[1]盛楚凡,王 琲,王错错,等.超重/肥胖相关射血分数保留型心力衰竭患者血清TyG指数对中重度心室舒张功能障碍的预测价值分析[J].现代检验医学杂志,2026,41(02):181-186.[doi:10.3969/j.issn.1671-7414.2026.02.030]
　SHENG Chufan,WANG Bei,WANG Cuocuo,et al.Predictive Value of Serum TyG Index for Moderate-to-Severe Ventricular Diastolic Dysfunction in Patients with Overweight/Obesity-Related Heart Failure with Preserved Ejection Fraction[J].Journal of Modern Laboratory Medicine,2026,41(02):181-186.[doi:10.3969/j.issn.1671-7414.2026.02.030]
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超重/肥胖相关射血分数保留型心力衰竭患者血清TyG指数对中重度心室舒张功能障碍的预测价值分析()

《现代检验医学杂志》[ISSN:/CN:]

卷:
第41卷
期数:
2026年02期
页码:
181-186
栏目:
论著
出版日期:
2026-03-15

文章信息/Info

Title:
Predictive Value of Serum TyG Index for Moderate-to-Severe Ventricular Diastolic Dysfunction in Patients with Overweight/Obesity-Related Heart Failure with Preserved Ejection Fraction
文章编号:
1671-7414（2026）02-181-06
作者:
盛楚凡，王 琲，王错错，赵旭东，李 雷
徐州医科大学附属医院全科医学科，江苏徐州221000
Author(s):
SHENG Chufan，WANG Bei，WANG Cuocuo，ZHAO Xudong，LI Lei
Department of General Practice, Affiliated Hospital of Xuzhou Medical University，Jiangsu Xuzhou 221000, China
关键词:
甘油三酯-葡萄糖指数; 射血分数保留型心力衰竭; 超重/肥胖; 左心室舒张功能障碍
分类号:
R541.6；446.1
DOI:
10.3969/j.issn.1671-7414.2026.02.030
文献标志码:
A
摘要:
目的?探讨超重/肥胖相关射血分数保留型心力衰竭(HFpEF)患者血清甘油三酯-葡萄糖指数(TyG指数)对中重度左心室舒张功能障碍(LVDD)的预测价值。方法收集2023年1月~2024年1月于徐州医科大学附属医院住院治疗的227例超重/肥胖相关HFpEF患者的临床资料。根据TyG指数四分位数值划分为低(n=57)、中低(n=58)、中高(n=56)及高(n=56)四组。比较四组间超声心动图指标的差异性。采用Spearman法分析TyG指数与超重/肥胖相关HFpEF患者中重度LVDD发生的相关性;Logistic回归模型评估发生中重度LVDD的独立危险因素并绘制受试者操作特征(ROC)曲线。在性别、年龄、糖尿病及体质指数(BMI)亚组中进行二元Logistic回归分析明确高风险人群。结果与其余三组相比,高TyG组左心房内径(LAD)、二尖瓣早期血流速度/二尖瓣心房收缩期最大血流(E/A)、二尖瓣早期血流速度/隔膜的早期舒张期运动速度比(E/e')升高,差异具有统计学意义(F=4.306~9.954,均P<0.05)。Spearman相关性分析结果提示TyG指数与超重/肥胖相关HFpEF患者发生中重度LVDD的风险呈正相关(r=0.452,P<0.001)。多因素Logistic回归分析发现高TyG指数、糖化血红蛋白(HbA1c)、低密度脂蛋白-胆固醇(LDL-C)及BMI均为其独立危险因素(Waldχ2=4.011~17.478,均P<0.05)。ROC曲线提示TyG指数预测效能良好,AUC为0.762(95%CI:0.701~0.823),进一步与HbA1c联合预测后AUC可达0.801(95%CI:0.745~0.857),此时联合模型的灵敏度达到91.3%,特异度为57.7%。亚组分析显示,高TyG指数在性别、年龄、糖尿病及BMI分层亚组中均与中重度心室舒张功能障碍显箸相关(OR=2.423~7.798,均P<0.05)。结论?TyG指数是超重/肥胖相关HFpEF患者发生中重度LVDD的危险因素,其联合HbA1c可提高预测效能,且在不同人群中均具有一定的风险评估价值。
Abstract:
Objective To evaluate the predictive value of serum triglyceride-glucose (TyG) index for moderate-to-severe left ven-tricular diastolic dysfunction (LVDD) in overweight/obese patients with heart failure with preserved ejection fraction (HFpEF). Methods Clinical data of 227 patients with overweight/obesity-related HFpEF hospitalized at the Affiliated Hospital of Xuzhou Medical University from January 2023 to January 2024 were retrospectively collected. Patients were stratified into four quartiles based on TyG index values: low (n=57), low-moderate (n=58), moderate-high (n=56), and high (n=56). Differences in echocar-diographic parameters were compared across the four groups. Spearman’s correlation was used to evaluate the association be-tween TyG index and moderate-to-severe LVDD. Logistic regression model was performed to identify independent risk factors for moderate-to-severe LVDD, and to generate receiver operating characteristic (ROC) curves. Binary Logistic regression analy-sis was performed in subgroups stratified by sex, age, diabetes status, and body mass index (BMI) to identify high-risk popula-tions. Results Compared with the other three groups, the high TyG group exhibited statistically significant increase in left atrial diameter (LAD), mitral early-to-atrial peak velocity ratio (E/A), and mitral early diastolic velocity to septal early diastolic myo-cardial velocity ratio (E/e’) (F=4.306~9.954, all P<0.05). Spearman correlation analysis indicated a positive association between TyG index and the risk of moderate-to-severe LVDD in overweight or obese HFpEF patients (r=0.452, P<0.05). The results of multivariate Logistic regression analysis showed that high TyG index, HbA1c, LDL-C, and BMI were independent risk factors (Wald χ2=4.011~17.478, all P < 0.05). ROC curve analysis demonstrated good predictive performance of the TyG index, with an AUC of 0.762 (95%CI: 0.701~0.823). Combining TyG index with HbA1c further improved AUC to 0.801 (95%CI:0.745~0.857), yielding a sensitivity of 91.3% and a specificity of 57.7%. Subgroup analysis showed that eleveated TyG index was significantly associated with moderate-to-severe LVDD acroll all subgroups stratified by sex, age, diabetes status and BMI (OR=2.423~7.798, all P<0.05). Conclusions The TyG index is a risk factor for moderate-to-severe LVDD in overweight or obese HF-pEF patients. Its combination with HbA1c enhances predictive accuracy. Moreover, TyG index demonstrated a consistent risk-predictive value across rarious populations.

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备注/Memo

备注/Memo:
基金项目：江苏省研究生科研与实践创新计划项目（SJCX24_1539）。
作者简介：盛楚凡（2000-），女，硕士生在读，住院医师，研究方向：心血管及代谢疾病、射血分数保留型心衰，E-mail：fou2105@126.com。
通讯作者：李雷（1972-），男，博士，教授，博士生导师，研究方向：老年心脑血管病与糖尿病心血管并发症，E-mail：ligroup-999@126.com。
更新日期/Last Update: 2026-03-15