摘要
目的探讨2型糖尿病(T2DM)患者甘油三酯葡萄糖(TyG)指数与全因死亡和心血管疾病(CVD)死亡风险的关联,为改善T2DM患者的预后和死亡风险防控提供科学依据。方法数据来源于江苏省社区糖尿病综合干预及应用研究,2013年12月至2014年1月采用整群随机抽样方法选取江苏省淮安市和常熟市15728名T2DM患者为研究对象,进行问卷调查、体格检查和实验室检测。随访截至2023年9月30日。根据TyG指数四分位数将研究对象分为Q_(1)~Q_(4)组4组。使用R.4.3.0软件进行单因素方差分析和χ^(2)检验,采用Cox比例风险回归模型评估TyG指数与全因死亡及CVD死亡的风险比(HR)及其95%置信区间(CI)。根据性别、年龄、体质指数(BMI)、吸烟、饮酒、糖尿病病程对TyG指数与死亡风险之间的关联进行分层分析。利用限制立方样条(RCS)分析TyG指数与死亡风险的剂量-反应关系。结果研究对象中位随访时间为9.77年,其间共死亡3057人,其中死于CVD 923人。Cox比例风险回归模型显示,与TyG指数Q_(1)组患者相比,Q_(4)组患者全因死亡风险增加60%(HR=1.60,95%CI 1.43~1.78),CVD死亡风险增加84%(HR=1.84,95%CI:1.51~2.25)。分层分析结果显示,TyG指数与性别存在交互作用(交互P值<0.01),女性全因死亡风险高于男性。RCS分析结果显示,TyG指数与T2DM患者的全因死亡风险和CVD死亡风险呈非线性剂量-反应关系(非线性P值分别为0.011、0.039)。结论T2DM患者TyG指数的升高与全因死亡风险和CVD死亡风险增加相关。
Objective To explore the correlation between the triglyceride-glucose(TyG)index and the all-cause death risk and the death risk of cardiovascular disease(CVD)in patients with type 2 diabetes mellitus(T2DM),and provide the scientific basis for prevention and control measures of improving the prognosis and death risk in T2DM patients.Methods The data were from the Jiangsu Province Community Diabetes Comprehensive Intervention and Application Study.From December 2013 to January 2014,the cluster random sampling method was used to select 15728 T2DM patients from Huai'an and Changshu cities in Jiangsu Province as the subjects.The investigation was performed with questionnaires,physical examinations,and laboratory tests.The follow-up end day was on September 30,2023.Based on the quartiles of the TyG index,the subjects were divided into four groups(Q1-Q4).Theχ^(2) test and one-way analysis of variance were used to analyze the data;Cox proportional hazards regression models were used to assess the hazard ratios(HR)and 95%confidence intervals(CI)between all-cause death risk/CVD death risk and the TyG index.Stratified analysis were conducted for correlation between TyG index and death risk based on sex,age,body mass index,smoking,alcohol consumption,and diabetes duration.The restricted cubic spline(RCS)analysis was used to analyze the dose-response relationship between the TyG index and death risk.The used software was R.4.3.0.Results The median follow-up time for the subjects was 9.77 years,during which 3057 cases died(923 cases death were due to CVD).Cox proportional hazards regression model showed that as compared to patients with TyG index Q1 group,the all-cause death risk increased 60%(HR=1.60,95%CI:1.43-1.78)and CVD death risk increased 84%(HR=1.84,95%CI:1.51-2.25)in the Q4 group.The results of stratified analysis showed that there was an interaction between the TyG index and gender(interaction Pvalue<0.01);and the allcause death risk in females was higher than that in males.The results of RCS analysis showed that the nonlinear dose-response relationship between the TyG index and all-cause death risk/CVD death risk in T2DM(nonlinear P values were 0.011 and 0.039,respectively).Conclusion The increase of TyG index in patients with T2DM correlates with the increase of risk for all-cause death and CVD death risk.
作者
王丽峰
俞浩
范习康
杨婕
覃玉
苏健
沈冲
陆艳
孙中明
武鸣
WANG Lifeng;YU Hao;FAN Xikang;YANG Jie;QIN Yu;SU Jian;SHEN Chong;LU Yan;SUN Zhongming;WU Ming(School of Public Health,Southeast University,Nanjing,Jiangsu Province 210009,China;不详)
出处
《中国慢性病预防与控制》
北大核心
2025年第10期732-737,共6页
Chinese Journal of Prevention and Control of Chronic Diseases
基金
江苏省医学领军人才和创新团队项目(K201105)
江苏省第五期“333工程”科研项目(BRA2020090)
江苏省卫生健康委员会医学科研项目(M2020085,H2023022)
苏州市科技局民生科技-科技示范工程项目(SS202010)。
关键词
TyG指数
心血管疾病
糖尿病
2型
死亡风险
TyG index
Cardiovascular diseases
Diabetes mellitus,type 2
Death risk
