射血分数正常的老年高血压病人TyG指数与左心室舒张功能的相关性分析

doi:10.3969/j.issn.1003-9198.2024.02.011

摘要/Abstract

摘要： 目的分析射血分数正常的老年高血压病人甘油三酯-葡萄糖乘积(TyG)指数与左心室舒张功能的相关性,并进一步探究影响病人舒张功能的相关因素。方法随机选取我院收治的确诊原发性高血压的220例老年病人作为研究对象,将其分为舒张功能正常组与舒张功能不全组,收集病人的相关临床资料,采用Pearson相关分析探讨TyG指数与左心室舒张功能的关系,并建立多元线性回归模型分析影响左心室舒张功能的危险因素。结果 TyG指数与平均E/e′、三尖瓣反流峰值速度(peak velocity of tricuspid regurgitation,TRPV)、左房最大容积指数(left atrial maximum volume index, LAVI)呈正相关,与E/A、等容舒张时间(isovolumic relaxation time,IVRT)无相关性。多元线性回归分析表明,年龄、女性、SBP及TyG指数对平均E/e′存在显著影响,是左心室舒张功能的独立影响因素。结论老年高血压人群TyG指数升高对于提示左心室舒张功能减低具有一定的临床价值。

关键词: 老年人, 原发性高血压, 左心室舒张功能, 甘油三酯-葡萄糖乘积指数

Abstract: Objective To analyze the correlation between triglyceride-glucose (TyG)index and left ventricular diastolic function in the elderly hypertensive patients with normal ejection fraction, and to explore the influencing factors affecting diastolic function. Methods A total of 220 elderly patients with essential hypertension were randomly selected from our hospital,and they were divided into normal diastolic function group and abnormal diastolic function group. The clinical data of the patients were collected. Pearson correlation analysis was conducted to investigate the relationship between TyG index and left ventricular diastolic function, and a multiple linear regression model was established to analyze the risk factors influencing the left ventricular diastolic function. Results TyG index was positively correlated with E/e′, peak velocity of tricuspid regurgitation(TRPV) and left atrial maximum volume index(LAVI). There was no correlation between TyG index and E/A, isovolumic relaxation time(IVRT). Multiple linear regression model analysis showed that age, female, systolic blood pressure and TyG index had significant effects on E/e′ and were independent influencing factors of left ventricular diastolic function. Conclusions The increase of TyG index in the hypertensive elderly has certain clinical value in indicating the decrease of left ventricular diastolic function.

Key words: aged, essential hypertension, left ventricular diastolic dysfunction, triglyceride-glucose index

中图分类号:

R 544.1

段力丹, 习玲, 许建萍. 射血分数正常的老年高血压病人TyG指数与左心室舒张功能的相关性分析[J]. 实用老年医学, 2024, 38(2): 152-156.

DUAN Lidan, XI Ling, XU Jianping. Correlation between TyG index and left ventricular diastolic function in elderly hypertensive patients with normal ejection fraction[J]. Practical Geriatrics, 2024, 38(2): 152-156.

