甘油三酯葡萄糖指数与冠状动脉粥样硬化性心脏病关系的研究进展

王烁珊; 吴敬国; 荆小莉; 张永威; 唐皓

doi:10.16766/j.cnki.issn.1674-4152.001972

甘油三酯葡萄糖指数与冠状动脉粥样硬化性心脏病关系的研究进展

doi: 10.16766/j.cnki.issn.1674-4152.001972

中山大学附属第一医院全科医学规培基地，广东广州 510000

基金项目:

国家自然科学基金 81372022

详细信息

通讯作者:
荆小莉，E-mail: jingxl@mail.sysu.edu.cn

中图分类号: R541.4 R446
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- 被引次数: 0
出版历程
- 收稿日期: 2020-07-12
- 网络出版日期: 2022-02-16

Research progress of triglyceride glucose index in coronary atherosclerotic heart disease

Department of General Medicine, the First Affiliated Hospital, Sun Yat Sen University, Guangzhou, Guangdong 510000, China

摘要

摘要: 冠状动脉粥样硬化性心脏病(冠心病)迄今为止仍然是威胁人类健康的主要疾病之一。随着生活水平的改善，胰岛素抵抗发病率越来越高，胰岛素抵抗状态与冠心病发生及发展中的病理生理过程有着密切的关系，研究两者之间的内在关系对于冠心病的早期预防、治疗及随访至关重要。传统的胰岛素抵抗检测方法操作过程复杂、耗时，价格昂贵，不适合在社区医院开展，更无法在大规模人群中推广。近几年，甘油三酯葡萄糖指数(triglyceride-glucose index，TyG)作为一项简单的胰岛素抵抗替代标志物逐渐被重视。目前，有许多研究证实TyG指数反映胰岛素抵抗能力与传统胰岛素抵抗指标相比，具有可靠、高效及简便的特点。关于TyG指数与冠心病之间的研究层出不穷，有较多研究发现TyG指数升高与冠心病患者冠状动脉病变严重程度及不良心血管预后具有正相关性。本文归纳总结胰岛素抵抗状态与冠心病的发病及进展关系，胰岛素抵抗检测项目的研究进展及新型胰岛素抵抗指标——TyG指数与冠心病之间的关系。旨在提高基层医师对该指标的认识，并为社区全科医师利用这项指标提供更多的理论依据。期望未来社区医生可利用TyG指数这一项简单的标志物，做好冠心病高危人群的筛查及随访工作，降低冠心病的发病率和死亡率。
- 冠心病 /
- 胰岛素抵抗 /
- 甘油三酯葡萄糖指数
Abstract: Coronary heart disease (CHD) is still one of the main diseases threatening human health. With the development of economy, and the improvement of our living standards, the incidence of insulin resistance is increasing. Insulin resistance is closely related to the occurrence and development of CHD. The study of the internal relationship between insulin resistance and the pathophysiological process of CHD is of great importance for the early prevention, treatment and follow-up of CHD. The traditional testing method for insulin resistance is complicated, time-consuming and expensive, so it is not suitable to be carried out in community hospitals, cannot be promoted in large-scale populations. In recent years, triglyceride-glucose index (TyG index) as a simple insulin resistance replacement index has been paid more and more attentions. At present, many studies have confirmed that TyG index response insulin resistance is reliable, efficient and simple compared with traditional indicators of insulin resistance. Many studies have found that elevated TyG index is positively correlated with the severity of CHD and poor cardiovascular prognosis. This paper summarizes the relationship between insulin resistance and CHD, the research progress of insulin resistance detection index, and the relationship between TyG index and CHD. This article aims to improve the understanding of TyG index by general practitioners and provide more theoretical basis for them to use this insulin resistance indicator. We hope that we can use the simple marker of TyG index in the screening coronary heart disease risk groups and follow-up work for CHD, and reduce the incidence rate and mortality of CHD.
- Coronary atherosclerotic heart disease /
- Insulin resistance /
- Triglyceride glucose index

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参考文献(40)

