TyG指数、TG/HDL-C比值与缺血性脑卒中患者神经功能相关性的研究进展
Research Progress on the Correlation between TyG Index, TG/HDL-C Ratio and Neurological Function in Patients with Ischemic Stroke
DOI: 10.12677/acm.2024.1482349, PDF,   
作者: 姜 珊, 袁 薇, 刁德敦, 吕雪雯:延安大学医学院,陕西 延安;王丙聚*:延安大学咸阳医院神经内科,陕西 延安;吴文宇:榆林市第一医院心血管内科,陕西 榆林
关键词: 脑卒中胰岛素抵抗空腹葡萄糖甘油三酯高密度脂蛋白胆固醇Stroke Insulin Resistance Fasting Plasma Glucose Triglyceride High Density Lipoprotein Cholesterol
摘要: 脑卒中是全球范围内死亡和残疾的主要原因之一,胰岛素抵抗参与脑卒中的多种病理机制,研究胰岛素替代指标与脑卒中的关系,对于早期识别高风险人群及疾病预后有重要的意义。本文系统地总结了TyG指数、TG/HDL-C比值与各个系统性疾病尤其是卒中的发生、发展及预后的关系研究,探讨二者对脑卒中患者发生早期神经功能恶化的预测价值,以便更好地指导卒中患者的预防。
Abstract: Stroke is one of the major causes of death and disability worldwide. Insulin resistance is involved in various pathologic mechanisms of stroke. Studying the relationship between insulin replacement indicators and stroke is of great significance for the early identification of high-risk groups and disease prognosis. This paper systematically summarized the studies on the relationship between TyG index, TG/HDL-C ratio and the occurrence, development and prognosis of various systemic diseases, especially stroke, and explored the predictive value of the two on the early neurological deterioration in stroke patients, so as to better guide the prevention of stroke patients.
文章引用:姜珊, 王丙聚, 袁薇, 刁德敦, 吕雪雯, 吴文宇. TyG指数、TG/HDL-C比值与缺血性脑卒中患者神经功能相关性的研究进展[J]. 临床医学进展, 2024, 14(8): 1268-1276. https://doi.org/10.12677/acm.2024.1482349

参考文献

[1] Guo, W., Zhu, W., Wu, J., Li, X., Lu, J., Qin, P., et al. (2021) Triglyceride Glucose Index Is Associated with Arterial Stiffness and 10-Year Cardiovascular Disease Risk in a Chinese Population. Frontiers in Cardiovascular Medicine, 8, Article 585776. [Google Scholar] [CrossRef] [PubMed]
[2] Barthels, D. and Das, H. (2020) Current Advances in Ischemic Stroke Research and Therapies. Biochimica et Biophysica Acta (BBA)—Molecular Basis of Disease, 1866, Article 165260. [Google Scholar] [CrossRef] [PubMed]
[3] Ormazabal, V., Nair, S., Elfeky, O., Aguayo, C., Salomon, C. and Zuñiga, F.A. (2018) Association between Insulin Resistance and the Development of Cardiovascular Disease. Cardiovascular Diabetology, 17, Article No. 122. [Google Scholar] [CrossRef] [PubMed]
[4] Bressler, P., Bailey, S.R., Matsuda, M. and DeFronzo, R.A. (1996) Insulin Resistance and Coronary Artery Disease. Diabetologia, 39, 1345-1350. [Google Scholar] [CrossRef] [PubMed]
[5] Di Pino, A. and DeFronzo, R.A. (2019) Insulin Resistance and Atherosclerosis: Implications for Insulin-Sensitizing Agents. Endocrine Reviews, 40, 1447-1467. [Google Scholar] [CrossRef] [PubMed]
[6] Kraemer, F.B. and Ginsberg, H.N. (2014) Gerald M. Reaven, MD: Demonstration of the Central Role of Insulin Resistance in Type 2 Diabetes and Cardiovascular Disease. Diabetes Care, 37, 1178-1181. [Google Scholar] [CrossRef] [PubMed]
