中国老年人甘油三酯-葡萄糖指数、低密度和高密度脂蛋白胆固醇与全因和心血管疾病死亡率的关系:一项回顾性队列研究。

IF 3.9 2区 医学 Q2 ENDOCRINOLOGY & METABOLISM
Frontiers in Endocrinology Pub Date : 2024-10-29 eCollection Date: 2024-01-01 DOI:10.3389/fendo.2024.1422086
Donghai Su, Zhantian An, Liyuan Chen, Xuejiao Chen, Wencan Wu, Yufang Cui, Yulin Cheng, Songhe Shi
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引用次数: 0

摘要

背景:基线甘油三酯-葡萄糖(TyG)指数和异常的低密度或高密度脂蛋白胆固醇(LDL-C或HDL-C)水平对全因和心血管疾病(CVD)死亡率的影响仍不清楚。本研究旨在探讨TyG指数、低密度脂蛋白胆固醇或高密度脂蛋白胆固醇与全因死亡率和心血管疾病死亡率之间的关系:这项回顾性队列研究分析了中国河南省新郑市 69,068 名年龄≥60 岁老年人在 2013 年 1 月至 2023 年 1 月期间的健康检查数据。采用 Cox 比例风险回归模型估算了 TyG 指数和低密度脂蛋白胆固醇或高密度脂蛋白胆固醇对全因死亡率和心血管疾病死亡率的危险比 (HR) 和 95% 置信区间 (CI)。限制立方样条曲线用于评估剂量-反应关系:在400,094人年的随访期间(中位数随访5.8年[四分位间范围3.0-9.12]),共记录了13,664例死亡,其中7,045例死于心血管疾病。与TyG指数处于第二四分位数的参与者相比,处于第四四分位数的参与者全因死亡风险增加了16%(HR:1.16,95% CI:1.12-1.22),心血管疾病死亡风险增加了8%(HR:1.08,95% CI:1.01-1.16)。低密度脂蛋白胆固醇(LDL-C)和高密度脂蛋白胆固醇(HDL-C)方面也观察到类似的结果,与低密度脂蛋白胆固醇处于第三四分位数的参与者相比,处于第四四分位数的参与者的全因和心血管疾病死亡风险分别为(HR:1.07,95% CI:1.02,1.12)和(HR:1.09,95% CI:1.01,1.17)。与 HDL-C 四分位数第二组相比,四分位数第四组参与者的全因和心血管疾病死亡风险分别为(HR:1.10,95% CI:1.05,1.16)和(HR:1.11,95% CI:1.04,1.18)。我们发现,TyG 指数与全因死亡率和心血管疾病死亡率呈非线性关系(P 非线性 0.05)。另一方面,高密度脂蛋白胆固醇(HDL-C)与低密度脂蛋白胆固醇(LDL-C)相反,与心血管疾病死亡率呈非线性关系。我们没有观察到TyG指数与低密度脂蛋白胆固醇或高密度脂蛋白胆固醇之间存在明显的交互作用(P>0.05):结论:TyG指数、低密度脂蛋白胆固醇(LDL-C)或高密度脂蛋白胆固醇(HDL-C)会增加全因死亡和心血管疾病死亡的风险,尤其是高TyG指数合并异常低密度脂蛋白胆固醇(LDL-C)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Association of triglyceride-glucose index, low and high-density lipoprotein cholesterol with all-cause and cardiovascular disease mortality in generally Chinese elderly: a retrospective cohort study.

Background: The impact of baseline triglyceride-glucose (TyG) index and abnormal low or high-density lipoprotein cholesterol (LDL-C or HDL-C) levels on all-cause and cardiovascular disease (CVD) mortality remains unclear. This study aimed to investigate the relationship between TyG index and LDL-C or HDL-C and all-cause and CVD mortality.

Methods: This retrospective cohort study analyzed data from health examinations of 69,068 older adults aged ≥60 in Xinzheng City, Henan Province, China, between January 2013 and January 2023. Cox proportional risk regression models were used to estimate the hazard ratio (HR) and 95% confidence interval (CI) of the TyG index and LDL-C or HDL-C about all-cause and CVD mortality. Restricted cubic spline was used to assess the dose-response relationship.

Results: During 400,094 person-years of follow-up (median follow-up 5.8 years [interquartile range 3.0-9.12]), 13,664 deaths were recorded, of which 7,045 were due to CVD. Compared with participants in the second quartile of the TyG index, participants in the fourth quartile had a 16% increased risk of all-cause mortality (HR: 1.16, 95% CI: 1.12,1.22), and an 8% increased risk of CVD mortality (HR: 1.08, 95% CI: 1.01,1.16). Similar results were observed in LDL-C and HDL-C, with all-cause and CVD mortality risks for participants in the fourth quartile compared with participants in the third quartile for LDL-C of (HR: 1.07, 95% CI: 1.02,1.12) and (HR: 1.09, 95% CI: 1.01,1.17), respectively. The risk of all-cause and CVD mortality in participants in the fourth quartile group compared with those in the second HDL-C quartile group was (HR: 1.10, 95% CI: 1.05,1.16) and (HR: 1.11, 95% CI: 1.04,1.18), respectively. We found that the TyG index was nonlinearly associated with all-cause and CVD mortality (P non-linear <0.05), and LDL-C was nonlinearly associated with all-cause mortality (P non-linear <0.05) but linearly associated with CVD mortality (P non-linear >0.05). HDL-C, on the other hand, was in contrast to LDL-C, which showed a non-linear association with CVD mortality. We did not observe a significant interaction between TyG index and LDL-C or HDL-C (P >0.05).

Conclusion: TyG index and LDL-C or HDL-C increased the risk of all-cause and CVD mortality, especially a high TyG index combined with abnormal LDL-C.

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来源期刊
Frontiers in Endocrinology
Frontiers in Endocrinology Medicine-Endocrinology, Diabetes and Metabolism
CiteScore
5.70
自引率
9.60%
发文量
3023
审稿时长
14 weeks
期刊介绍: Frontiers in Endocrinology is a field journal of the "Frontiers in" journal series. In today’s world, endocrinology is becoming increasingly important as it underlies many of the challenges societies face - from obesity and diabetes to reproduction, population control and aging. Endocrinology covers a broad field from basic molecular and cellular communication through to clinical care and some of the most crucial public health issues. The journal, thus, welcomes outstanding contributions in any domain of endocrinology. Frontiers in Endocrinology publishes articles on the most outstanding discoveries across a wide research spectrum of Endocrinology. The mission of Frontiers in Endocrinology is to bring all relevant Endocrinology areas together on a single platform.
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