Zhongguo quanke yixue (Feb 2022)
The Effect of Longitudinal Trajectories of Triglyceride-glucose Index on the New-onset Cardiovascular and Cerebrovascular Diseases
Abstract
BackgroundTriglyceride glucose index (TyG) at baseline is an important influencing factor of cardiovascular and cerebrovascular diseases (CVD) , but there is still a lack of prospective cohort studies on the influence of TyG longitudinal trajectory on new-onset CVD at home and abroad.ObjectiveTo explore the influence of TyG longitudinal trajectory on the occurrence of new-onset CVD.MethodsThe Kailuan Study has been followed up every 2 years that began in 2006. A prospective cohort study method was used to select those who participated in three consecutive health examinations in 2006, 2008, and 2010, with complete triacylglycerol and blood glucose levels, and no history of malignant tumors, cardiovascular and cerebrovascular diseases as the observation objects. The 2010 health check-up time point was used as the starting point for the follow-up, and the occurrence of CVD, death or the end of the follow-up (2017-12-31) was used as the end point of the follow-up. SAS Proc Traj program was used to establish the trajectory model of the research object TyG, four different groups were determine daccording to the longitudinal trajectories of TyG: low-stable group, medium and low-stable group, medium and high-stable group, and high-stable group. The general data and laboratory observation indicatorsof the patients were collected and the Cox proportional hazard model was used to analyze the influence of TyG longitudinal trajectory on new-onset CVD.ResultsA total of 54 258 subjects meeting the inclusion criteriawere included, including 13 150 cases (24.24%) in the low-stable group, 28 488 cases (52.50%) in the medium-low-stable group, 10 808 cases (19.92%) in the medium-high-stable group, and 1 812 cases (3.34%) cases in the high-stable group. There were statistically significant differences in the age, gender, BMI, heart rate, TyG2006, TyG2008, TyG2010, HDL-C, LDL-C, UA, hs-CRP, TG, FBG, ALT, smoking, drinking, and physical exercise and the proportion of taking lipid-lowering drugs among different groups (P<0.05) . The subjects were followed up for (6.73±1.12) years, and a total of 2 267 cases of CVD occurred, including 499 cases of acute myocardial infarction and 1 800 cases of stroke. There were significant difference in the cumulative incidence of CVD of patients among different TyG longitudinal trajectory groups (P<0.05) . Cox regression analysis showed after adjusting for confounding factors, the HR value (95%CI) of CVD in each group were 1.29 (1.14, 1.46) , 1.40 (1.20, 1.63) and 1.76 (1.41, 2.20) when compared with the low-stable group; the HR value (95%CI) for acute myocardial infarctionwere 1.48 (1.10, 1.98) , 1.91 (1.36, 2.69) and 2.03 (1.22, 3.36) in each group when compared with the low-stable group; the HR value (95%CI) for stroke were 1.23 (1.07, 1.42) , 1.27 (1.07, 1.50) and 1.63 (1.27, 2.08) in each group; the HR value (95%CI) for ischemic strokewere 1.25 (1.08, 1.45) , 1.35 (1.12, 1.60) and 1.77 (1.37, 2.30) in each group.ConclusionThe increased longitudinal trajectory of TyG index is a risk factor for the incidence of CVD and is independent of the baseline of TyG index.
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