背景:高甘油三酯-葡萄糖指数(TyG)与发生心力衰竭的较高风险相关。然而,TyG指数的纵向模式对心力衰竭风险的影响仍有待表征。因此,在本研究中,我们旨在表征TyG指数的运动轨迹与心力衰竭风险之间的关系.
方法:我们进行了一项前瞻性研究,研究对象有56,149名参加了2006-2007年、2008-2009年和2010-2011年连续三次调查,并且在第三次调查(2010-2011年)之前没有心力衰竭或癌症病史。TyG指数计算为ln[空腹甘油三酯(mg/dL)×空腹血糖(mg/dL)/2]。我们使用潜在混合模型来表征2006-2010年期间TyG指数的轨迹。此外,Cox比例风险模型用于计算各种TyG指数轨迹组发生心力衰竭的风险比(HR)和95%置信区间(CI)。
结果:从2006年到2010年,确定了四种不同的TyG轨迹:低稳定(n=13,554;范围,7.98-8.07),中度低稳定(n=29,435;范围,8.60-8.65),中等高稳定(n=11,262;范围,9.31-9.30),和升高稳定(n=1,898;范围,10.04-10.25).在10.04年的中位随访期内,总共发生了1,312例新的心力衰竭事件。在调整了潜在的混杂因素后,升高-稳定型心力衰竭的风险比(HR)和95%置信区间(CI),中等高度稳定,和中度低稳定组是1.55(1.15,2.08),1.32(1.08,1.60),和1.17(0.99,1.37),分别,与低稳定组相比。
结论:较高的TyG指数轨迹与较高的心力衰竭风险相关。这表明监测TyG指数轨迹可能有助于识别心力衰竭高危人群,并强调早期控制血糖和血脂对预防心力衰竭的重要性。
BACKGROUND: A high triglyceride-glucose index (TyG) is associated with a higher risk of incident heart failure. However, the effects of longitudinal patterns of TyG index on the risk of heart failure remain to be characterized. Therefore, in the present study, we aimed to characterize the relationship between the trajectory of TyG index and the risk of heart failure.
METHODS: We performed a prospective study of 56,149 participants in the Kailuan study who attended three consecutive surveys in 2006-2007, 2008-2009, and 2010-2011 and had no history of heart failure or cancer before the third wave survey (2010-2011). The TyG index was calculated as ln [fasting triglycerides (mg/dL) × fasting plasma glucose (mg/dL)/2], and we used latent mixture modeling to characterize the trajectory of the TyG index over the period 2006-2010. Additionally, Cox proportional risk models were used to calculate the hazard ratio (HR) and 95% confidence interval (CI) for incident heart failure for the various TyG index trajectory groups.
RESULTS: From 2006 to 2010, four different TyG trajectories were identified: low-stable (n = 13,554; range, 7.98-8.07), moderate low-stable (n = 29,435; range, 8.60-8.65), moderate high-stable (n = 11,262; range, 9.31-9.30), and elevated-stable (n = 1,898; range, 10.04-10.25). A total of 1,312 new heart failure events occurred during a median follow-up period of 10.04 years. After adjustment for potential confounders, the hazard ratios (HRs) and 95% confidence intervals (CIs) for incident heart failure for the elevated-stable, moderate high-stable, and moderate low-stable groups were 1.55 (1.15, 2.08), 1.32 (1.08, 1.60), and 1.17 (0.99, 1.37), respectively, compared to the low-stable group.
CONCLUSIONS: Higher TyG index trajectories were associated with a higher risk of heart failure. This suggests that monitoring TyG index trajectory may help identify individuals at high risk for heart failure and highlights the importance of early control of blood glucose and lipids for the prevention of heart failure.