参考文献

[1] 《中国心血管健康与疾病报告》2021(冠心病部分内容) [J]. 心肺血管病杂志, 2022, 41(12): 1205-1211.
[2] 张廷杰, 徐俊波, 黄刚. 医学研究的典范:Framingham心脏研究70年回顾 [J]. 中华心血管病杂志, 2020, 48(9): 805-810.
[3] ARONOW W S. Hypertension and left ventricular hypertrophy [J]. Ann Transl Med, 2017, 5(15): 310.
[4] 束长城, 魏万林. 高血压左心室肥厚的形成机制研究进展 [J]. 中国循证心血管医学杂志, 2018, 10(6): 760-762.
[5] PALMIERO P, ZITO A, MAIELLO M, et al. Left ventricular diastolic function in hypertension: methodological considerations and clinical implications [J]. J Clin Med Res, 2015, 7(3): 137-144.
[6] TIRANDI A, CARBONE F, MONTECUCCO F, et al. The role of metabolic syndrome in sudden cardiac death risk: recent evidence and future directions [J]. Eur J Clin Invest, 2022, 52(2): e13693.
[7] SALAZAR M R, CARBAJAL H A, ESPECHE W G, et al. Comparison of two surrogate estimates of insulin resistance to predict cardiovascular disease in apparently healthy individuals [J]. Nutr Metab Cardiovasc Dis, 2017, 27(4): 366-373.
[8] WANG Y, YANG W, JIANG X. Association between triglyceride-glucose index and hypertension: a meta-analysis [J]. Front Cardiovasc Med, 2021, 8: 644035.
[9] ZHAO S, YU S, CHI C, et al. Association between macro- and microvascular damage and the triglyceride glucose index in community-dwelling elderly individuals: the Northern Shanghai Study [J]. Cardiovasc Diabetol, 2019, 18(1): 95.
[10] 中国高血压防治指南修订委员会, 高血压联盟(中国), 中华医学会心血管病学分会中国医师协会高血压专业委员会, 等. 中国高血压防治指南(2018年修订版)[J]. 中国心血管杂志, 2019, 24(1):24-56.
[11] NAGUEH S F, SMISETH O A, APPLETON C P, et al. Recommendations for the evaluation of left ventricular diastolic function by echocardiography: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging [J]. Eur Heart J Cardiovasc Imaging, 2016, 17(12): 1321-1360.
[12] POULSEN S H, ANDERSEN N H, IVARSEN P I, et al. Doppler tissue imaging reveals systolic dysfunction in patients with hypertension and apparent "isolated" diastolic dysfunction [J]. J Am Soc Echocardiogr, 2003, 16(7): 724-731.
[13] GU J, YIN Z F, ZHANG H L, et al. Characteristics and outcomes of transitions among heart failure categories: a prospective observational cohort study [J]. ESC Heart Fail, 2020, 7(2): 616-625.
[14] DEFRONZO R A, TOBIN J D, ANDRES R. Glucose clamp technique: a method for quantifying insulin secretion and resistance [J]. Am J Physiol, 1979, 237(3): E214-E223.
[15] TAM C S, XIE W, JOHNSON W D, et al. Defining insulin resistance from hyperinsulinemic-euglycemic clamps [J]. Diabetes care, 2012, 35(7): 1605-1610.
[16] XIE H, SONG J, SUN L, et al. Independent and combined effects of triglyceride-glucose index on prehypertension risk: a cross-sectional survey in China [J]. J Hum Hypertens, 2021, 35(3): 207-214.
[17] KARCZ-SOCHA I, ZWIRSKA-KORCZALA K, ZEMBALA M, et al. Ghrelin PYY 3-36 serum changes in left ventricular hypertrophic, insulin-resistant, hypertensive obese patients [J]. Obes Facts, 2011, 4(5): 386-392.
[18] TAN C, WANG A, LIU C, et al. Puerarin improves vascular insulin resistance and cardiovascular remodeling in salt-sensitive hypertension [J].Am J Chin Med, 2017, 45(6): 1169-1184.
[19] MADONNA R, PIERAGOSTINO D, ROSSI C, et al. Simulated hyperglycemia impairs insulin signaling in endothelial cells through a hyperosmolar mechanism [J].Vascul Pharmacol, 2020, 130: 106678.
[20] 唐昱, 盛国太, 葛郁芝, 等. 高血压左心室肥厚患者结缔组织生长因子和B型钠尿肽的变化及临床意义[J]. 中华老年心脑血管病杂志, 2011, 13(2): 119-121.
[21] 陈源源. 围绝经期高血压[J]. 中华老年心脑血管病杂志, 2017, 19(6): 670-672.
[22] 王葛, 赵力, 李田昌. 探讨不同性别老年冠心病患者临床特点及危险因素[J]. 中华老年心脑血管病杂志, 2019, 21(5): 483-486.