肥胖和糖尿病是心力衰竭发病的主要风险因素。近年来，尽管单次血糖和甘油三酯水平与心衰发病风险之间的关系得到了广泛研究，但关于长期累积甘油三酯-葡萄糖指数暴露量与心力衰竭的关系的研究较为有限。本研究旨在探讨长期累积甘油三酯-葡萄糖指数与心力衰竭之间的关系，并评估其在心力衰竭发生中的作用。通过进行前瞻性队列研究，我们将长期跟踪观察一定人群的甘油三酯-葡萄糖指数暴露量，并记录其心力衰竭发生情况。我们计划使用统计学分析方法，以确定甘油三酯-葡萄糖指数的累积暴露量与心力衰竭之间的关系，并探讨其中的潜在机制。通过这项研究，我们希望进一步了解甘油三酯-葡萄糖指数在心力衰竭发生中的作用，为心力衰竭的预防和治疗提供更有针对性的策略。
Relationship between cumulative exposure to triglyceride-glucose index and heart failure: a prospective cohort study.
发表日期：2023 Sep 04
作者：
Huancong Zheng, Guanzhi Chen, Kuangyi Wu, Weiqiang Wu, Zegui Huang, Xianxuan Wang, Zekai Chen, Zefeng Cai, Zhiwei Cai, Yulong Lan, Shouling Wu, Youren Chen
来源：
Cardiovascular Diabetology
摘要：
高三酸甘油酯-葡萄糖指数（TyG）是心力衰竭的主要风险因素，然而高TyG指数对心力衰竭发生风险的长期影响仍不清楚。因此，我们旨在确定TyG指数累积暴露与心力衰竭风险之间的关系。本研究共招募了来自“开卢安”研究的56,149名参与者，他们在2006年、2008年和2010年连续参加了健康检查，并且没有心力衰竭或癌症病史。累积TyG指数通过对每个时间间隔的平均TyG指数进行加权求和（值×时间）计算得出。参与者根据累积TyG指数分为四个四分位数组。研究于2020年12月31日结束，主要结果是随访期间新发生的心力衰竭。此外，使用Cox比例风险回归模型和限制性立方样条分析进一步评估累积TyG指数与心力衰竭风险之间的关系。在中位随访期为10.04年的期间，共发生1,312例新发心力衰竭事件。在校正潜在混杂因素后，Cox回归分析显示，相较于Q1组，Q2、Q3和Q4组的心力衰竭风险的风险比（95%可信区间）分别为1.02（0.83,1.25）、1.29（1.07,1.56）和1.40（1.15,1.71）。亚组分析显示累积TyG指数与BMI或腰围之间存在显著交互作用，但年龄、性别与累积TyG指数之间不存在交互作用。限制性立方样条分析显示累积TyG指数与心力衰竭风险之间存在剂量-反应关系。此外，敏感性分析的结果与主要结果一致。高累积TyG指数与心力衰竭风险较高相关。因此，TyG指数可能有助于识别高心力衰竭风险的个体。本研究结果强调了临床实践中对TyG指数的长期监测的重要性。 © 2023. BioMed Central Ltd., part of Springer Nature.
High triglyceride-glucose index (TyG) is a major risk factor for heart failure, but the long-term effect of high TyG index on the risk of developing heart failure remains unclear. Therefore, we aimed to determine the relationship between the cumulative exposure to TyG index and the risk of heart failure.A total of 56,149 participants from the Kailuan Study, who participated in three consecutive health examinations in 2006, 2008, and 2010 and had no history of heart failure or cancer were recruited for this study. The cumulative TyG index was calculated as the weighted sum (value × time) of the mean TyG index for each time interval. The participants were placed into quartiles based on their cumulative TyG index. The study ended on December 31, 2020, and the primary outcome was new-onset heart failure during the follow-up period. In addition, a Cox proportional hazards regression model and a restricted cubic spline analysis were used to further evaluate the relationship between cumulative TyG index and the risk of heart failure.During a median follow-up period of 10.04 years, a total of 1,312 new heart failure events occurred. After adjustment for potential confounding factors, the Cox regression analysis showed that the hazard ratios (95% confidence intervals) for the risk of heart failure in the Q2, Q3, and Q4 groups were 1.02 (0.83,1.25), 1.29 (1.07,1.56) and 1.40 (1.15,1.71), respectively, vs. the Q1 group. The subgroup analysis showed a significant interaction between cumulative TyG index and BMI or waist circumference, but there was no interaction between age, sex and cumulative TyG index. The restricted cubic spline analysis showed a dose-response relationship between cumulative TyG index and the risk of heart failure. In addition, the sensitivity analysis generated results that were consistent with the primary results.High cumulative TyG index is associated with a higher risk of heart failure. Thus, the TyG index may be useful for the identification of individuals at high risk of heart failure. The present findings emphasize the importance of the long-term monitoring of the TyG index in clinical practice.© 2023. BioMed Central Ltd., part of Springer Nature.