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IF 8.5 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular Diabetology Pub Date : 2025-02-28 DOI:10.1186/s12933-025-02587-x

Jiajun Liu, Yihui Fu, Pengpeng Liang, Zhangxiao Song, Yue Li, Hongyan Wu

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引用次数: 0

摘要

背景：甘油三酯葡萄糖指数（TyG甘油三酯葡萄糖指数（TyG）是评估代谢状况的有效参数。然而，TyG 和其他代谢参数是否能预测代谢综合征（MetS）患者的临床结果仍不确定。我们研究了代谢综合征队列中 TyG、甘油三酯葡萄糖-腰围-身高比（TyG-WHtR）和胰岛素抵抗代谢评分（METS-IR）与全因死亡率和心血管死亡率的关系，并确定这种关系是否会随着年龄的增长而改变：方法：选取 2001 年至 2018 年间参加美国国家健康与营养调查（NHANES）的参与者，并将其分为两组：年龄较小的个体（年龄为 10 岁）和年龄较大的个体（年龄为 15 岁）：该研究共有8271名参与者，包括5456名年轻参与者和2815名老年参与者，在8.3年的中位随访期内共观察到1407例死亡。与第一四分位数（Q1）相比，第四四分位数（Q4）的 TyG、TyG-WHtR 和 METS-IR 与全因死亡风险增加有关（HR 1.63，95% CI 1.12-2.39；HR 2.78，95% CI 1.68-4.61；HR 1.36，95% CI 1.12-2.02）和心血管死亡率（分别为 HR 2.04，95% CI 1.15-4.90；HR 4.99，95% CI 1.76-14.11；HR 2.69，95% CI 1.89-8.15）。RCS 结果显示，在老年组中，TyG、TyG-WHtR、METS-IR 与全因死亡率（分别为 P = 0.082；P = 0.712；P = 0.062）或心血管死亡率（分别为 P = 0.176；P = 0.793；P = 0.482）之间没有明显的非线性关联。TyG-WHtR在预测年轻组的3年死亡率方面显示出最高的曲线下面积，全因死亡率为0.653，心血管死亡率为0.688：我们的研究结果凸显了TyG、TyG-WHtR和METS-IR在MetS人群中的预测价值，为医疗实践和公共卫生提供了新的证据。

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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The association between novel metabolic parameters and all-cause/cardiovascular mortality in patients with metabolic syndrome is modified by age.

Background: Triglyceride glucose index (TyG) serves as an effective parameter for assessing metabolic status. However, it remains uncertain whether TyG and other metabolic parameters can predict clinical outcomes in people with metabolic syndrome (MetS). We investigated the association of TyG, triglyceride glucose-waist to height ratio (TyG-WHtR), and metabolic score for insulin resistance (METS-IR) with all-cause and cardiovascular mortality in the MetS cohort and determined whether this association changes with age.

Method: Participants enrolled in the National Health and Nutrition Examination Survey (NHANES) between 2001 and 2018 were selected and categorized into two groups: younger individuals (age < 65 years) and older individuals (age ≥ 65 years). Three new metabolic indices of TyG, TyG-WHtR, and METS-IR were constructed. The weighted Cox proportional hazards model and restricted cubic spline (RCS) models were employed to evaluate the relation between three indices and mortality outcomes. The time-dependent receiver operating characteristic (ROC) curve assessed the ability of different indices to predict mortality. Sensitivity analysis was conducted to evaluate the robustness and reliability of the findings.

Results: The study comprised a total of 8271 participants, including 5456 younger participants and 2815 older participants, and 1407 deaths were observed over a median follow-up period of 8.3 years. Compared with the first quartile (Q1), the fourth quartile's (Q4) TyG, TyG-WHtR, and METS-IR were linked to an increased risk of all-cause mortality (HR 1.63, 95% CI 1.12-2.39; HR 2.78, 95% CI 1.68-4.61; HR 1.36, 95% CI 1.12-2.02, respectively) and cardiovascular mortality (HR 2.04, 95% CI 1.15-4.90; HR 4.99, 95% CI 1.76-14.11; HR 2.69, 95% CI 1.89-8.15, respectively) in the younger group but not in the older group. The RCS results showed no significant non-linear associations between TyG, TyG-WHtR, METS-IR, and all-cause (P = 0.082; P = 0.712; P = 0.062, respectively) or cardiovascular mortality (P = 0.176; P = 0.793; P = 0.482, respectively) in the older age group. TyG-WHtR demonstrated the highest area under the curve for predicting 3-year mortality in the younger age group, with values of 0.653 for all-cause mortality and 0.688 for cardiovascular mortality.

Conclusion: Our results highlight the predictive value of TyG, TyG-WHtR, and METS-IR in the MetS population, providing new evidence for medical practice and public health.

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来源期刊

Cardiovascular Diabetology 医学-内分泌学与代谢

CiteScore

12.30

自引率

15.10%

发文量

240

审稿时长

1 months

期刊介绍： Cardiovascular Diabetology is a journal that welcomes manuscripts exploring various aspects of the relationship between diabetes, cardiovascular health, and the metabolic syndrome. We invite submissions related to clinical studies, genetic investigations, experimental research, pharmacological studies, epidemiological analyses, and molecular biology research in this field.