METHODS: The study population was derived from the National Health and Nutrition Examination Survey (NHANES) spanning from 1999 to 2018. The exposure variable, TyG, was calculated based on triglyceride and fasting blood glucose levels, while the outcome of interest was CHF. A multivariate logistic regression analysis was employed to assess the association between TyG and CHF.
RESULTS: A total of 13,644 patients with diabetes and prediabetes were included in this study. The results from the fitting curve analysis demonstrated a non-linear U-shaped correlation between TyG and CHF. Additionally, linear logistic regression analysis showed that each additional unit of TyG was associated with a non-significant odds ratio (OR) of 1.03 (95%CI: 0.88-1.22, P = 0.697) for the prevalence of CHF. A two-piecewise logistic regression model was used to calculate the threshold effect of the TyG. The log likelihood ratio test (p < 0.05) indicated that the two-piecewise logistic regression model was superior to the single-line logistic regression model. The TyG tangent point was observed at 8.60, and on the left side of this point, there existed a negative correlation between TyG and CHF (OR: 0.54, 95%CI: 0.36-0.81). Conversely, on the right side of the inflection point, a significant 28% increase in the prevalence of CHF was observed per unit increment in TyG (OR: 1.28, 95%CI: 1.04-1.56).
CONCLUSIONS: The findings from this study suggest a U-shaped correlation between TyG and CHF, indicating that both elevated and reduced levels of TyG are associated with an increased prevalence of CHF.
方法:研究人群来自1999年至2018年的国家健康和营养检查调查(NHANES)。曝光变量,TyG,是根据甘油三酯和空腹血糖水平计算的,而感兴趣的结果是CHF。采用多变量逻辑回归分析评估TyG和CHF之间的关联。
结果:本研究共纳入13,644例糖尿病和糖尿病前期患者。拟合曲线分析的结果证明了TyG和CHF之间的非线性U形相关性。此外,线性logistic回归分析显示,每增加一个TyG单位,CHF患病率的非显著比值比(OR)为1.03(95CI:0.88-1.22,P=0.697).使用两个分段逻辑回归模型来计算TyG的阈值效应。对数似然比检验(p<0.05)表明,两分段逻辑回归模型优于单线逻辑回归模型。在8.60处观察到TyG切点,在该点的左侧,TyG与CHF呈负相关(OR:0.54,95CI:0.36~0.81)。相反,在拐点的右侧,TyG每增加1个单位,CHF患病率显著增加28%(OR:1.28,95CI:1.04~1.56).
结论:这项研究的结果表明,TyG和CHF之间存在U形相关性,提示TyG水平升高和降低均与CHF患病率增加相关。