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中华临床医师杂志(电子版) ›› 2025, Vol. 19 ›› Issue (08) : 559 -566. doi: 10.3877/cma.j.issn.1674-0785.2025.08.001

临床研究

甘油三酯葡萄糖指数与老年社区人群内皮功能障碍的相关性研究
温欢1, 苏博2, 刘金波1, 王宏宇1,()   
  1. 1 100144 北京,北京大学首钢医院血管医学中心
    2 100191 北京,北京大学第一医院临床药理研究所
  • 收稿日期:2025-08-21 出版日期:2025-08-30
  • 通信作者: 王宏宇
  • 基金资助:
    首都卫生发展科研专项(2020-2-6042)

Association between triglyceride-glucose index and endothelial dysfunction in an elderly community-based population

Huan Wen1, Bo Su2, Jinbo Liu1, Hongyu Wang1,()   

  1. 1 Vascular Medicine Center, Peking University Shougang Hospital, Beijing 100144, China
    2 Institute of Clinical Pharmacology, Peking University First Hospital, Beijing 100191, China
  • Received:2025-08-21 Published:2025-08-30
  • Corresponding author: Hongyu Wang
引用本文:

温欢, 苏博, 刘金波, 王宏宇. 甘油三酯葡萄糖指数与老年社区人群内皮功能障碍的相关性研究[J/OL]. 中华临床医师杂志(电子版), 2025, 19(08): 559-566.

Huan Wen, Bo Su, Jinbo Liu, Hongyu Wang. Association between triglyceride-glucose index and endothelial dysfunction in an elderly community-based population[J/OL]. Chinese Journal of Clinicians(Electronic Edition), 2025, 19(08): 559-566.

目的

明确甘油三酯葡萄糖指数(TyG index)与老年社区人群内皮功能障碍的相关性,为心血管疾病的早期预测提供新思路。

方法

采用横断面研究方法,纳入无心血管疾病既往史的1648例老年人群,收集一般人口学资料、既往病史、体格检查及实验室检测指标,计算TyG index,采用反应性充血指数(RHI)评估内皮功能。按TyG index三分位数分为低、中、高3组,通过Pearson相关分析TyG index与临床指标的相关性,采用logistic回归模型分析TyG index与内皮功能障碍的关联,并进行分层交互作用检验。

结果

内皮功能障碍组TyG index水平显著高于正常组(P<0.05);随TyG index升高,内皮功能障碍检出率依次为41.0%、45.4%、48.4%(χ2=6.117,P<0.05)。Pearson相关分析显示,TyG index与体重指数、总胆固醇、低密度脂蛋白胆固醇、收缩压、舒张压呈正相关(均P<0.05),与高密度脂蛋白胆固醇、RHI呈负相关(均P<0.05)。校正混杂因素后,高TyG index组发生内皮功能障碍的风险是低TyG index组的1.43倍(95% CI:1.09~1.87,P<0.05)。分层分析显示,TyG index与高血压、糖尿病、高脂血症对内皮功能障碍的影响无交互作用(均P>0.05)。

结论

老年社区人群中TyG index升高与内皮功能障碍显著相关,TyG index可作为评估内皮功能、预测心血管疾病风险的简易指标,为心血管疾病的早期预防提供参考。

Objective

To clarify the correlation between the triglyceride-glucose (TyG) index and endothelial dysfunction in an elderly community-based population, in order to provide new insights for the early prediction of cardiovascular diseases.

Methods

A cross-sectional study was conducted, enrolling 1648 elderly individuals with no prior history of cardiovascular disease. General demographic data, past medical history, physical examination findings, and laboratory test indicators were collected. The TyG index was calculated, and endothelial function was evaluated using the Reactive Hyperemia Index (RHI). Participants were divided into three groups (low, medium, and high) according to the tertiles of the TyG index. Pearson correlation analysis was performed to explore the correlation between the TyG index and clinical indicators. Logistic regression models were used to analyze the association between the TyG index and endothelial dysfunction, and stratified interaction tests were conducted to examine potential interaction effects.