[1]	TOWNSEND N, WILSON L, BHATNAGAR P, et al. Cardiovascular disease in Europe: epidemiological update 2016[J]. Eur Heart J, 2016, 37(42): 3232-3245. doi: 10.1093/eurheartj/ehw334
[2]	北京高血压防治协会, 北京糖尿病防治协会, 北京慢性病防治与健康教育研究会, 等. 基层心血管病综合管理实践指南2020[J]. 中国医学前沿杂志(电子版), 2020, 12(8): 1-73. https://www.cnki.com.cn/Article/CJFDTOTAL-YXQY202008002.htm
[3]	胡盛寿, 高润霖, 刘力生, 等. 《中国心血管病报告2018》概要[J]. 中国循环杂志, 2019, 34(3): 209-220. doi: 10.3969/j.issn.1000-3614.2019.03.001
[4]	ORMAZABAL V, NAIR S, ELFEKY O, et al. Association between insulin resistance and the development of cardiovascular disease[J]. Cardiovasc Diabetol, 2018, 17(1): 122. doi: 10.1186/s12933-018-0762-4
[5]	DI PINO A, DEFRONZO R A. Insulin resistance and atherosclerosis: implications for insulin-sensitizing agents[J]. Endocr Rev, 2019, 40(6): 1447-1467. doi: 10.1210/er.2018-00141
[6]	ADEVA-ANDANY M M, AMENEIROS-RODRÍGUEZ E, FERNÁNDEZ-FERNÁNDEZ C, et al. Insulin resistance is associated with subclinical vascular disease in humans[J]. World J Diabetes, 2019, 10(2): 63-77. doi: 10.4239/wjd.v10.i2.63
[7]	HARI KUMAR K V S. The good, the bad, and the ugly facets of insulin resistance[J]. Med J Armed Forces India, 2020, 76(1): 4-7. doi: 10.1016/j.mjafi.2019.07.001
[8]	AKOUMIANAKIS I, ANTONIADES C. Impaired vascular redox signaling in the vascular complications of obesity and diabetes mellitus[J]. Antioxid Redox Signal, 2019, 30(3): 333-353. doi: 10.1089/ars.2017.7421
[9]	CHEN W, WANG S, LV W, et al. Causal associations of insulin resistance with coronary artery disease and ischemic stroke: a Mendelian randomization analysis[J]. BMJ Open Diabetes Res Care, 2020, 8(1): e001217. doi: 10.1136/bmjdrc-2020-001217
[10]	DEFRONZO R A, TOBIN J D, ANDRES R. Glucose clamp technique: a method for quantifying insulin secretion and resistance[J]. Am J Physiol, 1979, 237(3): E214-E223. http://pdfs.semanticscholar.org/b451/a01e4fd7b523374eaa94de032e2d1f5574ed.pdf
[11]	MATTHEWS D R, HOSKER J P, RUDENSKI A S, et al. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man[J]. Diabetologia, 1985, 28(7): 412-419. doi: 10.1007/BF00280883
[12]	SO A, SAKAGUCHI K, OKADA Y, et al. Relation between HOMA-IR and insulin sensitivity index determined by hyperinsulinemic-euglycemic clamp analysis during treatment with a sodium-glucose cotransporter 2 inhibitor[J]. Endocr J, 2020, 67(5): 501-507. doi: 10.1507/endocrj.EJ19-0445
[13]	MOHD NOR N S, LEE S, BACHA F, et al. Triglyceride glucose index as a surrogate measure of insulin sensitivity in obese adolescents with normoglycemia, prediabetes, and type 2 diabetes mellitus: comparison with the hyperinsulinemic-euglycemic clamp[J]. Pediatr Diabetes, 2016, 17(6): 458-465. doi: 10.1111/pedi.12303
[14]	CHAMROONKIADTIKUN P, ANANCHAISARP T, WANICHANON W. The triglyceride-glucose index, a predictor of type 2 diabetes development: A retrospective cohort study[J]. Prim Care Diabetes, 2020, 14(2): 161-167. doi: 10.1016/j.pcd.2019.08.004