[7] Wang, A., Wang, G., Liu, Q., Zuo, Y., Chen, S., Tao, B., et al. (2021) Triglyceride-Glucose Index and the Risk of Stroke and Its Subtypes in the General Population: An 11-Year Follow-Up. Cardiovascular Diabetology, 20, Article No. 46. [Google Scholar] [CrossRef] [PubMed]
[8] Heise, T., Zijlstra, E., Nosek, L., Heckermann, S., Plum-Mörschel, L. and Forst, T. (2016) Euglycaemic Glucose Clamp: What It Can and Cannot Do, and How to Do It. Diabetes, Obesity and Metabolism, 18, 962-972. [Google Scholar] [CrossRef] [PubMed]
[9] Wallace, T.M., Levy, J.C. and Matthews, D.R. (2004) Use and Abuse of HOMA Modeling. Diabetes Care, 27, 1487-1495. [Google Scholar] [CrossRef] [PubMed]
[10] Lim, J., Kim, J., Koo, S.H. and Kwon, G.C. (2019) Comparison of Triglyceride Glucose Index, and Related Parameters to Predict Insulin Resistance in Korean Adults: An Analysis of the 2007-2010 Korean National Health and Nutrition Examination Survey. PLOS ONE, 14, e0212963. [Google Scholar] [CrossRef] [PubMed]
[11] Mohd Nor, N.S., Lee, S., Bacha, F., Tfayli, H. and Arslanian, S. (2015) 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. Pediatric Diabetes, 17, 458-465. [Google Scholar] [CrossRef] [PubMed]
[12] Vasques, A.C.J., Novaes, F.S., de Oliveira, M.d.S., Matos Souza, J.R., Yamanaka, A., Pareja, J.C., et al. (2011) Tyg Index Performs Better than HOMA in a Brazilian Population: A Hyperglycemic Clamp Validated Study. Diabetes Research and Clinical Practice, 93, e98-e100. [Google Scholar] [CrossRef] [PubMed]
[13] Fritz, J., Bjørge, T., Nagel, G., Manjer, J., Engeland, A., Häggström, C., et al. (2019) The Triglyceride-Glucose Index as a Measure of Insulin Resistance and Risk of Obesity-Related Cancers. International Journal of Epidemiology, 49, 193-204. [Google Scholar] [CrossRef] [PubMed]
[14] Borrayo, G. (2018) Tg/Hdl-C Ratio as Cardio-Metabolic Biomarker Even in Normal Weight Women. Acta Endocrinologica (Bucharest), 14, 261-267. [Google Scholar] [CrossRef] [PubMed]
[15] McLaughlin, T., Reaven, G., Abbasi, F., Lamendola, C., Saad, M., Waters, D., et al. (2005) Is There a Simple Way to Identify Insulin-Resistant Individuals at Increased Risk of Cardiovascular Disease? The American Journal of Cardiology, 96, 399-404. [Google Scholar] [CrossRef] [PubMed]
[16] Nur Zati Iwani, A.K., Jalaludin, M.Y., Wan Mohd Zin, R.M., Fuziah, M.Z., Hong, J.Y.H., Abqariyah, Y., et al. (2019) TG: HDL-C Ratio Is a Good Marker to Identify Children Affected by Obesity with Increased Cardiometabolic Risk and Insulin Resistance. International Journal of Endocrinology, 2019, 1-9. [Google Scholar] [CrossRef] [PubMed]
[17] Xia, W., Yao, X., Chen, Y., Lin, J., Vielhauer, V. and Hu, H. (2020) Elevated TG/HDL-C and Non-Hdl-C/hdl-C Ratios Predict Mortality in Peritoneal Dialysis Patients. BMC Nephrology, 21, Article No. 324. [Google Scholar] [CrossRef] [PubMed]
[18] Bornfeldt, K.E. and Tabas, I. (2011) Insulin Resistance, Hyperglycemia, and Atherosclerosis. Cell Metabolism, 14, 575-585. [Google Scholar] [CrossRef] [PubMed]