Results

The TyG index in the endothelial dysfunction group was significantly higher than that of the normal group (P<0.05). With the increase of the TyG index, the detection rates of endothelial dysfunction were 41.0%, 45.4%, and 48.4%, respectively (χ2=6.117, P<0.05). Pearson correlation analysis showed that the TyG index was positively correlated with body mass index, total cholesterol, low-density lipoprotein cholesterol, systolic blood pressure, and diastolic blood pressure (all P<0.05), and negatively correlated with high-density lipoprotein cholesterol and RHI (both P<0.05). After adjusting for confounding factors, the risk of endothelial dysfunction in the high TyG index group was 1.43 times that in the low TyG index group (95% confidence interval: 1.09~1.87, P<0.05). Stratified analysis showed no interaction between the TyG index and hypertension, diabetes, or hyperlipidemia in terms of their effects on endothelial dysfunction (all P>0.05).

Conclusion

An elevated TyG index is significantly associated with endothelial dysfunction in elderly community populations. The TyG index can serve as a simple indicator for evaluating endothelial function and predicting the risk of cardiovascular diseases, providing a reference for the early prevention of cardiovascular diseases.

表1 血管内皮功能正常组和内皮功能障碍组老年社区人群的一般临床资料比较结果
项目 整体(1648例) 内皮功能正常组(908例) 内皮功能障碍组(740例) t/χ2/Z值 P
年龄(岁,
±s
60.1±6.7 59.8±6.7 60.5±6.7 4.841 0.028
性别[例(%)] 11.527 <0.001
男性 558(33.9) 275(30.3) 283(38.2)
女性 1090(66.1) 633(69.7) 457(61.8)
受教育程度[例(%)] 10.723 0.005
初中及以下学历 486(29.5) 245(27.0) 241(32.6)
高中或同等学历 756(45.9) 414(45.6) 342(46.2)
大学及以上学历 406(24.6) 249(27.4) 157(21.2)
吸烟状况[例(%)] 31.619 <0.001
从不吸烟 1201(72.9) 712(72.8) 489(66.1)
已戒烟 154(9.3) 70(7.7) 84(11.4)
目前仍吸烟 293(17.8) 126(13.9) 167(22.6)
饮酒状况[例(%)] 7.098 0.029
从不饮酒 1144(69.4) 651(71.7) 493(66.6)
已戒酒 53(3.2) 22(2.4) 31(4.2)
目前仍饮酒 451(27.4) 235(25.9) 216(29.2)
BMI(kg/m2
±s
25.1±3.3 24.9±3.1 25.3±3.6 4.231 0.040
收缩压(mmHg,
±s
125.1±15.6 126.3±15.6 123.6±15.4 12.177 <0.001
舒张压(mmHg,
±s
72.6±10.0 72.8±10.3 72.2±9.7 1.734 0.188
TC(mmol/L,
±s
5.31±1.07 5.35±1.06 5.25±1.09 3.578 0.059
TG(mmol/L,
±s
1.68±1.00 1.63±0.94 1.75±1.06 5.916 0.015
FBG(mmol/L,
±s
6.12±1.59 6.06±1.54 6.18±1.65 2.357 0.125
HDL-C(mmol/L,
±s
1.40±0.31 1.42±0.32 1.37±0.31 8.429 0.004
LDL-C(mmol/L,
±s
2.90±0.79 2.93±0.80 2.85±0.77 4.283 0.039
HbA1c(%,
±s
5.77±1.02 5.76±1.00 5.77±1.04 0.039 0.843
高血压[例(%)] 2.793 0.095
647(39.3) 340(37.4) 307(41.5)
1001(60.7) 568(62.6) 433(58.5)
糖尿病[例(%)] 1.336 0.248
318(19.3) 166(18.3) 152(20.5)
1330(80.7) 742(81.7) 588(79.5)
高脂血症[例(%)] 5.116 0.024
687(41.7) 356(39.2) 331(44.7)
961(58.3) 552(60.8) 409(55.3)
服药状况[例(%)] 1.954 0.162
545(33.1) 287(31.6) 258(34.9)
1103(66.9) 621(68.4) 482(65.1)
TyG index(
±s
8.86±0.57 8.82±0.56 8.90±0.58 7.642 0.006
RHI(
±s
1.88±0.59 2.27±0.51 1.41±0.19 1871.819 <0.001
表2 不同TyG index水平老年社区人群的临床资料比较结果
