| 修倩茹,于皓南,程国杰.甘油三酯 -葡萄糖指数与阵发性心房颤动病人预后的关联:一项前瞻性队列研究[J].安徽医药,2026,30(4):800-805. |
| 甘油三酯 -葡萄糖指数与阵发性心房颤动病人预后的关联:一项前瞻性队列研究 |
| Association between triglyceride-glucose index and prognosis in patients with paroxysmal atrial fibrillation: a prospective cohort study |
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| DOI：10.3969/j.issn.1009-6469.2026.04.032 |
| 中文关键词: 心房颤动 高甘油三酯血症 血糖 前瞻性研究 TyG指数 危险因素 主要不良心脑血管事件 预后 |
| 英文关键词: Atrial fibrillation Hypertriglyceridemial Blood glucose Prospective study TyG index Risk factors Major adverse cardiac and cerebrovascular events Prognosi |
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| 中文摘要: |
| 目的探讨甘油三酯 -葡萄糖( the triglyceride-glucose，TyG)指数与阵发性心房颤动( atrial fibrillation，AF)病人心律失常转归的关联。方法这项前瞻性研究纳入 2020年 12月至 2023年 6月在北京市大兴区人民医院住院的阵发性 AF病人，随访截止时间为 2024年 10月 1日。主要结局是阵发性 AF在随访期间是否转化为持续性 AF。使用限制性立方样条( re-stricted cubic spline，RCS)评估 TyG指数与阵发性 AF病人与心律失常转归的相关性。使用逻辑回归链接的广义线模型评估不同区间的 TyG指数对应预后的效应，计算比值比( odds ratio，OR)和对应的置信区间( confidence interval，CI)。计算 E值以评估未测量的混杂因素对结局的影响。结果最终纳入 286例阵发性 AF病人，其中 122例( 42.66%)阵发性 AF病人最终转变为持续性 AF。RCS模型表明 TyG指数与阵发性 AF病人的心律失常转归存在非线性关联( P for overall<0.05，P for lineari-ty<0.05)。二次项系数检验和 U型检验的结果提示两者属于 U型关联( U-test P<0.01)。以 TyG指数等于 9作为阈值点，TyG指数 <9.00时［ OR:0.36，95%CI:(0.16，0.80)，P<0.05］，即阵发性 AF转变为持续性 AF的风险随着 TyG指数的升高而下当降；当 TyG指数 ≥9.00时［ OR:3.49，95%CI:(1.11，10.93)P<0.05］即阵发性 AF转变为持续性 AF的风险随着 TyG指数的升高而上升。结论 TyG指数与AF人群的心律失常类型转归，有关，，过高或过低的 TyG指数会增加阵发性 AF转变为持续性 AF |
| 英文摘要: |
| Objective To investigate the association between the triglyceride-glucose (TyG) index and the arrhythmia progression in patients with paroxysmal atrial fibrillation (AF).Methods This prospective study enrolled patients with paroxysmal AF admitted to theDepartment of Cardiovascular Medicine at Beijing Daxing District People's Hospital from December 2020 to June 2023, with follow-up concluding on 1 October 2024. The primary outcome was the progression from paroxysmal AF to persistent AF during the follow-up pe-riod. Restricted cubic spline (RCS) analysis was used to assess the correlation between the TyG index and arrhythmia progression inparoxysmal AF patients. Quadratic coefficient testing and U-shaped tests were employed to evaluate potential U-shaped associationsand identify threshold points. A generalized linear model with logistic regression links was used to assess the effect of different TyG in-dex intervals on the prognosis, calculating the odds ratio (OR) and corresponding confidence intervals (CI). The E-value was calculated to evaluate the minimum strength of the unmeasured confounding factors associated with the outcome.Results In this study, a total of286 patients with paroxysmal AF were ultimately included, of which 122 patients (42.66%) with paroxysmal AF progressed to persistentAF. The RCS model revealed a non-linear association between the TyG index and the arrhythmia transition in patients with paroxysmal AF (P for overall<0.05, P for linearity<0.05). The results of the quadratic term coefficient test and U-shaped test indicated a U-shaped relationship between them (u-test P<0.01). Using a TyG index threshold of 9, when the TyG index was <9.00 [OR:0.36, 95%CI: (0.16, 0.80), P<0.05], the risk of transitioning from paroxysmal AF to persistent AF decreased with increasing TyG index. Conversely, whenthe TyG index was ≥9.00 [OR:3.49, 95%CI: (1.11, 10.93), P<0.05], the risk of transitioning from paroxysmal AF to persistent AF in-creased with rising TyG index.Conclusion The TyG index is associated with the arrhythmia progression in AF patients, where bothhigh and low TyG index levels increase the risk of conversion from paroxysmal AF to persistent AF. |
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