[19] Eeg-Olofsson, K., Gudbjörnsdottir, S., Eliasson, B., Zethelius, B. and Cederholm, J. (2014) The Triglycerides-to-Hdl-Cholesterol Ratio and Cardiovascular Disease Risk in Obese Patients with Type 2 Diabetes: An Observational Study from the Swedish National Diabetes Register (NDR). Diabetes Research and Clinical Practice, 106, 136-144. [Google Scholar] [CrossRef] [PubMed]
[20] Hong, S., Han, K. and Park, C. (2020) The Triglyceride Glucose Index Is a Simple and Low-Cost Marker Associated with Atherosclerotic Cardiovascular Disease: A Population-Based Study. BMC Medicine, 18, Article No. 361. [Google Scholar] [CrossRef] [PubMed]
[21] Tian, X., Zuo, Y., Chen, S., Liu, Q., Tao, B., Wu, S., et al. (2021) Triglyceride-Glucose Index Is Associated with the Risk of Myocardial Infarction: An 11-Year Prospective Study in the Kailuan Cohort. Cardiovascular Diabetology, 20, Article No. 19. [Google Scholar] [CrossRef] [PubMed]
[22] Salazar, M.R., Carbajal, H.A., Espeche, W.G., Aizpurúa, M., Leiva Sisnieguez, C.E., March, C.E., et al. (2013) Identifying Cardiovascular Disease Risk and Outcome: Use of the Plasma Triglyceride/High-Density Lipoprotein Cholesterol Concentration Ratio versus Metabolic Syndrome Criteria. Journal of Internal Medicine, 273, 595-601. [Google Scholar] [CrossRef] [PubMed]
[23] Rader, D.J. (2007) Effect of Insulin Resistance, Dyslipidemia, and Intra-Abdominal Adiposity on the Development of Cardiovascular Disease and Diabetes Mellitus. The American Journal of Medicine, 120, S12-S18. [Google Scholar] [CrossRef] [PubMed]
[24] 徐晨婕, 侯亚冰, 曹新西, 等. 冠心病及脑卒中的发病率和死亡率与互联网搜索引擎数据的关联分析[J]. 中国慢性病预防与控制, 2020, 28(4): 270-273+279+322.
[25] 于晓燕, 汤婷, 赵佳文, 等. 个体化康复运动训练合八段锦运动对冠心病PCI术后患者心功能、生活质量和心境状态的影响[J]. 现代生物医学进展, 2022, 22(2): 294-298.
[26] Niknam Sarabi, H., Farsi, Z., Butler, S. and Pishgooie, A.H. (2021) Comparison of the Effectiveness of Position Change for Patients with Pain and Vascular Complications after Transfemoral Coronary Angiography: A Randomized Clinical Trial. BMC Cardiovascular Disorders, 21, Article No. 114. [Google Scholar] [CrossRef] [PubMed]
[27] Luo, E., Wang, D., Yan, G., Qiao, Y., Liu, B., Hou, J., et al. (2019) High Triglyceride-Glucose Index Is Associated with Poor Prognosis in Patients with Acute St-Elevation Myocardial Infarction After Percutaneous Coronary Intervention. Cardiovascular Diabetology, 18, Article No. 150. [Google Scholar] [CrossRef] [PubMed]
[28] Lee, E.Y., Yang, H.K., Lee, J., Kang, B., Yang, Y., Lee, S., et al. (2016) Triglyceride Glucose Index, a Marker of Insulin Resistance, Is Associated with Coronary Artery Stenosis in Asymptomatic Subjects with Type 2 Diabetes. Lipids in Health and Disease, 15, Article No. 155. [Google Scholar] [CrossRef] [PubMed]
[29] Won, K., Park, E.J., Han, D., Lee, J.H., Choi, S., Chun, E.J., et al. (2020) Triglyceride Glucose Index Is an Independent Predictor for the Progression of Coronary Artery Calcification in the Absence of Heavy Coronary Artery Calcification at Baseline. Cardiovascular Diabetology, 19, Article No. 34. [Google Scholar] [CrossRef] [PubMed]