项目 低TyG index组(549例) 中TyG index组(549例) 高TyG index组(550例) F/χ2/H值 P
年龄(岁,
±s
59.5±7.2 60.8±6.3a 60.1±6.5 4.860 0.008
性别[例(%)] 0.942 0.624
男性 181(33.0) 182(33.2) 195(35.5)
女性 368(67.0) 367(66.8) 355(64.5)
受教育程度[例(%)] 8.160 0.086
初中及以下学历 146(26.6) 176(32.1) 164(29.8)
高中或同等学历 247(45.0) 247(45.0) 262(47.6)
大学及以上学历 156(28.4) 126(23.0) 124(22.5)
吸烟状况[例(%)] 5.011 0.286
从不吸烟 405(73.8) 413(75.2) 383(69.6)
已戒烟 50(9.1) 49(8.9) 55(10.0)
目前仍吸烟 94(17.1) 87(15.8) 112(20.4)
饮酒状况[例(%)] 7.118 0.130
从不饮酒 386(70.3) 397(72.3) 361(65.6)
已戒酒 20(3.6) 16(2.9) 17(3.1)
目前仍饮酒 143(26.0) 136(24.8) 172(31.3)
BMI(kg/m2
±s
24.0±3.1 25.5±3.4a 25.8±3.3a 50.122 <0.001
收缩压(mmHg,
±s
122.2±16.9 125.5±15.2a 127.6±14.0ab 17.031 <0.001
舒张压(mmHg,
±s
71.1±10.5 72.8±9.8a 73.7±9.6a 9.838 <0.001
TC(mmol/L,
±s
5.08±1.05 5.33±1.00a 5.51±1.12ab 23.462 <0.001
TG(mmol/L,
±s
0.93±0.20 1.47±0.28a 2.65±1.14ab 904.859 <0.001
FBG(mmol/L,
±s
5.44±0.69 5.94±1.12a 6.97±2.17ab 156.483 <0.001
HDL-C(mmol/L,
±s
1.52±0.32 1.40±0.29a 1.28±0.28ab 83.491 <0.001
LDL-C(mmol/L,
±s
2.65±0.70 2.91±0.75a 3.13±0.84ab 53.160 <0.001
HbA1c(%,
±s
5.40±0.66 5.68±0.87a 6.22±1.25ab 101.201 <0.001
高血压[例(%)] 23.229 <0.001
171(31.1) 232(42.3)a 244(44.4)a
378(68.9) 317(57.7) 306(55.6)
糖尿病[例(%)] 64.998 <0.001
63(11.5) 90(16.4)a 165(30.0)ab
486(88.5) 459(83.6) 385(70.0)
高脂血症[例(%)] 102.92 <0.001
157(28.6) 210(38.3)a 320(58.2)ab
392(71.4) 339(61.7) 230(41.8)
服药状况[例(%)] 27.716 <0.001
136(24.8) 193(35.2)a 216(39.3)a
413(75.2) 356(64.8) 334(60.7)
内皮功能障碍[例(%)] 6.117 0.047
225(41.0) 249(45.4) 266(48.4)a
324(59.0) 300(54.6) 284(51.6)
TyG index(
±s
8.27±0.22 8.81±0.13a 9.49±0.38ab 2939.096 <0.001
RHI(
±s
1.95±0.64 1.88±0.59 1.81±0.52ab 8.553 <0.001
表3 老年社区人群TyG index与各指标的相关性Pearson分析结果
表4 不同TyG index水平老年社区人群血管内皮功能障碍发生风险的logistic回归分析结果
表5 不同TyG index水平老年社区人群血管内皮功能障碍发生风险的亚组分析结果
1
Zhao D, Liu J, Wang M, et al. Epidemiology of cardiovascular disease in China: current features and implications [J]. Nat Rev Cardiol, 2019, 16(4):203-212.
2
Jiang M, Ren X, Han L, et al. Associations between sarcopenic obesity and risk of cardiovascular disease: a population-based cohort study among middle-aged and older adults using the Charls [J]. Clin Nutr, 2024, 43(3):796-802.
3
Wang X, He B. Endothelial dysfunction: molecular mechanisms and clinical implications [J]. MedComm (2020), 2024, 5(8): e651.
4
Rajai N, Toya T, Sara JD, et al. Prognostic value of peripheral endothelial function on major adverse cardiovascular events above traditional risk factors [J]. Eur J Prev Cardiol, 2023, 30(16): 1781-1788.
5
Koo BK, Chung WY, Moon MK. Peripheral arterial endothelial dysfunction predicts future cardiovascular events in diabetic patients with albuminuria: a prospective cohort study [J]. Cardiovasc Diabetol, 2020, 19(1): 82.
6
Hill MA, Yang Y, Zhang L, et al. Insulin resistance, cardiovascular stiffening and cardiovascular disease [J]. Metabolism, 2021, 119: 154766.
7
