摘要: |
目的 通过队列研究分析甘油三酯葡萄糖指数(TyG)联合不同肥胖指标与四川省泸州地区糖尿病前期人群10年新发缺血性脑卒中(IS)的相关性。方法 选择2011年参与泸州地区流行病学调查并且符合糖尿病前期诊断的普通居民2 551例,分别按基线TyG-腰围(WC)、TyG-腰围身高比(WtHR)、TyG-BMI、TyG-腰臀比(WHR)的四分位数分为第1、第2、第3、第4四分位组(Q1、Q2、Q3、Q4组),观察各组10年新发IS情况。通过多因素logistic回归分析探索TyG-WC、TyG-WtHR、TyG-WHR与新发IS的关系。结果 纳入研究的2 551例糖尿病前期个体在非干预性随访至第10年时,因各种原因死亡123例,死亡率为4.8%;新发IS 142例,发生率为5.6%;新发糖尿病224例,其中22例同时新发IS,占新发糖尿病患者的9.8%。按照TyG-WC、TyG-WtHR四分位数分组,糖尿病前期人群10年新发IS的发生率均为Q4组>Q3组>Q2组>Q1组,差异有统计学意义(P<0.05);按照TyG-BMI四分位数分组,新发IS的发生率差异无统计学意义(P>0.05);按照TyG-WHR四分位数分组,新发IS的发生率为Q3组>Q4组>Q2组>Q1组,差异有统计学意义(P<0.05)。多因素logistic回归分析显示,无论在未调整任何变量的情况下还是调整多因素后,TyG-WtHR均与糖尿病前期人群新发IS相关。结论 TyG-WtHR是糖尿病前期人群发生IS的危险因素,加强对高TyG-WtHR的糖尿病前期人群的分级管理或可降低IS的发生风险。 |
关键词: 甘油三酯葡萄糖指数 腰围身高比 缺血性脑卒中 糖尿病前期 |
DOI:10.16781/j.CN31-2187/R.20220827 |
投稿时间:2022-10-24修订日期:2023-07-10 |
基金项目:国家重点研发计划(2016YFC0901200),西南医科大学校级课题(2019SQN013). |
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Correlation between triglyceride glucose index combined with different obesity indexes and new-onset ischemic stroke in 10 years among prediabetes individuals |
MIAO Ying1,WANG Yu2,YAN Pijun1,BAI Xue1,CHEN Pan1,WAN Qin1* |
(1. Department of Endocrinology and Metabolism, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan, China; 2. Department of Cardiology, Luzhou People's Hospital, Luzhou 646000, Sichuan, China * Corresponding author) |
Abstract: |
Objective To analyze the correlation between triglyceride glucose index (TyG) combined with different obesity indexes and new-onset ischemic stroke (IS) in 10 years in prediabetes population in Luzhou, Sichuan through cohort study. Methods A total of 2 551 residents who participated in the epidemiological survey in Luzhou in 2011 and were diagnosed as having prediabetes were enrolled. According to the quartiles of baseline TyG-waist circumference (WC), TyG-waist to height ratio (WtHR), TyG-body mass index (BMI), and TyG-waist to hip ratio (WHR), they were divided into the 1st, 2nd, 3rd, and 4th quartiles groups (Q1, Q2, Q3, and Q4 groups). The incidence of new-onset IS in each group in 10 years was analyzed. The relationships between TyG-WC, TyG-WtHR, TyG-WHR and new-onset IS were analyzed by multivariate logistic regression. Results Among the 2 551 prediabetes subjects enrolled in the study, 123 died of various causes during the 10 years of non-intervention follow-up, with a mortality of 4.8%; 142 had new-onset IS, with an incidence of 5.6%; and 224 had new-onset diabetes mellitus, including 22 also had new-onset IS, accounting for 9.8%. The quartile grouping analyses of TyG-WC and TyG-WtHR showed that the incidence of new-onset IS in prediabetes subjects over 10 years was Q4 group>Q3 group>Q2 group>Q1 group, with significant differences (P<0.05). The quartile grouping analysis of TyG-BMI showed that there was no significant difference in the incidence of new-onset IS (P>0.05). The quartile grouping analysis of TyG-WHR showed that the incidence of new-onset IS was Q3 group>Q4 group>Q2 group>Q1 group, with significant difference (P<0.05). Multivariate logistic regression analysis showed that TyG-WtHR was associated with new-onset IS in prediabetes subjects, either without adjusting any variable or after adjusting multiple factors. Conclusion TyG-WtHR is a risk factor of IS in prediabetes individuals. Enhancing management of prediabetes patients with high TyG-WtHR may reduce the risk of IS. |
Key words: triglyceride glucose index waist to height ratio ischemic stroke prediabetes |