[30] Reardon, C.A., Lingaraju, A., Schoenfelt, K.Q., Zhou, G., Cui, C., Jacobs-El, H., et al. (2018) Obesity and Insulin Resistance Promote Atherosclerosis through an IFNγ-Regulated Macrophage Protein Network. Cell Reports, 23, 3021-3030. [Google Scholar] [CrossRef] [PubMed]
[31] Roth, G.A., Abate, D., Abate, K.H., Abay, S.M., Abbafati, C., Abbasi, N., et al. (2018) Global, Regional, and National Age-Sex-Specific Mortality for 282 Causes of Death in 195 Countries and Territories, 1980-2017: A Systematic Analysis for the Global Burden of Disease Study 2017. The Lancet, 392, 1736-1788. [Google Scholar] [CrossRef] [PubMed]
[32] Huang, Y., Gao, L., Xie, X. and Tan, S.C. (2014) Epidemiology of Dyslipidemia in Chinese Adults: Meta-Analysis of Prevalence, Awareness, Treatment, and Control. Population Health Metrics, 12, Article No. 28. [Google Scholar] [CrossRef] [PubMed]
[33] Yu, S., Sun, Z., Zheng, L., Guo, X., Yang, H. and Sun, Y. (2015) Prevalence of Diabetes and Impaired Fasting Glucose in Hypertensive Adults in Rural China: Far from Leveling-Off. International Journal of Environmental Research and Public Health, 12, 14764-14779. [Google Scholar] [CrossRef] [PubMed]
[34] da Silva, A.A., do Carmo, J.M., Li, X., Wang, Z., Mouton, A.J. and Hall, J.E. (2020) Role of Hyperinsulinemia and Insulin Resistance in Hypertension: Metabolic Syndrome Revisited. Canadian Journal of Cardiology, 36, 671-682. [Google Scholar] [CrossRef] [PubMed]
[35] Mancusi, C., Izzo, R., di Gioia, G., Losi, M.A., Barbato, E. and Morisco, C. (2020) Insulin Resistance the Hinge between Hypertension and Type 2 Diabetes. High Blood Pressure & Cardiovascular Prevention, 27, 515-526. [Google Scholar] [CrossRef] [PubMed]
[36] Rossier, B.C., Bochud, M. and Devuyst, O. (2017) The Hypertension Pandemic: An Evolutionary Perspective. Physiology, 32, 112-125. [Google Scholar] [CrossRef] [PubMed]
[37] Wu, Z., Zhou, D., Liu, Y., Li, Z., Wang, J., Han, Z., et al. (2021) Association of Tyg Index and TG/HDL-C Ratio with Arterial Stiffness Progression in a Non-Normotensive Population. Cardiovascular Diabetology, 20, Article No. 134. [Google Scholar] [CrossRef] [PubMed]
[38] Wang, Y., Yang, W. and Jiang, X. (2021) Association between Triglyceride-Glucose Index and Hypertension: A Meta-analysis. Frontiers in Cardiovascular Medicine, 8, Article 644035. [Google Scholar] [CrossRef] [PubMed]
[39] Grobbee, D.E. and Bots, M.L. (1994) Carotid Artery Intima-Media Thickness as an Indicator of Generalized Atherosclerosis. Journal of Internal Medicine, 236, 567-573. [Google Scholar] [CrossRef] [PubMed]
[40] Ahn, S., Lee, J. and Lee, J. (2020) Inverse Association between Triglyceride Glucose Index and Muscle Mass in Korean Adults: 2008–2011 Knhanes. Lipids in Health and Disease, 19, Article No. 243. [Google Scholar] [CrossRef] [PubMed]
