背景:甘油三酯葡萄糖-体重指数(TyG-BMI)和血红蛋白糖化指数(HGI)是胰岛素抵抗的公认替代指标。然而,这些标志物对高血压人群中心力衰竭(HF)患病率提供附加预测价值的程度,以及它们在各种糖尿病状态下的预测效用,还有待澄清。因此,本研究旨在探讨TyG-BMI和HGI对不同糖尿病状态个体HF风险的独立和协同作用。
方法:来自研究人群(n=9847)的数据来自国家健康和营养检查调查(NHANES)。使用多变量逻辑回归模型来估计比值比(OR)和95%置信区间(CI),以评估TyG-BMI和HGI与各种糖尿病状态下HF患病率之间的综合关联。
结果:在总人口中,与参考组(低TyG-BMI和低HGI)相比,对于低TyG-BMI和高HGI的组合,HF患病率的OR(95%CI)为1.30(1.04,1.64),2.40(1.76,3.29)对于高TyG-BMI和低HGI,高TyG-BMI和高HGI分别为3.47(2.41、4.99)。有趣的是,在血糖正常的个体中,较高的TyG-BMI和HGI并未显著增加HF的患病率.相反,在糖尿病前期人群中,对于高TyG-BMI和低HGI的组合,HF患病率的OR(95CI)为2.42(1.69,3.48),高TyG-BMI和高HGI分别为4.30(2.45、7.54)。同样,在糖尿病人群中,低TyG-BMI和高HGI对HF患病率的OR(95CI)为2.22(1.43,3.45),4.04(2.43,6.73)对于高TyG-BMI和低HGI,高TyG-BMI和高HGI的4.13(2.25,7.59),与低TyG-BMI和低HGI相比。
结论:这项研究表明,升高的TyG-BMI和HGI水平对高血压成人HF的患病率产生协同影响,尤其是那些糖尿病前期和糖尿病患者。此外,糖尿病前期和糖尿病的存在可能会放大TyG-BMI和HGI对HF患病率的有害联合作用.
BACKGROUND: The Triglyceride glucose-body mass index (TyG-BMI) and hemoglobin glycation index (HGI) are well-established surrogate markers for insulin resistance. Nevertheless, the extent to which these markers offer additive predictive value for heart failure (HF) prevalence in hypertensive populations, and their predictive utility across various diabetic statuses, remains to be clarified. Consequently, this study aimed to explore the independent and synergistic effects of TyG-BMI and HGI on HF risk among individuals with different diabetic statuses.
METHODS: Data from the study population (n = 9847) were obtained from the National Health and Nutrition Examination Survey (NHANES). Multivariable logistic regression models were employed to estimate odds ratios (ORs) and 95% confidence intervals (CIs) to assess the combined associations between TyG-BMI and HGI and the prevalence of HF across various diabetic statuses.
RESULTS: In the total population, compared to the reference group (low TyG-BMI and low HGI), the OR (95% CI) for HF prevalence was 1.30 (1.04, 1.64) for the combination of low TyG-BMI and high HGI, 2.40 (1.76, 3.29) for high TyG-BMI and low HGI, and 3.47 (2.41, 4.99) for high TyG-BMI and high HGI. Interestingly, among normoglycemic individuals, higher TyG-BMI and HGI did not significantly increase the prevalence of HF. Conversely, in the prediabetic population, the OR (95%CI) for HF prevalence was 2.42 (1.69, 3.48) for the combination of high TyG-BMI and low HGI, and 4.30 (2.45, 7.54) for high TyG-BMI and high HGI. Similarly, in the diabetic population, the OR (95%CI) for HF prevalence was 2.22 (1.43, 3.45) for low TyG-BMI and high HGI, 4.04 (2.43, 6.73) for high TyG-BMI and low HGI, and 4.13 (2.25, 7.59) for high TyG-BMI and high HGI, compared to low TyG-BMI and low HGI.
CONCLUSIONS: This study reveals that elevated TyG-BMI and HGI levels exert a synergistic impact on the prevalence of HF in hypertensive adults, especially in those with prediabetes and diabetes. Additionally, the presence of prediabetes and diabetes may amplify the detrimental combined effect of TyG-BMI and HGI on HF prevalence.