The value of TyG index combined with vascular function indexes in predicting the degree of coronary artery stenosis
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摘要: 目的 探讨甘油三酯葡萄糖乘积指数(TyG指数)、联合肱动脉血流介导的血管舒张(FMD)、踝肱指数(ABI)、臂踝脉搏波传导速度(baPWV)这3种血管功能相关指标对冠心病患者冠状动脉(冠脉)狭窄程度的预测价值。方法 回顾性纳入确诊为冠心病的患者200例，根据Gensini评分将患者分为低狭窄组(97例)和高狭窄组(103例)，通过检测TyG指数、FMD、ABI、baPWV等指标，分析其与冠脉狭窄程度的相关性。构建logistic回归模型并绘制指标联合接受者操作特性(ROC)曲线，评估TyG指数与3种血管功能指标对冠脉狭窄程度的预测能力。结果 冠心病人群中，冠脉高狭窄患者吸烟史、TyG指数、FMD、ABI、baPWV、超敏C反应蛋白水平与冠脉低狭窄患者存在明显差异。Logistic多因素回归分析显示，吸烟、TyG指数、baPWV是冠脉狭窄的独立危险因素。以TyG指数和baPWV的联合系数绘制的ROC曲线下面积为0.705，可以较好预测冠心病患者冠脉狭窄程度。结论 TyG指数是冠脉狭窄程度的独立危险因素。TyG指数联合baPWV可较好地预测冠心病患者的冠脉狭窄程度。
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关键词:
- 冠心病 /
- 冠状动脉狭窄程度 /
- 甘油三酯葡萄糖乘积指数 /
- 血管功能
Abstract: Objective To investigate the value of triglyceride glucose product index(TyG index), combined brachial artery flow-mediated vasodilation(FMD), ankle-brachial index(ABI) and brachial-ankle pulse wave velocity(baPWV) in predicting the degree of coronary artery stenosis in patients with coronary atherosclerotic heart disease.Methods The 200 patients with coronary atherosclerotic heart disease were retrospectively enrolled. According to Gensini score, the patients were divided into low stenosis group and high stenosis group. The correlation between TyG index, FMD, ABI, baPWV and the degree of coronary artery stenosis was analyzed. The logistic regression model was constructed and the receiver operating characteristic(ROC) curve was drawn to evaluate the ability of TyG index and three vascular function related indexes in predicting the degree of coronary artery stenosis.Results Among patients with coronary heart disease, the history of smoking, TyG index, FMD, ABI, baPWV, Hs-CRP were significantly increased in high coronary artery stenosis group than those in low coronary artery stenosis group. Logistic multivariate regression analysis showed that smoking, TyG index and baPWV were independent risk factors. The area under the ROC curve drawn by the combined coefficient of TyG index and baPWV was 0.705.Conclusion TyG index is an independently risk factor in judging the degree of coronary artery stenosis of coronary heart disease. TyG index and baPWV can better predict the degree of coronary artery stenosis. -
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图 1 对于冠脉“高狭窄”状态的诊断预测ROC曲线图
Figure 1. The ROC curve for the diagnosis and prediction of the "high stenosis" state of the coronary arteries
表 1 基本临床资料
Table 1. Basic clinical data
X±S, M(P25, P75) 指标 低狭窄组(97例) 高狭窄组(103例) P值 男/例(%) 63(64.9) 80(77.7) 0.046 年龄/岁 63.4±10.7 61.5±12.7 0.241 BMI/(kg·m-2) 25.76±3.49 25.90±3.90 0.782 吸烟史/例(%) 36(37.1) 62(60.2) 0.001 高血压/例(%) 67(69.1) 77(74.8) 0.371 心力衰竭/例(%) 6(6.2) 15(14.6) 0.053 心律失常/例(%) 6(6.2) 4(3.9) 0.455 糖尿病/例(%) 40(41.2) 43(41.7) 0.942 ALP/(mmol·L-1) 65.57±18.72 68.32±25.64 0.389 TyG/(mmol·L-1) 3.79(2.65，5.44) 4.80(3.60，6.90) < 0.001 FMD/% 9.21±2.28 8.32±1.90 0.003 ABI 1.05±0.10 1.00±0.13 0.015 BaPWV/(m·s-1) 18.46±3.93 20.28±4.35 0.002 Hs-CRP/(mg·L-1) 1.03(0.55，2.75) 2.54(0.81，5.73) 0.014 LDL-C/(mmol·L-1) 2.48±0.71 2.35±0.75 0.205 Gensini评分/分 10(5.5，18) 62(41，89) < 0.001 
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表 2 狭窄程度为因变量的多因素logistic回归
Table 2. Multivariate logistic regression with the "degree of stenosis" as the dependent variable
X±S 项目 β OR 95%CI P值 截距 -2.19 TyG指数 0.28 1.32 1.10~1.60 0.003 baPWV 0.178 1.20 1.08~1.32 0.001 吸烟史 1.42 4.13 1.78~9.60 0.001
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