空腹甘油三酯血糖指数与原发性高血压患者动脉硬化的相关性研究

曾荣; 闫家富; 郑恪扬; 王佐广; 屈丰雪; 穆以瑶; 程文立

doi:10.16766/j.cnki.issn.1674-4152.002035

空腹甘油三酯血糖指数与原发性高血压患者动脉硬化的相关性研究

doi: 10.16766/j.cnki.issn.1674-4152.002035

1.
首都医科大学附属北京安贞医院高血压科，北京 100029
2.
首都医科大学附属北京安贞医院北京市心肺血管疾病研究所高血压研究室，北京 100029

基金项目:

国家自然科学基金项目 81370229

详细信息

通讯作者:
程文立，E-mail：chengwenli2000@163.com

中图分类号: R544.1 R543.5
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- 文章访问数: 194
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- 被引次数: 0
出版历程
- 收稿日期: 2021-04-13
- 网络出版日期: 2022-02-16

Relationship between fasting triglyceride glucose index and arteriosclerosis in patients with essential hypertension

1.
Department of Hypertension, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China

摘要

摘要: 目的研究不同空腹甘油三酯血糖(triglyceride glucose index，TyG)指数原发性高血压患者的动态血压及臂踝脉搏波速度(brachia-ankle pulse wave velocity，ba-PWV)情况，探讨TyG指数与ba-PWV的相关性。方法本研究为回顾性研究，连续选取2014年8月—2015年12月住院的原发性高血压患者466例。根据TyG指数分为低、中、高3组，比较不同组间的动态血压及ba-PWV差异，并利用多元线性回归模型分析ba-PWV的影响因素。结果随着TyG指数组别级数越大，患者中高脂血症及糖尿病的比率越高，BMI平均值越大，总胆固醇、甘油三酯、低密度脂蛋白胆固醇、尿酸及空腹血糖水平也逐渐升高。TyG指数高组24小时平均收缩压及舒张压显著高于低组[(132.3±14.8)mm Hg vs. (127.0±14.9)mm Hg, P=0.003；(81.1±11.8)mm Hg vs. (77.8±11.5)mm Hg，P=0.038]，TyG指数高组24 h平均心率显著高于低组(P=0.002)。TyG指数高组ba-PWV显著高于低组[(1 734.6±908.1) cm/s vs. (1 560.2±312.5) cm/s，P=0.022]。多元线性回归分析显示年龄、24小时平均收缩压及TyG指数是ba-PWV的影响因素。结论 TyG指数与血压、心率和ba-PWV正相关。TyG指数可在临床实践中用于预测动脉硬化情况。
- 空腹甘油三酯血糖指数 /
- 动脉硬化 /
- 臂踝脉搏波速度 /
- 原发性高血压 /
- 动态血压监测
Abstract: Objective To study the ambulatory blood pressure and brachial-ankle pulse wave velocity (ba-PWV) in essential hypertension patients with different fasting triglyceride glucose index (TyG index) groups, and to explore the correlation between TyG index and ba-PWV. Methods This retrospective study selected 466 inpatients with essential hypertension from August 2014 to December 2015. According to TyG index, the patients were divided into three groups by trisection. The differences of ambulatory blood pressure and ba-PWV among the three groups were compared, and the influencing factors of ba-PWV were analyzed by multiple linear regression model. Results With the increase of TyG index, the ratios of hyperlipidemia and diabetes of the patients raised, the average BMI increased, and the levels of total cholesterol, triglyceride, low density lipoprotein cholesterol, uric acid and fasting blood glucose evaluated gradually. The average systolic and diastolic blood pressure of 24 hours in the highest TyG index group were significantly higher than those in the lowest TyG index group [(132.3±14.8) mm Hg vs. (127.0±14.9) mm Hg, P=0.003; (81.1±11.8) mm Hg vs. (77.8±11.5) mm Hg, P=0.038], the average heart rate of 24 hours in the highest TyG index group was significantly higher than that in the lowest TyG index group (P=0.002). Ba-PWV was significantly higher in the highest TyG index group than that in the lowest TyG index group [(1 734.6±908.1) cm/s vs. (1 560.2±312.5) cm/s, P=0.022]. Multiple linear regression analysis showed that age, 24-hour systolic blood pressure and TyG index were the affecting factors of ba-PWV. Conclusion TyG index was positively correlated with blood pressure, heart rate and ba-PWV. It can be used to predict atherosclerosis in clinical practice.
- Fasting triglyceride glucose index /
- Arteriosclerosis /
- Brachial-ankle pulse wave velocity /
- Essential hypertension /
- Ambulatory blood pressure monitoring

