-WHtR with MI, ST-elevation MI (STEMI) and non-ST-elevation MI (NSTEMI). The receiver operating characteristic (ROC) curve and the area under the curve (AUC) were employed to examine the predictive value of four indicators.

Results: The hazard ratios (HRs) and 95% confidence intervals (CIs) of MI in the highest quartiles for TyG, TyG-BMI, TyG-WC, and TyG-WHtR were 1.36 (1.28-1.44), 1.47 (1.39-1.56), 1.53 (1.43-1.64), and 1.58 (1.48-1.68) in the fully-adjusted model. Comparable findings were observed when the outcomes were reclassified as STEMI or NSTEMI. However, the associations of TyG-BMI, TyG-WC, and TyG-WHtR with the risk of STEMI were weaker than MI and NSTEMI. A linear dose-response association between TyG and the risk of MI and NSTEMI were demonstrated. TyG-BMI, TyG-WC, and TyG-WHtR all showed nonlinear patterns in their associations with the risk of MI, STEMI, and NSTEMI. TyG-WC was most effective in diagnosing MI (AUC: 0.648, 95% CI: 0.644-0.653), STEMI (AUC: 0.631, 95% CI: 0.622-0.639), and NSTEMI (AUC: 0.647, 95% CI: 0.641-0.654).

Conclusion: The TyG index was linearly associated with increased risk of MI and NSTEMI, whereas TyG-BMI, TyG-WC, and TyG-WHtR were nonlinearly associated with increased risk of MI and NSTEMI. There were distinct patterns in the relationships between these indicators with STEMI. TyG-WC provided the best diagnostic effectiveness for MI, STEMI, and NSTEMI.

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来源期刊
International Journal of Obesity
International Journal of Obesity 医学-内分泌学与代谢
CiteScore
10.00
自引率
2.00%
发文量
221
审稿时长
3 months
期刊介绍: The International Journal of Obesity is a multi-disciplinary forum for research describing basic, clinical and applied studies in biochemistry, physiology, genetics and nutrition, molecular, metabolic, psychological and epidemiological aspects of obesity and related disorders. We publish a range of content types including original research articles, technical reports, reviews, correspondence and brief communications that elaborate on significant advances in the field and cover topical issues.
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