超重/肥胖相关射血分数保留型心力衰竭患者血清TyG指数对中重度心室舒张功能障碍的预测价值分析OA
Predictive Value of Serum TyG Index for Moderate-to-Severe Ventricular Diastolic Dysfunction in Patients with Overweight/Obesity-Related Heart Failure with Preserved Ejection Fraction
目的 探讨超重/肥胖相关射血分数保留型心力衰竭(HFpEF)患者血清甘油三酯-葡萄糖指数(TyG指数)对中重度左心室舒张功能障碍(LVDD)的预测价值.方法 收集2023年1月～2024年1月于徐州医科大学附属医院住院治疗的227例超重/肥胖相关HFpEF患者的临床资料.根据TyG指数四分位数值划分为低(n=57)、中低(n=58)、中高(n=56)及高(n=56)四组.比较四组间超声心动图指标的差异性.采用Spearman法分析TyG指数与超重/肥胖相关HFpEF患者中重度LVDD发生的相关性;Logistic回归模型评估发生中重度LVDD的独立危险因素并绘制受试者操作特征(ROC)曲线.在性别、年龄、糖尿病及体质指数(BMI)亚组中进行二元Logistic回归分析明确高风险人群.结果 与其余三组相比,高TyG组左心房内径(LAD)、二尖瓣早期血流速度/二尖瓣心房收缩期最大血流(E/A)、二尖瓣早期血流速度/隔膜的早期舒张期运动速度比(E/e')升高,差异具有统计学意义(F=4.306～9.954,均P＜0.05).Spearman相关性分析结果提示TyG指数与超重/肥胖相关HFpEF患者发生中重度LVDD的风险呈正相关(r=0.452,P＜0.001).多因素Logistic回归分析发现高TyG指数、糖化血红蛋白(HbA1c)、低密度脂蛋白-胆固醇(LDL-C)及BMI均为其独立危险因素(Wald x2=4.011～17.478,均P＜0.05).ROC曲线提示TyG指数预测效能良好,AUC 为 0.762(95％CI:0.701～0.823),进一步与 HbA1c联合预测后 AUC 可达0.801(95％CI:0.745～0.857),此时联合模型的灵敏度达到91.3％,特异度为57.7％.亚组分析显示,高TyG指数在性别、年龄、糖尿病及BMI分层亚组中均与中重度心室舒张功能障碍显箸相关(OR=2.423～7.798,均P＜0.05).结论 TyG指数是超重/肥胖相关HFpEF患者发生中重度LVDD的危险因素,其联合HbA1c可提高预测效能,且在不同人群中均具有一定的风险评估价值.
Objective To evaluate the predictive value of serum triglyceride-glucose(TyG)index for moderate-to-severe left ven-tricular diastolic dysfunction(LVDD)in overweight/obese patients with heart failure with preserved ejection fraction(HFpEF).Methods Clinical data of 227 patients with overweight/obesity-related HFpEF hospitalized at the Affiliated Hospital of Xuzhou Medical University from January 2023 to January 2024 were retrospectively collected.Patients were stratified into four quartiles based on TyG index values:low(n=57),low-moderate(n=58),moderate-high(n=56),and high(n=56).Differences in echocar-diographic parameters were compared across the four groups.Spearman's correlation was used to evaluate the association be-tween TyG index and moderate-to-severe LVDD.Logistic regression model was performed to identify independent risk factors for moderate-to-severe LVDD,and to generate receiver operating characteristic(ROC)curves.Binary Logistic regression analy-sis was performed in subgroups stratified by sex,age,diabetes status,and body mass index(BMI)to identify high-risk popula-tions.Results Compared with the other three groups,the high TyG group exhibited statistically significant increase in left atrial diameter(LAD),mitral early-to-atrial peak velocity ratio(E/A),and mitral early diastolic velocity to septal early diastolic myo-cardial velocity ratio(E/e')(F=4.306～9.954,all P＜0.05).Spearman correlation analysis indicated a positive association between TyG index and the risk of moderate-to-severe LVDD in overweight or obese HFpEF patients(r=0.452,P＜0.05).The results of multivariate Logistic regression analysis showed that high TyG index,HbA1c,LDL-C,and BMI were independent risk factors(Wald x2=4.011～17.478,all P＜0.05).ROC curve analysis demonstrated good predictive performance of the TyG index,with an AUC of 0.762(95％CI:0.701～0.823).Combining TyG index with HbA1c further improved AUC to 0.801(95％CI:0.745～0.857),yielding a sensitivity of 91.3％and a specificity of 57.7％.Subgroup analysis showed that eleveated TyG index was significantly associated with moderate-to-severe LVDD acroll all subgroups stratified by sex,age,diabetes status and BMI(OR=2.423～7.798,all P＜0.05).Conclusions The TyG index is a risk factor for moderate-to-severe LVDD in overweight or obese HF-pEF patients.Its combination with HbA1c enhances predictive accuracy.Moreover,TyG index demonstrated a consistent risk-predictive value across rarious populations.
盛楚凡;王琲;王错错;赵旭东;李雷
徐州医科大学附属医院全科医学科,江苏徐州 221000徐州医科大学附属医院全科医学科,江苏徐州 221000徐州医科大学附属医院全科医学科,江苏徐州 221000徐州医科大学附属医院全科医学科,江苏徐州 221000徐州医科大学附属医院全科医学科,江苏徐州 221000
医药卫生
甘油三酯-葡萄糖指数射血分数保留型心力衰竭超重/肥胖左心室舒张功能障碍
triglyceride-glucose indexheart failure with preserved ejection fractionoverweight/obeseventricular diastolic dysfunction
《现代检验医学杂志》 2026 (2)
181-186,6
江苏省研究生科研与实践创新计划项目(SJCX24_1539).
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