[41] Bullón-Vela, V., Abete, I., Tur, J.A., Konieczna, J., Romaguera, D., Pintó, X., et al. (2020) Relationship of Visceral Adipose Tissue with Surrogate Insulin Resistance and Liver Markers in Individuals with Metabolic Syndrome Chronic Complications. Therapeutic Advances in Endocrinology and Metabolism, 11, Article 204201882095829. [Google Scholar] [CrossRef] [PubMed]
[42] Jeong, S. and Lee, J.H. (2021) The Verification of the Reliability of a Triglyceride-Glucose Index and Its Availability as an Advanced Tool. Metabolomics, 17, Article No. 97. [Google Scholar] [CrossRef] [PubMed]
[43] Alizargar, J. and Bai, C. (2018) Comparison of Carotid Ultrasound Indices and the Triglyceride Glucose Index in Hypertensive and Normotensive Community-Dwelling Individuals: A Case Control Study for Evaluating Atherosclerosis. Medicina, 54, Article 71. [Google Scholar] [CrossRef] [PubMed]
[44] Peng, J., Luo, F., Ruan, G., Peng, R. and Li, X. (2017) Hypertriglyceridemia and Atherosclerosis. Lipids in Health and Disease, 16, Article No. 233. [Google Scholar] [CrossRef] [PubMed]
[45] Poznyak, A., Grechko, A.V., Poggio, P., Myasoedova, V.A., Alfieri, V. and Orekhov, A.N. (2020) The Diabetes Mellitus-Atherosclerosis Connection: The Role of Lipid and Glucose Metabolism and Chronic Inflammation. International Journal of Molecular Sciences, 21, Article 1835. [Google Scholar] [CrossRef] [PubMed]
[46] Bang, O.Y. (2006) Intracranial Atherosclerotic Stroke: Specific Focus on the Metabolic Syndrome and Inflammation. Current Atherosclerosis Reports, 8, 330-336. [Google Scholar] [CrossRef] [PubMed]
[47] Salomaa, V., Riley, W., Kark, J.D., Nardo, C. and Folsom, A.R. (1995) Non-Insulin-Dependent Diabetes Mellitus and Fasting Glucose and Insulin Concentrations Are Associated with Arterial Stiffness Indexes. Circulation, 91, 1432-1443. [Google Scholar] [CrossRef] [PubMed]
[48] Wang, Q., Zhao, Y., Wang, X., Ji, X., Sang, S., Shao, S., et al. (2020) Association between Asymptomatic Intracranial Arterial Stenosis and Insulin Resistance or Diabetes Mellitus: A Cross-Sectional Study in Rural Shandong, China. BMJ Open Diabetes Research & Care, 8, e001788. [Google Scholar] [CrossRef] [PubMed]
[49] López-Cancio, E., Galán, A., Dorado, L., Jiménez, M., Hernández, M., Millán, M., et al. (2012) Biological Signatures of Asymptomatic Extra-and Intracranial Atherosclerosis. Stroke, 43, 2712-2719. [Google Scholar] [CrossRef] [PubMed]
[50] Perseghin, G., Ghosh, S., Gerow, K. and Shulman, G.I. (1997) Metabolic Defects in Lean Nondiabetic Offspring of NIDDM Parents: A Cross-Sectional Study. Diabetes, 46, 1001-1009. [Google Scholar] [CrossRef] [PubMed]
[51] Lee, Y., Hirose, H., Ohneda, M., Johnson, J.H., McGarry, J.D. and Unger, R.H. (1994) Beta-Cell Lipotoxicity in the Pathogenesis of Non-Insulin-Dependent Diabetes Mellitus of Obese Rats: Impairment in Adipocyte-Beta-Cell Relationships. Proceedings of the National Academy of Sciences, 91, 10878-10882. [Google Scholar] [CrossRef] [PubMed]
