The Triglyceride-Glucose Index, an Insulin Resistance Marker, Was Non-linear Associated With All-Cause and Cardiovascular Mortality in the General Population.
The Triglyceride-Glucose Index, an Insulin Resistance Marker, Was Non-linear Associated With All-Cause and Cardiovascular Mortality in the General Population.
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DOI：
10.3389/fcvm.2020.628109
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发表时间：
2020
影响因子：
3.6
通讯作者：
Feng YQ
中科院分区：
文献类型：
--
作者：
Liu XC;He GD;Lo K;Huang YQ;Feng YQ
背景：甘油三酯-葡萄糖（TyG）指数可以作为胰岛素抵抗（IR）的便捷替代品，但其与长期死亡风险关系的流行病学证据有限。方法：1999-2014 年全国健康与营养调查的参与者根据 TyG 指数（<8、8-9、9-10、>10）进行分组。进行 Cox 回归来计算风险比 (HR) 和 95% 置信区间 (CI)。进行限制三次样条和分段线性回归来检测TyG指数和死亡率之间关系的形状。结果：总共纳入了 19,420 名参与者（48.9% 为男性）。平均而言，参与者随访了 98.2 个月，观察到 2,238 例（11.5%）和 445 例（2.3%）因全因或心血管疾病死亡。调整混杂因素后，TyG 指数与全因风险升高（HR，1.10；95% CI，1.00–1.20）和心血管死亡风险升高（HR，1.29；95% CI，1.05–1.57）独立相关。样条分析显示，TyG指数与死亡率呈非线性关系（全部非线性P<0.001），全因死亡阈值为9.36，心血管死亡阈值为9.52。全因死亡和心血管死亡高于阈值点的 HR 分别为 1.50 (95% CI, 1.29–1.75) 和 2.35 (95% CI, 1.73–3.19)。低于阈值点未发现显着差异（所有 P > 0.05）。结论：TyG 指数升高反映了更严重的 IR，并与全因死亡率和心血管疾病死亡率呈非线性相关。
Background: The triglyceride-glucose (TyG) index could serve as a convenient substitute of insulin resistance (IR), but epidemiological evidence on its relationship with the long-term risk of mortality is limited. Methods: Participants from the National Health and Nutrition Examination Survey during 1999–2014 were grouped according to TyG index (<8, 8–9, 9–10, >10). Cox regression was conducted to compute the hazard ratios (HRs) and 95% confidence interval (CI). Restricted cubic spline and piecewise linear regression were performed to detect the shape of the relationship between TyG index and mortality. Results: A total of 19,420 participants (48.9% men) were included. On average, participants were followed-up for 98.2 months, and 2,238 (11.5%) and 445 (2.3%) cases of mortality due to all-cause or cardiovascular disease were observed. After adjusting for confounders, TyG index was independently associated with an elevated risk of all-cause (HR, 1.10; 95% CI, 1.00–1.20) and cardiovascular death (HR, 1.29; 95% CI, 1.05–1.57). Spline analyses showed that the relationship of TyG index with mortality was non-linear (All non-linear P < 0.001), and the threshold value were 9.36 for all-cause and 9.52 for cardiovascular death, respectively. The HRs above the threshold point were 1.50 (95% CI, 1.29–1.75) and 2.35 (95% CI, 1.73–3.19) for all-cause and cardiovascular death. No significant difference was found below the threshold points (All P > 0.05). Conclusion: Elevated TyG index reflected a more severe IR and was associated with mortality due to all-cause and cardiovascular disease in a non-linear manner.