DataSheet_1_Triglyceride glucose index is associated with functional coronary artery stenosis in hypertensive patients.docx

BackgroundThe triglyceride glucose (TyG) index is an effective method for determining insulin resistance (IR). Limited research has explored the connection between the TyG index and functionally significant stenosis in hypertensive patients. Furthermore, the connections between the TyG index, fat attenuation index (FAI) and atherosclerotic plaque characteristics are also worth exploring.
MethodsThe study screened 1622 hypertensive participants without coronary artery disease history who underwent coronary computed tomography angiography. The TyG index was calculated as ln (fasting glucose [mg/dL] * fasting TG [mg/dL]/2). Adverse plaque characteristics (HRPCs), high-risk plaques (HRPs), FAI, and CT-derived fractional flow reserve (FFRCT) were analyzed and measured for all patients. Functionally significant stenosis causing ischemia is defined as FFRCT ≤ 0.80. Two patient groups were created based on the FFRCT: the FFRCT < 0.80 group and the FFRCT > 0.80 group. In hypertensive patients, the association between the TyG index and FFRCT was examined applying a logistic regression model.
ResultsThe TyG index was higher for people with FFRCT ≤ 0.80 contrast to those with FFRCT > 0.80. After controlling for additional confounding factors, the logistic regression model revealed a clear connection between the TyG index and FFRCT ≤ 0.80 (OR = 1.718, 95% CI 1.097–2.690, p = 0.018). The restricted cubic spline analysis displayed a nonlinear connection between the TyG index and FFRCT ≤ 0.80 (p for nonlinear = 0.001). The TyG index increased the fraction of individuals with HRPs and HRPCs, FAI raised, and FFRCT decreased (p < 0.05). The multivariate linear regression analysis illustrated a powerfulcorrelation between high TyG index levels and FAI, FFRCT, positive remodeling (PR), and low-attenuation plaque (LAPs) (standardized regression coefficients: 0.029 [p = 0.007], -0.051 [p < 0.001], 0.029 [p = 0.027], and 0.026 [p = 0.046], separately).
ConclusionIn hypertensive patients, the TyG index showed an excellent association with a risk of FFRCT ≤ 0.80. Additionally, the TyG index was also linked to FAI, FFRCT, PR, and LAPs.

背景：甘油三酯葡萄糖(TyG)指数是评估胰岛素抵抗(insulin resistance, IR)的有效手段。目前针对该指数与高血压患者功能性显著狭窄的关联研究尚有限。此外，甘油三酯葡萄糖指数、脂肪衰减指数(fat attenuation index, FAI)与动脉粥样硬化斑块特征之间的关联也有待进一步探索。
方法：本研究共纳入1622名无冠状动脉粥样硬化性心脏病(coronary artery disease)病史、且接受过冠状动脉计算机断层血管造影(coronary computed tomography angiography)的高血压受试者。甘油三酯葡萄糖指数计算公式为：ln(空腹血糖[mg/dL] × 空腹甘油三酯[mg/dL]/2)。对所有受试者的不良斑块特征(adverse plaque characteristics, HRPCs)、高危斑块(high-risk plaques, HRPs)、脂肪衰减指数及CT衍生的血流储备分数(CT-derived fractional flow reserve, FFRCT)进行分析与测量。将导致心肌缺血的功能性显著狭窄定义为FFRCT ≤ 0.80。基于FFRCT值将受试者分为两组：FFRCT < 0.80组与FFRCT > 0.80组。在高血压人群中，采用logistic回归模型分析甘油三酯葡萄糖指数与FFRCT的关联。
结果：与FFRCT > 0.80的受试者相比，FFRCT ≤ 0.80的受试者甘油三酯葡萄糖指数水平更高。在校正其他混杂因素后，logistic回归模型显示甘油三酯葡萄糖指数与FFRCT ≤ 0.80存在显著关联（优势比OR=1.718，95%置信区间CI：1.097~2.690，p=0.018）。限制性立方样条分析显示，甘油三酯葡萄糖指数与FFRCT ≤ 0.80之间存在非线性关联（非线性检验p=0.001）。甘油三酯葡萄糖指数升高与高危斑块及不良斑块特征的检出率升高、脂肪衰减指数升高及FFRCT降低显著相关（p < 0.05）。多因素线性回归分析显示，高甘油三酯葡萄糖指数水平与脂肪衰减指数、FFRCT、正向重构(positive remodeling, PR)及低衰减斑块(low-attenuation plaque, LAPs)存在显著相关性（标准化回归系数分别为0.029[p=0.007]、-0.051[p<0.001]、0.029[p=0.027]及0.026[p=0.046]）。
结论：在高血压患者中，甘油三酯葡萄糖指数与FFRCT ≤ 0.80的风险存在显著关联。此外，甘油三酯葡萄糖指数还与脂肪衰减指数、FFRCT、正向重构及低衰减斑块存在关联。