[15]	GUERRERO-ROMERO F, VILLALOBOS-MOLINA R, JIMÉNEZ-FLORES J R, et al. Fasting triglycerides and glucose index as a diagnostic test for insulin resistance in young adults[J]. Arch Med Res, 2016, 47(5): 382-387. doi: 10.1016/j.arcmed.2016.08.012
[16]	NAVARRO-GONZÁLEZ D, SÁNCHEZ-ÍÑIGO L, PASTRANA-DELGADO J, et al. Triglyceride-glucose index (TyG index) in comparison with fasting plasma glucose improved diabetes prediction in patients with normal fasting glucose: The Vascular-Metabolic CUN cohort[J]. Prev Med, 2016, 86: 99-105. doi: 10.1016/j.ypmed.2016.01.022
[17]	LOW S, KHOO K C J, IRWAN B, et al. The role of triglyceride glucose index in development of Type 2 diabetes mellitus[J]. Diabetes Res Clin Pract, 2018, 143: 43-49. doi: 10.1016/j.diabres.2018.06.006
[18]	LEE D Y, LEE E S, KIM J H, et al. Predictive value of triglyceride glucose index for the risk of incident diabetes: A 4-Year retrospective longitudinal study[J]. PLoS One, 2016, 11(9): e0163465. doi: 10.1371/journal.pone.0163465
[19]	ZHANG M, WANG B, LIU Y, et al. Cumulative increased risk of incident type 2 diabetes mellitus with increasing triglyceride glucose index in normal-weight people: The Rural Chinese Cohort Study[J]. Cardiovasc Diabetol, 2017, 16(1): 30. doi: 10.1186/s12933-017-0514-x
[20]	LAMBRINOUDAKI I, KAZANI M V, ARMENI E, et al. The TyG index as a marker of subclinical atherosclerosis and arterial stiffness in lean and overweight postmenopausal women[J]. Heart Lung Circ, 2018, 27(6): 716-724. doi: 10.1016/j.hlc.2017.05.142
[21]	LEE S B, AHN C W, LEE B K, et al. Association between triglyceride glucose index and arterial stiffness in Korean adults[J]. Cardiovasc Diabetol, 2018, 17(1): 41. doi: 10.1186/s12933-018-0692-1
[22]	殷为勇, 王香云, 肖美娟, 等. 甘油三酯葡萄糖指数与颅内动脉粥样硬化性狭窄的研究[J]. 中国现代医生, 2016, 54(4): 12-14, 18. https://www.cnki.com.cn/Article/CJFDTOTAL-ZDYS201604005.htm
[23]	SÁNCHEZ-ÍÑIGO L, NAVARRO-GONZÁLEZ D, FERNÁNDEZ-MONTERO A, et al. The TyG index may predict the development of cardiovascular events[J]. Eur J Clin Invest, 2016, 46(2): 189-197. doi: 10.1111/eci.12583
[24]	REARDON C A, LINGARAJU A, SCHOENFELT K Q, et al. Obesity and insulin resistance promote atherosclerosis through an IFNgamma-Regulated macrophage protein network[J]. Cell Rep, 2018, 23(10): 3021-3030. doi: 10.1016/j.celrep.2018.05.010
[25]	WON K B, KIM Y S, LEE B K, et al. The relationship of insulin resistance estimated by triglyceride glucose index and coronary plaque characteristics[J]. Medicine(Baltimore), 2018, 97(21): e10726. http://www.onacademic.com/detail/journal_1000040459176610_8ed1.html
[26]	KIM M K, AHN C W, KANG S, et al. Relationship between the triglyceride glucose index and coronary artery calcification in Korean adults[J]. Cardiovasc Diabetol, 2017, 16(1): 108. doi: 10.1186/s12933-017-0589-4
[27]	PARK K, AHN C W, LEE S B, et al. Elevated TyG index predicts progression of coronary artery calcification[J]. Diabetes Care, 2019, 42(8): 1569-1573. doi: 10.2337/dc18-1920
[28]	F PIEPOLI M. 2016 European Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts)[J]. Int J Behav Med, 2017, 24(3): 321-419. doi: 10.1007/s12529-016-9583-6
