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甘油三酯-血糖指数与既往心血管疾病成年人全因和心血管死亡率的关系:基于美国国家健康和营养调查 2007-2018 年数据的队列研究

Association between Triglyceride-Glucose Index and risk of all-cause and cardiovascular mortality in adults with prior cardiovascular disease: a cohort study using data from the US National Health and Nutrition Examination Survey, 2007-2018.

机构信息

Department of Cardiology, The Second People's Hospital of Hefei, Hefei, Anhui, China.

The Fifth Clinical Medical School, Anhui Medical University, Hefei, Anhui, China.

出版信息

BMJ Open. 2024 Jul 5;14(7):e084549. doi: 10.1136/bmjopen-2024-084549.

Abstract

OBJECTIVE

The association between the Triglyceride-Glucose (TyG) Index and mortality rates in patients with cardiovascular disease (CVD) remains unclear. This study investigates the association between the TyG index and the incidence of all-cause and CVD-specific mortality among individuals with a history of CVD.

DESIGN

Population-based cohort study.

SETTING

Data were sourced from the US National Health and Nutrition Examination Survey (2007-2018) and linked mortality data, with follow-up continuing until 31 December 2019.

PARTICIPANTS

The study population comprised 3422 individuals aged 20 years or older with a documented history of CVD.

OUTCOME MEASURES

We examined the association between the TyG index and the risk of all-cause and cardiovascular mortality.

RESULTS

Over a median follow-up of 5.79 years, 1030 deaths occurred, including 339 due to CVD. Cox regression analysis, adjusted for multiple confounders, showed that individuals in the highest TyG index quartile, compared with those in the lowest, had HRs of 0.76 (95% CI: 0.60 to 0.96) for all-cause mortality and 0.58 (95% CI: 0.39 to 0.89) for CVD mortality. There was a significant inverse relationship between higher TyG index levels and lower mortality risks. For each unit increase in the TyG index, the adjusted HRs for all-cause and CVD mortality decreased by 18% (HR 0.82; 95% CI: 0.71 to 0.94) and 27% (HR 0.73; 95% CI: 0.57 to 0.92), respectively.

CONCLUSIONS

TyG index values are negatively associated with all-cause and CVD mortality risks among individuals with previous CVD. Further interventional studies are needed to clarify the impact of TyG levels on cardiovascular health.

摘要

目的

甘油三酯-葡萄糖(TyG)指数与心血管疾病(CVD)患者的死亡率之间的关系尚不清楚。本研究旨在探讨 TyG 指数与既往 CVD 患者全因和 CVD 特异性死亡率之间的关系。

设计

基于人群的队列研究。

设置

数据来自美国国家健康和营养调查(2007-2018 年)和链接死亡率数据,随访持续至 2019 年 12 月 31 日。

参与者

研究人群包括 3422 名年龄在 20 岁或以上、有 CVD 病史的个体。

结局测量

我们研究了 TyG 指数与全因和心血管死亡率风险之间的关系。

结果

在中位数为 5.79 年的随访期间,发生了 1030 例死亡,其中 339 例死于 CVD。经多因素校正的 Cox 回归分析显示,与 TyG 指数最低 quartile 组相比,TyG 指数最高 quartile 组的全因死亡率和 CVD 死亡率的 HR 分别为 0.76(95%CI:0.60 至 0.96)和 0.58(95%CI:0.39 至 0.89)。TyG 指数越高,死亡风险越低,呈显著负相关。TyG 指数每增加一个单位,全因和 CVD 死亡率的调整 HR 分别降低 18%(HR 0.82;95%CI:0.71 至 0.94)和 27%(HR 0.73;95%CI:0.57 至 0.92)。

结论

在既往 CVD 患者中,TyG 指数与全因和 CVD 死亡率风险呈负相关。需要进一步的干预性研究来阐明 TyG 水平对心血管健康的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fd7f/11227790/db1e9dc3f0e6/bmjopen-2024-084549f01.jpg

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