Liang S, Wang C, Zhang J, et al. Triglyceride-glucose index and coronary artery disease: a systematic review and meta-analysis of risk, severity, and prognosis [J]. Cardiovasc Diabetol, 2023, 22(1): 170.
8
Wu Z, Liu L, Wang W, et al. Triglyceride-glucose index in the prediction of adverse cardiovascular events in patients with premature coronary artery disease: a retrospective cohort study [J]. Cardiovasc Diabetol, 2022, 21(1): 142.
9
Sun YH, Hu NQ, Huang XY, et al. Central and peripheral blood pressures in relation to the triglyceride-glucose index in a Chinese population [J]. Cardiovasc Diabetol, 2024, 23(1): 3.
10
Li J, Dong Z, Wu H, et al. The triglyceride-glucose index is associated with atherosclerosis in patients with symptomatic coronary artery disease, regardless of diabetes mellitus and hyperlipidaemia [J]. Cardiovasc Diabetol, 2023, 22(1): 224.
11
Wang L, Cong HL, Zhang JX, et al. Triglyceride-glucose index predicts adverse cardiovascular events in patients with diabetes and acute coronary syndrome [J]. Cardiovasc Diabetol, 2020, 19(1): 80.
12
Wang L, Wang Y, Wang W, et al. Predictive value of triglyceride glucose index combined with neutrophil-to-lymphocyte ratio for major adverse cardiac events after PCI for acute ST-segment elevation myocardial infarction [J]. Sci Rep, 2024, 14(1): 12634.
13
Zhang W, Liu L, Chen H, et al. Association between the triglyceride-glucose index and the presence and prognosis of coronary microvascular dysfunction in patients with chronic coronary syndrome [J]. Cardiovasc Diabetol, 2023, 22(1): 113.
14
Hu R, Zhang Y, Qian W, et al. Pediococcus acidilactici promotes the longevity of C. elegans by regulating the Insulin/IGF-1 and JNK/MAPK signaling, fat accumulation and chloride Ion [J]. Front Nutr, 2022, 9: 821685.
15
Quan X, Zhang L, Li Y, et al. TCF2 attenuates FFA-induced damage in islet β-cells by regulating production of insulin and ROS [J]. Int J Mol Sci, 2014, 15(8):13317-13332.
16
Silva-Velasco DL, Hong E, Beltran-Ornelas JH, et al. Hydrogen sulfide ameliorates hypertension and vascular dysfunction induced by insulin resistance in rats by reducing oxidative stress and activating eNOS [J]. Eur J Pharmacol, 2024, 963: 176266.
17
Feng J, Luo H, Qiu Y, et al. Down-regulation of DDAH2 and eNOS induces endothelial dysfunction in sinoaortic-denervated rats [J]. Eur J Pharmacol, 2011, 661(1-3): 86-91.
18
Sáez T, Spaans F, Kirschenman R, et al. High-cholesterol diet during pregnancy induces maternal vascular dysfunction in mice: potential role for oxidized LDL-induced LOX-1 and AT1 receptor activation [J]. Clin Sci (Lond), 2020, 134(17): 2295-2313.
19
Miao R, Yu R, Zhou H, et al. Novel use of structural equation modelling to examine diet and metabolic traits associated with microvascular endothelial dysfunction in middle-aged Chinese males: a cross-sectional study [J]. BMJ Open, 2023, 13(9): e073357.
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