Association of Abnormal Glucose Metabolism and Inflammation With Prognosis in Patients With Acute Coronary Syndrome

IF 3.7 2区医学 Q2 ENDOCRINOLOGY & METABOLISM

Journal of Diabetes Pub Date : 2025-07-30 DOI:10.1111/1753-0407.70134

Chong Zhang, Wenjin Peng, Tianqi Wang, Meng Ning, Yi Chen, Yingwu Liu

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Abstract

Background

In acute coronary syndrome (ACS) patients, the relationship between abnormal glucose metabolism markers, such as the triglyceride-glucose (TyG) index and stress hyperglycemia ratio (SHR), and inflammatory markers remains unclear. Furthermore, their interaction and impact on long-term prognosis have yet to be investigated in clinical cohorts.

Methods

In this study, K-means clustering was performed on the TyG index, SHR, and inflammatory markers, including high mobility group box-1 protein, platelet-derived growth factor, phenylacetylglutamine, lysophosphatidic acid, and citrullinated histone H3. A Cox proportional hazards model was used to assess the association between cluster phenotypes and 1-year major adverse cardiovascular events (MACE) risk in ACS patients.

Results

Among 363 ACS patients, 62 developed MACE during the 1-year follow-up. SHR correlated positively with the TyG index and inflammatory markers. K-means clustering identified two phenotypes: normal glucose metabolism/low inflammation and abnormal glucose metabolism/high inflammation. Multivariable Cox analysis showed the latter was strongly linked to MACE (adjusted hazard ratio: 3.84, 95% confidence interval: 1.93–7.64), and early guideline-directed medical therapy reduced MACE risk in this high-risk group.

Conclusions

ACS patients with abnormal glucose metabolism and high inflammation have a higher long-term MACE risk than those with normal glucose metabolism and low inflammation. Early guideline-directed medical therapy, alongside anti-inflammatory therapy and hypoglycemic agents, may improve long-term outcomes in this high-risk group.

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急性冠脉综合征患者糖代谢异常、炎症与预后的关系

背景在急性冠脉综合征（ACS）患者中，异常糖代谢标志物如甘油三酯-葡萄糖（TyG）指数和应激性高血糖比（SHR）与炎症标志物之间的关系尚不清楚。此外，它们的相互作用和对长期预后的影响尚未在临床队列中进行研究。方法在本研究中，对TyG指数、SHR和炎症标志物进行k均值聚类，包括高迁移率group box-1蛋白、血小板衍生生长因子、苯乙酰谷氨酰胺、溶血磷脂酸和葡氨酸组蛋白H3。采用Cox比例风险模型评估ACS患者聚类表型与1年主要不良心血管事件（MACE）风险之间的关系。结果363例ACS患者中，62例在1年随访期间发生MACE。SHR与TyG指数、炎症指标呈正相关。K-means聚类鉴定出两种表型：正常糖代谢/低炎症和异常糖代谢/高炎症。多变量Cox分析显示，后者与MACE密切相关（调整后的风险比：3.84,95%可信区间：1.93-7.64），早期指导的药物治疗降低了这一高危人群的MACE风险。结论糖代谢异常、高炎症的ACS患者长期发生MACE的风险高于糖代谢正常、低炎症的ACS患者。早期指导的药物治疗，以及抗炎治疗和降糖药，可能改善这一高危人群的长期预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Diabetes ENDOCRINOLOGY & METABOLISM-

CiteScore

6.50

自引率

2.20%

发文量

审稿时长

>12 weeks

期刊介绍： Journal of Diabetes (JDB) devotes itself to diabetes research, therapeutics, and education. It aims to involve researchers and practitioners in a dialogue between East and West via all aspects of epidemiology, etiology, pathogenesis, management, complications and prevention of diabetes, including the molecular, biochemical, and physiological aspects of diabetes. The Editorial team is international with a unique mix of Asian and Western participation. The Editors welcome submissions in form of original research articles, images, novel case reports and correspondence, and will solicit reviews, point-counterpoint, commentaries, editorials, news highlights, and educational content.