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表 1 3组原发性高血压患者一般特征比较

组别	例数	男性[例(%)]	年龄(x±s，岁)	BMI(x±s)	2型糖尿病[例(%)]	高脂血症[例(%)]	吸烟史[例(%)]	饮酒史[例(%)]	血肌酐(x±s，μmol/L)
TyG指数低组	155	93(60.0)	53.8±15.2	25.9±3.6	30(19.4)	102(65.8)	50(32.3)	26(16.8)	72.5±22.1
TyG指数中组	155	100(64.5)	50.6±13.4	27.9±4.8^a	42(27.1)	126(81.3)^a	57(36.8)	33(21.3)	71.8±20.9
TyG指数高组	156	98(62.8)	51.7±12.5	28.2±3.3^a	61(39.1)^ab	147(94.2)^ab	73(46.8)^a	26(16.7)	70.8±23.8
F值		0.342	2.182	15.212	7.755	21.78	3.667	0.722	0.176
P值		0.71	0.114	< 0.001	< 0.001	< 0.001	0.026	0.486	0.839

组别	例数	总胆固醇(x±s，mmol/L)	甘油三酯(x±s，mmol/L)		低密度脂蛋白胆固醇(x±s，mmol/L)	血尿酸(x±s，μmol/L)		空腹血糖(x±s，mmol/L)	糖化血红蛋白(x±s，%)
TyG指数低组	155	4.2±1.0	1.0±0.8		2.6±0.7	331.0±112.4		5.3±0.8	5.8±0.8
TyG指数中组	155	4.6±1.0^a	1.7±0.9^a		2.9±0.8^a	371.4±131.1^a		5.6±0.9	6.4±1.6
TyG指数高组	156	5.1±1.3^ab	3.8±3.4^ab		2.9±1.0^a	397.9±133.7^a		6.5±2.0^ab	6.6±6.3
F值		23.113	76.682		9.078	10.94		35.867	1.02
P值		< 0.001	< 0.001		< 0.001	< 0.001		< 0.001	0.362
注：与TyG指数低组比较，^aP < 0.05；与TyG指数中组比较，^bP < 0.05。

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表 2 3组原发性高血压患者动态血压及ba-PWV比较(x ±s)

组别	例数	24小时平均收缩压(mm Hg)	24小时平均舒张压(mm Hg)	24小时平均心率(次/min)	日间平均收缩压(mm Hg)	日间平均舒张压(mm Hg)	日间平均心率(次/min)
TyG指数低组	155	127.0±14.9	77.8±11.5	66.7±8.6	129.2±15.0	79.6±11.6	69.7±9.5
TyG指数中组	155	129.5±14.2	80.6±12.4	68.8±9.0	131.6±14.4	82.7±12.6	71.7±9.8
TyG指数高组	156	132.3±14.8^a	81.1±11.8^a	70.1±9.6^a	133.7±14.4^a	82.9±11.9^a	73.0±10.4^a
F值		5.266	3.494	5.736	3.742	3.546	4.378
P值		0.005	0.031	0.003	0.024	0.03	0.013

组别	例数	夜间平均收缩压(mm Hg)	夜间平均舒张压(mm Hg)	夜间平均心率(次/min)	收缩压夜间下降率(%)	舒张压夜间下降率(%)	ba-PWV(cm/s)
TyG指数低组	155	122.8±16.6	73.9±12.1	60.6±8.2	4.9±8.0	7.0±8.1	1 560.2±312.5
TyG指数中组	155	125.5±16.8	76.5±13.5	62.8±8.4	4.8±8.1	7.5±8.4	1 590.3±292.0
TyG指数高组	156	129.0±17.8^a	77.6±12.6^a	64.5±9.6^a	3.7±8.0	6.2±7.4	1 734.6±908.1^a
F值		5.082	3.472	7.871	0.963	1.017	4.014
P值		0.007	0.032	< 0.001	0.382	0.363	0.019
注：与TyG指数低组比较，^aP < 0.05。1 mm Hg=0.133 kPa。

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表 3 影响ba-PWV的多元线性回归分析结果

因素	B	B'	SE	t值	P值
年龄	12.482	0.295	1.224	10.200	< 0.001
24小时平均收缩压	7.704	0.193	1.248	6.170	< 0.001
TyG指数	54.826	0.082	17.862	3.070	0.002
注：年龄、24小时平均收缩压、TyG指数均以实际值赋值。

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