| 黄榕卿,童飞飞,罗青青,高媛,郑广勇,陈晓敏,许国章.三酰甘油葡萄糖指数联合肥胖指标与中国中老年人心血管疾病风险的关联[J].中华流行病学杂志,2026,47(3):416-423 |
| 三酰甘油葡萄糖指数联合肥胖指标与中国中老年人心血管疾病风险的关联 |
| Association between triglyceride glucose index combined with obesity index and cardiovascular disease risk in middle-aged and old adults in China |
| 收稿日期:2025-07-16 出版日期:2026-03-19 |
| DOI：10.3760/cma.j.cn112338-20250716-00494 |
| 中文关键词: 三酰甘油葡萄糖指数|肥胖|体质指数|腰高比|体重腰围指数|心血管疾病 |
| 英文关键词: Triglyceride glucose index|Obesity|Body mass index|Waist-to-height ratio|Weight-adjusted-waist index|Cardiovascular disease |
| 基金项目:宁波市重点技术研发项目（2022Z149） |
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| 中文摘要: |
| 目的 探讨三酰甘油葡萄糖（TyG）指数及其与肥胖相关指标联合的新型复合代谢指标与中国中老年人心血管疾病（CVD）风险之间的关联。方法 基于2011-2020年中国健康与退休纵向研究数据，纳入6 158名基线时无CVD的中老年人。采用Cox比例风险回归模型评估各指标与CVD发生的关联。同时使用Kaplan-Meier曲线和限制性立方样条（RCS）探索其剂量反应关系和非线性趋势。亚组分析用于检验不同人口特征下该关联的稳定性。结果 在9年的随访期间，共发生1 639名CVD事件。调整混杂因素后，高水平的TyG指数及其联合肥胖指标与CVD风险增加显著相关。与Q1组相比，Q4组TyG、TyG-BMI、TyG-腰高比（WHtR）和TyG-体重腰围指数（WWI）的HR值（95%CI）分别为1.36（1.19~1.57）、1.74（1.51~2.01）、1.55（1.34~1.79）和1.38（1.20~1.60）。RCS分析显示，TyG和TyG-BMI与CVD风险呈线性关系，而TyG-WHtR与TyG-WWI表现出非线性关联。亚组分析提示上述关联在不同年龄、性别、文化程度和高血压状态人群中均具有良好一致性（交互均P>0.05）。结论 TyG指数联合肥胖指标与中国中老年人CVD风险显著相关，关注中老年人群的TyG指数和肥胖指标对我国老年人CVD防治和慢性病指导工作有一定参考价值。 |
| 英文摘要: |
| Objective To evaluate the association between triglyceride glucose (TyG) index and its novel composite metabolic indexes combined with obesity-related indexes and cardiovascular disease (CVD) risk in middle-aged and old adults in China. Methods Based on data from the China Health and Retirement Longitudinal Study from 2011 to 2020, a study was conducted in 6 158 middle-aged and old adults without CVD at baseline survey. Cox proportional hazard regression model was used to assess the association of each indicator with the risk for CVD. Kaplan-Meier curve and restricted cubic spline (RCS) were also used to explore the dose-response relationship and nonlinear trends. Subgroup analyses were used to test the stability of the association in people with different demographic characteristics. Results A total of 1 639 CVD events occurred during the 9-year follow-up period. After adjusting for confounding factors, high levels of TyG index and its combined obesity index were significantly associated with an increased risk for CVD. Compared with the Q1group, the HRs (95%CIs) of TyG, TyG-BMI, TyG-waist-to-height ratio (WHtR), and TyG-weight-adjusted-waist index (WWI) were 1.36 (95%CI: 1.19-1.57), 1.74 (95%CI: 1.51-2.01), 1.55 (95%CI: 1.34-1.79), and 1.38 (95%CI: 1.20-1.60) in the Q4 group, respectively. RCS analysis showed that TyG and TyG-BMI had linear association with the risk for CVD, whereas TyG-WHtR and TyG-WWI had non-linear association with the risk for CVD. Subgroup analyses suggested that the associations were in good agreement in people in different age, sex, education level and hypertension status group (all P for interaction >0.05). Conclusions The TyG index combined with obesity index is significantly associated with the risk for CVD in middle-aged and old adults in China. Paying attention to the TyG index and obesity index in the middle-aged and old adults can benefit the prevention and treatment of CVD and other chronic diseases in the elderly in China. |
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