甘油三酯葡萄糖体质指数与早发冠心病患者冠状动脉病变程度的相关性

Association of the triglyceride glucose-body mass index with the extent of coronary artery disease in patients with premature coronary artery disease

摘要:

目的]探讨甘油三酯葡萄糖体质指数(TyG-BMI)与早发冠心病(PCAD)患者冠状动脉病变程度的相关性。 [方法]回顾性分析2023年1月—12月于徐州市中心医院通过冠状动脉造影确诊的533例PCAD患者的临床资料,根据TyG-BMI三分位法分为T1组(TyG-BMI≤228.27)、T2组(228.27＜TyG-BMI≤248.90)和T3组(TyG-BMI指数＞248.90)。采用Gensini评分评估冠状动脉病变程度,分为低中评分组(Gensini评分≤70分)和高评分组(Gensini评分＞70分)。采用单因素和多因素Logistic回归模型分析TyG-BMI与高Gensini评分冠状动脉病变发生的关系；采用Spearman相关分析法分析TyG-BMI与Gensini评分之间的相关性；采用ROC曲线分析TyG-BMI对严重冠状动脉病变的预测价值。 [结果]T3组多支冠状动脉病变数显著增加,且Gensini评分更高(P＜0.001)。Logistic回归分析发现,高水平的TyG-BMI是PCAD患者严重冠状动脉病变的独立危险因素(OR＝1.031,95%CI:1.021～1.040,P＜0.001),T3组严重冠状动脉病变的风险为T1组的3.57倍(OR＝3.57,95%CI:2.170～5.870,P＜0.001)。Spearman相关分析发现,TyG-BMI与PCAD患者冠状动脉病变的严重程度呈正相关(r＝0.202,P＜0.001)。ROC曲线分析发现,TyG-BMI预测PCAD患者高Gensini评分的曲线下面积为0.704(95%CI:0.656～0.752),优于TyG指数(P＜0.05)。 [结论]高水平的TyG-BMI可作为PCAD患者严重冠状动脉病变的有效预测指标。

Abstract:

Aim To investigate the relationship between the triglyceride glucose-body mass index (TyG-BMI) and the extent of coronary artery disease in patients with premature coronary artery disease (PCAD). Methods A retrospective analysis was performed on the clinical data of 533 PCAD patients diagnosed by coronary angiography at Xuzhou Central Hospital from January 2023 to December 2023. Patients were divided into three groups based on TyG-BMI tertiles:group T1 (TyG-BMI≤228.27), group T2 (228.27＜TyG-BMI≤248.90), and group T3 (TyG-BMI＞248.90). The extent of coronary artery disease was quantitatively assessed using the Gensini score, which was categorized into low/mid-risk (Gensini score≤70) and high-risk (Gensini score＞70) groups. Univariate and multivariate Logistic regression models were used to analyze the relationship between TyG-BMI and the occurrence of high Gensini score coronary artery disease. Spearman correlation analysis was employed to assess the correlation between TyG-BMI and Gensini score. ROC curve was used to analyze the predictive value of TyG-BMI for severe coronary artery disease. Results Patients in group T3 had more multi-vessel lesions and higher Gensini scores (P＜0.001). Logistic regression analysis showed that a high level of the TyG-BMI was an independent risk factor for severe coronary artery disease in patients with PCAD (OR＝1.1,5%CI:1.021～1.040, P＜0.001). Compared with group T1, the risk for severe coronary artery disease in group T3 was 3.57-fold higher (OR＝3.7,5%CI:2.170～5.870, P＜0.001). Spearman correlation analysis showed that TyG-BMI was positively correlated with the severity of coronary artery disease (r＝0.202, P＜0.001). ROC curve analysis showed that the area under curve of TyG-BMI was 0.704 (95%CI:0.656～0.752), which was superior to that of the TyG index in predictive value (P＜0.05). Conclusion A high level of the TyG-BMI can be used as an effective predictor of severe coronary artery disease in patients with PCAD.