[29]	PARK G M, CHO Y R, WON K B, et al. Triglyceride glucose index is a useful marker for predicting subclinical coronary artery disease in the absence of traditional risk factors[J]. Lipids Health Dis, 2020, 19(1): 7. doi: 10.1186/s12944-020-1187-0
[30]	LI S, GUO B, CHEN H, et al. The role of the triglyceride (triacylglycerol) glucose index in the development of cardiovascular events: a retrospective cohort analysis[J]. Sci Rep, 2019, 9(1): 7320. doi: 10.1038/s41598-019-43776-5
[31]	MAO Q, ZHOU D, LI Y, et al. The triglyceride-glucose index predicts coronary artery disease severity and cardiovascular outcomes in patients with non-ST-segment elevation acute coronary syndrome[J]. Dis Markers, 2019, 2019: 6891537. http://www.ncbi.nlm.nih.gov/pubmed/31281548
[32]	JIN J L, SUN D, CAO Y X, et al. Triglyceride glucose and haemoglobin glycation index for predicting outcomes in diabetes patients with new-onset, stable coronary artery disease: a nested case-control study[J]. Ann Med, 2018, 50(7): 576-586. doi: 10.1080/07853890.2018.1523549
[33]	MA X, DONG L, SHAO Q, et al. Triglyceride glucose index for predicting cardiovascular outcomes after percutaneous coronary intervention in patients with type 2 diabetes mellitus and acute coronary syndrome[J]. Cardiovasc Diabetol, 2020, 19(1): 31. doi: 10.1186/s12933-020-01006-7
[34]	LUO E, WANG D, YAN G, et al. High triglyceride-glucose index is associated with poor prognosis in patients with acute ST-elevation myocardial infarction after percutaneous coronary intervention[J]. Cardiovasc Diabetol, 2019, 18(1): 150. doi: 10.1186/s12933-019-0957-3
[35]	DA SILVA A A, DO CARMO J M, LI X, et al. Role of hyperinsulinemia and insulin resistance in hypertension: metabolic syndrome revisited[J]. Can J Cardiol, 2020, 36(5): 671-682. doi: 10.1016/j.cjca.2020.02.066
[36]	ZAMORA M, VILLENA J A. Contribution of impaired insulin signaling to the pathogenesis of diabetic cardiomyopathy[J]. Int J Mol Sci, 2019, 20(11): 2833. doi: 10.3390/ijms20112833
[37]	KAUR R, KAUR M, SINGH J. Endothelial dysfunction and platelet hyperactivity in type 2 diabetes mellitus: molecular insights and therapeutic strategies[J]. Cardiovasc Diabetol, 2018, 17(1): 121. doi: 10.1186/s12933-018-0763-3
[38]	GAIZ A, MOSAWY S, COLSON N, et al. Thrombotic and cardiovascular risks in type two diabetes; Role of platelet hyperactivity[J]. Biomed Pharmacother, 2017, 94: 679-686. doi: 10.1016/j.biopha.2017.07.121
[39]	REAVEN G M, KNOWLES J W, LEONARD D, et al. Relationship between simple markers of insulin resistance and coronary artery calcification[J]. J Clin Lipidol, 2017, 11(4): 1007-1012. doi: 10.1016/j.jacl.2017.05.013
[40]	SÁNCHEZ-GARCÍA A, RODRÍGUEZ-GUTIÉRREZ R, MANCILLAS-ADAME L, et al. Diagnostic accuracy of the triglyceride and glucose index for insulin resistance: a systematic review[J]. Int J Endocrinol, 2020, 2020: 4678526. http://www.researchgate.net/publication/339842433_Diagnostic_Accuracy_of_the_Triglyceride_and_Glucose_Index_for_Insulin_Resistance_A_Systematic_Review