Triglyceride glucose and haemoglobin glycation index for predicting outcomes in diabetes patients with new-onset, stable coronary artery disease: a nested case-control study
Triglyceride glucose and haemoglobin glycation index for predicting outcomes in diabetes patients with new-onset, stable coronary artery disease: a nested case-control study
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DOI：
10.1080/07853890.2018.1523549
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发表时间：
2018-01-01
影响因子：
4.4
通讯作者：
Li, Jian-Jun
中科院分区：
文献类型：
--
作者：
Jin, Jing-Lu;Sun, Di;Li, Jian-Jun
目的：先前的研究表明，甘油三酯血糖(TYG)和血红蛋白糖化指数(HGI)都是心血管风险的预测因子。然而，TYG指数和HGI在2型糖尿病(T2 DM)和稳定性冠状动脉病变(CAD)患者中的预后价值尚未确定。方法：我们对1282例T2 DM稳定性冠心病患者进行了嵌套病例对照研究。随访3846人年。共有160名患者(12.5%)在年龄、性别、既往使用降脂药物和随访持续时间方面进行了识别和匹配。结果：在Kaplan-Meier分析中，TYG指数和HGI的上三分位数显著降低了无事件生存率(分别为p=.002；p=.036)。在报告中，TYG指数和HGI在调整混杂危险因素后均与MACCEs的风险增加相关[调整后的HR(95%CI)：1.693(1.238-2.316)；1.215(1.046-1.411)]。此外，在COX模型中加入TYG指数使C-统计量增加到0.638(95%CI：0.595-0.683，p=0.002)，而加入HGI后C-统计量无统计学意义(P=.240)。结论：TYG指数和HGI指数均能预测新发、稳定冠心病的T2 DM患者的心血管预后，但TYG指数可能更好。
Aim: Previous studies have shown that both triglyceride glucose (TyG) and haemoglobin glycation indexes (HGI) are predictors of cardiovascular risk. However, the prognostic value of TyG index and HGI in patients with type 2 diabetes mellitus (T2DM) and stable coronary artery disease (CAD) is not determined.Methods: We conducted a nested case-control study among 1282 T2DM patients with stable CAD. Patients were followed up for 3846 person-years. A total of 160 patients with events (12.5%) were identified and matched individually on age, gender, previous use of lipid lowering agents and duration of follow-up with 640 controls.Results: In Kaplan-Meier analysis, the upper tertiles of TyG index and HGI had a significant lower event-free survival (p=.002; p=.036, respectively). Of the note, both TyG index and HGI were associated with increased risk of MACCEs after adjusting for confounding risk factors [adjusted HR (95% CI): 1.693 (1.238-2.316); 1.215 (1.046-1.411), respectively]. Moreover, adding TyG index to the Cox model increased the C-statistic to 0.638 (95%CI: 0.595-0.683, p=.002) while the C-statistic was not statistically improved when HGI was included (p=.240).Conclusions: Both TyG index and HGI could predict cardiovascular outcomes in T2DM patients with new-onset, stable CAD while TyG index might be better.