甘油三酯–葡萄糖指数在心血管风险分层中的动态演进与临床应用背景

Dynamic Evolution and Clinical Application of the Triglyceride‑Glucose Index in Cardiovascular Risk Stratification

摘要: 甘油三酯–葡萄糖(triglyceride-glucose, TyG)指数作为评估胰岛素抵抗的简便指标，近年来在心血管风险分层领域引发了持续关注。传统的风险评估模型在面对代谢紊乱人群时，其预测效能往往有所欠缺，而TyG指数恰好凭借其数据易获取、计算简便的特点，在一定程度上弥补了这一短板。本文旨在系统梳理TyG指数从静态标志物向动态轨迹评估的演进脉络，重点探讨其在心血管风险中的动态关联机制、临床转化价值，以及未来可能的发展走向。现有证据表明，相较于单次测量结果，TyG指数的长期累积负荷、波动幅度及其变化轨迹，往往能更准确地反映出心血管事件的发生风险。基于动态分型所构建的闭环管理策略，有望推动心血管疾病的预防策略从群体化指南向个体化决策转变，为精准干预开辟出新的思路。

Abstract: The triglyceride-glucose (TyG) index, a simple surrogate marker of insulin resistance, has attracted sustained attention in cardiovascular risk stratification in recent years. Traditional risk assessment models often show limited predictive performance in populations with metabolic disorders. By contrast, the TyG index, with its readily available components and straightforward calculation, partially overcomes this limitation. This review systematically outlines the evolutionary trajectory of the TyG index from a static biomarker to a dynamic trajectory‑based assessment tool. We focus on its dynamic association with cardiovascular risk, clinical translational value, and future research directions. Accumulating evidence indicates that, compared with a single measurement, the long-term cumulative burden, variability, and trajectory of the TyG index can more accurately predict cardiovascular events. A closed-loop management strategy based on dynamic phenotyping shows potential to shift cardiovascular prevention from population‑based guidelines toward individualized decision-making, thereby opening new avenues for precision cardiovascular intervention.