[52] García, A.G., Urbina Treviño, M.V., Villalpando Sánchez, D.C. and Aguilar, C.A. (2019) Diagnostic Accuracy of Triglyceride/glucose and Triglyceride/HDL Index as Predictors for Insulin Resistance in Children with and without Obesity. Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 13, 2329-2334. [Google Scholar] [CrossRef] [PubMed]
[53] Mózes, F.E., Lee, J.A., Vali, Y., Alzoubi, O., Staufer, K., Trauner, M., et al. (2023) Performance of Non-Invasive Tests and Histology for the Prediction of Clinical Outcomes in Patients with Non-Alcoholic Fatty Liver Disease: An Individual Participant Data Meta-Analysis. The Lancet Gastroenterology & Hepatology, 8, 704-713. [Google Scholar] [CrossRef] [PubMed]
[54] Yu, Y., Cai, J., She, Z. and Li, H. (2018) Insights into the Epidemiology, Pathogenesis, and Therapeutics of Nonalcoholic Fatty Liver Diseases. Advanced Science, 6, Article 1808525. [Google Scholar] [CrossRef] [PubMed]
[55] Gaggini, M., Morelli, M., Buzzigoli, E., DeFronzo, R., Bugianesi, E. and Gastaldelli, A. (2013) Non-Alcoholic Fatty Liver Disease (NAFLD) and Its Connection with Insulin Resistance, Dyslipidemia, Atherosclerosis and Coronary Heart Disease. Nutrients, 5, 1544-1560. [Google Scholar] [CrossRef] [PubMed]
[56] 林雄峰. TyG指数及TyG-BMI与非酒精性脂肪性肝病的相关性研究[D]: [硕士学位论文]. 福州: 福建医科大学, 2021.
[57] Che, B., Zhong, C.K., Zhang, R.J., et al. (2023) Triglyceride-Glucose Index and Triglyceride to High-Density Lipoprotein Cholesterol Ratio as Potential Cardiovascular Disease Risk Factors: An Analysis of UK Biobank Data. Cardiovascular Diabetology, 22, Article No. 34. [Google Scholar] [CrossRef] [PubMed]
[58] 杨曦, 柳怡莹, 万沁. TG/HDL-C、TyG指数对T2DM患者高尿酸血症的预测价值[J]. 天津医药, 2021, 49(6): 603-608.
[59] Wang, X., Feng, B.Y., Huang, Z.G., et al. (2022) Relationship of Cumulative Exposure to the Triglyceride-Glucose Index with Ischemic Stroke: A 9-Year Prospective Study in the Kailuan Cohort. Cardiovascular Diabetology, 21, Article No. 66. [Google Scholar] [CrossRef] [PubMed]
[60] Zhou, Y., Pan, Y.S., Yan, H.Y., et al. (2020) Triglyceride Glucose Index and Prognosis of Patients with Ischemic Stroke. Frontiers in Neurology, 11, Article 456. [Google Scholar] [CrossRef] [PubMed]
[61] Cai, W., Xu, J., Wu, X., et al. (2023) Association between Triglyceride-Glucose Index and All-Cause Mortality in Critically Ill Patients with Ischemic Stroke: Analysis of the MIMIC-IV Database. Cardiovascular Diabetology, 22, Article No. 138.
[62] Toh, E.M.S., Amanda, Y.L., Lim, C.M., et al. (2022) Association of Triglyceride-Glucose Index with Clinical Outcomes in Patients with Acute Ischemic Stroke Receiving Intravenous Thrombolysis. Scientific Reports, 12, Article No. 1596. [Google Scholar] [CrossRef] [PubMed]
[63] 王梦, 卢丹丹, 祖赛, 等. TyG指数与轻型缺血性卒中患者早期神经功能恶化的相关性分析[J]. 中风与神经疾病杂志, 2022, 39(9): 808-812.