摘要
目的:探究甘油三酯葡萄糖(TyG)指数联合糖化血红蛋白(HbA1c)对 2 型糖尿病(T2DM)老年患者左心室收缩功能障碍的预测价值.方法:回顾性分析 2018 年 12 月—2022 年 12 月武汉市第四医院就诊的 166 例T2DM老年患者的临床资料.根据TyG 指数的四分位数值将患者分为TyG-1 组(TyG≤8.89)、TyG-2 组(TyG>8.89～9.44)、TyG-3 组(TyG>9.44～9.83)、TyG-4 组(TyG>9.83).比较不同TyG指数T2DM老年患者超声特征的差异,分析TyG指数联合HbA1c对T2DM老年患者左心室收缩功能障碍的预测价值.结果:TyG-2 组、TyG-3 组、TyG-4 组患者空腹血糖、总胆固醇、甘油三酯、载脂蛋白A1、载脂蛋白B及高血压比例较TyG-1 组升高(P<0.05).TyG-3 组、TyG-4 组患者空腹血糖、HbA1c、低密度脂蛋白、甘油三酯、载脂蛋白B较TyG-2 组升高(P<0.05).TyG-4 组患者空腹血糖、HbA1c、总胆固醇、甘油三酯、载脂蛋白A1 较TyG-3 组升高(P<0.05).TyG-3组、TyG-4 组患者整体纵向峰值应变(GLS)值较TyG-1 组、TyG-2 组降低(P<0.05).Logistic回归分析结果显示,HbA1c、TyG指数是T2DM老年患者左心室收缩功能障碍的独立影响因子.TyG指数、HbA1c预测T2DM老年患者左心室收缩功能障碍的ROC曲线下面积分别为 0.775(P<0.05,95%CI:0.705～0.844)、0.758(P<0.05,95%CI:0.684～0.831).TyG指数联合HbA1c预测T2DM老年患者左心室收缩功能障碍的ROC曲线下面积为 0.801(P<0.05,95%CI:0.733～0.869),当预测概率值取最佳截断值0.506 时,预测的灵敏度为 73.17%、特异度为 77.38%.结论:TyG指数联合HbA1c对T2DM老年患者左心室收缩功能障碍具有较好的预测价值.
Abstract
Objective:To investigate the predictive value of triglyceride glucose(TyG)index combined with glycated hemoglobin(HbA1c)on left ventricular systolic dysfunction in elderly patients with type 2 diabetes mellitus(T2DM).Methods:The clinical data of 166 elderly patients with T2DM attending Wuhan Fourth Hospital from December 2018 to December 2022 were retrospectively analyzed.The patients were divided into TyG-1 group(TyG≤8.89),TyG-2 group(TyG>8.89～9.44),TyG-3 group(TyG>9.44～9.83)and TyG-4 group(TyG>9.83)according to the quartile values of TyG index.Then we compared the differences in clinical ultrasound characteristics of T2DM patients with different TyG indices and analyzed the predictive value of TyG index combined with HbA1c on left ventricular systolic dysfunction in elderly patients with T2DM.Results:Fasting blood glucose,total cholesterol,triglycerides,apolipoprotein A1,apolipoprotein B(ApoB)and the proportion of hyperten-sion were higher in the TyG-2,TyG-3 and TyG-4 groups compared with the TyG-1 group(P<0.05).Fasting blood glucose,HbA1c,low-density lipoprotein(LDL),triglycerides and ApoB were elevated in patients in the TyG-3 and TyG-4 groups com-pared with the TyG-2 group(P<0.05).Fasting blood glucose,HbA1c,total cholesterol,triglycerides and apolipoprotein A1 were elevated in patients in the TyG-4 group compared with the TyG-3 group(P<0.05).The overall longitudinal peak strain(GLS)values were lower in patients in the TyG-3 and TyG-4 groups compared with the TyG-1 and TyG-2 groups(P<0.05).The re-sults of Logistic regression analysis showed that HbA1c and TyG index were independent risk factors for left ventricular sys-tolic dysfunction in elderly patients with T2DM.The areas under the ROC curves for TyG index and HbA1c predicting left ventricular systolic dysfunction in elderly patients with T2DM was 0.775(P<0.05,95%CI:0.705～0.844),0.758(P<0.05,95%CI:0.684～0.831),respectively.The area under the ROC curve of TyG index combined with HbA1c to predict left ventricular sys-tolic dysfunction in elderly patients with T2DM was 0.801(P<0.05,95%CI:0.733～0.869),with a sensitivity of 73.17%and a specificity of 77.38%when the predictive probability value was taken as the best cutoff value of 0.506.Conclusion:TyG index combined with HbA1c has a good predictive value for left ventricular systolic dysfunction in elderly patients with T2DM.
国家科技期刊平台
NSTL
万方数据