甘油三酯葡萄糖指数与24 h动态血压的关联

The association between triglyceride glucose index and 24-hour ambulatory blood pressure

    摘要
  • 摘要:
    目的 探讨甘油三酯葡萄糖指数（TyG指数）与24 h动态血压的关联。
    方法 采用横断面研究方法，选取在2006—2020年期间完成开滦研究健康体检，接受24 h动态血压监测（24hABPM）的观察对象6606例。将观察对象按TyG指数四分位数分为第1四分位组（n = 1651）、第2四分位组（n = 1652）、第3四分位组（n = 1652）、第4四分位组（n = 1651），采用广义线性模型分析观察对象TyG指数与24 h动态血压的关联，采用限制性立方样条图探讨TyG指数与24 h动态血压参数之间的剂量-反应关系，并根据观察对象是否患高血压和性别进行分层分析。
    结果 在符合纳入标准的6606例观察对象中，男性4841例（73.30%），平均年龄为（61.55±11.13）岁，平均TyG指数为8.87±0.72。在校正年龄、性别、吸烟、饮酒、受教育程度、超敏C反应蛋白、估算的肾小球滤过率、低密度脂蛋白胆固醇、打鼾、糖尿病、体育锻炼情况、体重指数、服用降压药、服用降糖药和服用降脂药后，广义线性模型结果显示：以TyG指数第1四分位组为参照，第4四分位组的24 h收缩压（24hSBP）、24 h舒张压（24hDBP）、日间收缩压（dSBP）、日间舒张压（dDBP）和夜间收缩压（nSBP）分别增加2.06 （0.86～3.26）、0.88 （0.13～1.64）、2.01 （0.78～3.23）、0.89 （0.12～1.66）和2.20 （0.86～3.54）mmHg（均P＜0.05）。TyG指数每增加一个单位，24hSBP、24hDBP、dSBP、dDBP、nSBP和夜间舒张压（nDBP）分别增加1.31 （0.71～1.91）、0.61 （0.23～0.98）、1.30 （0.69～1.91）、0.63 （0.24～1.01）、1.29 （0.62～1.95）和0.52 （0.11～0.94）mmHg（均P＜0.05）。限制性立方样条图显示，TyG指数与24 h动态血压各项参数之间均呈线性正相关（P总体＜0.01；P非线性＞0.05）。分层分析结果显示：在非高血压人群中，以TyG指数第1四分位组为参照，第4四分位组24hSBP、24hDBP、dSBP、dDBP和nSBP分别增加3.24 （1.41～5.06）、1.33 （0.20～2.46）、3.42 （1.57～5.28）、1.50 （0.35～2.66）和2.47 （0.48～4.45）mmHg（均P＜0.05）；在高血压人群中，TyG指数第1四分位组与第4四分位组24 h动态血压参数差异无统计学意义（均P＞0.05）；在女性人群中，以TyG指数第1四分位组为参照，第4四分位组的dSBP增加2.49 （0.14～4.85）mmHg（P＜0.05）；在男性人群中，以TyG指数第1四分位组为参照，第4四分位组的24hSBP、dSBP和nSBP分别增加1.70 （0.27～3.14）、1.51 （0.06～2.97）和2.35 （0.75～3.95）mmHg（均P＜0.05）。
    结论 在非高血压人群中，TyG指数与24hSBP、24hDBP、dSBP、dDBP和nSBP呈正向关联；在男性人群中，TyG指数与24hSBP、dSBP和nSBP呈正向关联。

     

    Abstract:
    Objective To investigate the association between triglyceride glucose index (TyG index) and 24-hour ambulatory blood pressure.
    Methods A total of 6606 participants in Kailuan Study who completed the health examination and received 24-hour ambulatory blood pressure monitoring (24hABPM) from 2006 to 2020 were included in this cross-sectional study. The subjects were divided into Q1 group (n = 1651), Q2 group (n = 1652), Q3 group (n = 1652) and Q4 group (n = 1651) according to the quartile of TyG index. The generalized linear model was used to analyze the association between TyG index and 24 h ambulatory blood pressure in different groups. Restricted cubic spline plots were used to explore the dose-response relationship between TyG index and 24hABPM parameters. Stratified analysis was performed according to whether the subjects had hypertension and gender.
    Results Among 6606 subjects who met the inclusion criteria, 4841 (73.30%) were male, the mean age was (61.55±11.13) years, and the mean TyG index was 8.87±0.72. After adjusting for age, gender, smoking, drinking, education, high-sensitivity C-reactive protein, estimated glomerular filtration rate, low-density lipoprotein cholesterol, snoring, diabetes, physical activity, body mass index, taking antihypertensive drugs, taking antidiabetic drugs, and taking lipid-lowering drugs, generalized linear models showed that 24-hour systolic blood pressure (24hSBP), 24-hour diastolic blood pressure (24hDBP), daytime systolic blood pressure (dSBP), daytime diastolic blood pressure (dDBP) and nighttime systolic blood pressure (nSBP) increased by 2.06 (0.86–3.26), 0.88 (0.13–1.64), 2.01 (0.78–3.23), 0.89 (0.12–1.66), 2.20 (0.86–3.54) mmHg, respectively in Q4 group compared with Q1 group (all P＜0.05). For each unit increase in TyG index, 24hSBP, 24hDBP, dSBP, dDBP, nSBP, nighttime diastolic blood pressure (nDBP) increased by 1.31 (0.71–1.91), 0.61 (0.23–0.98), 1.30 (0.69–1.91), 0.63 (0.24–1.01), 1.29 (0.62–1.95), and 0.52 (0.11–0.94) mmHg, respectively (all P＜0.05). The restricted cubic spline plots analysis showed that there was a positive linear correlation between TyG index and 24hABPM parameters (Poverall＜0.01, Pnon-linear ＞ 0.05). The results of stratified analysis showed that in the non-hypertensive population, 24hSBP, 24hDBP, dSBP, dDBP, and nSBP in the Q4 group increased by 3.24 (1.41–5.06), 1.33 (0.20–2.46), 3.42 (1.57–5.28), 1.50 (0.35–2.66), and 2.47 (0.48–4.45) mmHg, respectively, compared with Q1 group (all P＜0.05). There was no significant difference in 24hABPM parameters between the Q1 group and Q4 group in hypertensive patients (all P ＞ 0.05). In the female population, compared with the Q1 group, the dSBP of the Q4 group increased by 2.49 (0.14–4.85) mmHg (P＜0.05). In the male population, compared with the Q1 group, 24hSBP, dSBP and nSBP in the Q4 group increased by 1.70 (0.27–3.14), 1.51 (0.06–2.97) and 2.35 (0.75–3.95) mmHg, respectively (all P＜0.05).
    Conclusions In non-hypertensive subjects, TyG index is positively correlated with 24hSBP, 24hDBP, dSBP, dDBP and nSBP. In male population, TyG index is positively correlated with 24hSBP, dSBP and nSBP.

     

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