The Correlation Between TyG Index,TG/HDL-C And The Severity Of Coronary Artery Disease Extension

Background:Coronary heart disease refers to a kind of disease which caused by myocardial blood supply,hypoxia,or necrosis because of vascular stenosis or even occlusion.The proportion of the elderly in China is increasing year by year.The genetic susceptibility of the disease,changes in living environment and changes in lifestyle have gradually increased the proportion of coronary heart diseases.The annual health and medical expenditures consumed by coronary heart disease and its complications have caused a huge burden on the country and the family.The main risk factors of coronary heart disease include: 1.age,gender;2.glucose and lipid metabolism disorder;3.higher blood pressure;4.smoking;5.higher body fat rate,etc.Diabetics are more prone to coronary heart disease due to various reasons such as increased inflammation and endothelial dysfunction caused by insulin resistance,high circulating blood glucose and lipid metabolism disorders.Relevant studies in recent years have shown that the Triglyceride Glucose index(TyG index)and the Triglyceride to High-Density Lipoprotein Cholesterol Ratio(TG/HDL-C)are related to IR.TyG index and TG/HDL-C are considered as simple clinical surrogate markers which can evaluate the degree of IR.In clinical practice,coronary angiography is generally used to confirm the presence of coronary atherosclerosis,but whether TyG index and TG/HDL-C can be used to predict the degree of coronary artery disease is not clear.Through researching the relationship of them,TG/HDL-C and TyG index may not only become standard parameters for stratifying cardiovascular risk,but also can be used to guide prevention and treatment.Objective:Analyze the general clinical data,blood lipids,biochemical and other indicators of the enrolled patients,explore the correlation between TyG index,TG/HDL-C and the degree of coronary artery disease,and judge theirs availability in predicting the severity of coronary artery disease.Methods:The enrolled population of this study are the patients who were hospitalized in Subei Hospital during 2018.09-2020.09 and underwent angiography during the hospitalization and met the relevant standards.According to the final examination results,they were divided into: CHD-group 79 cases(control group),CHD+ group 144 cases.Then the enrolled population were divided into 3 subgroups: no coronary heart disease and no diabetes(control group,CHD-DM-,72 cases),coronary heart disease but no diabetes group(CHD+DM-,72 Cases),the group with both coronary heart disease and diabetes(CHD+DM+,72 cases).Collect the age,gender,BMI,smoking status,drinking status,hypertension,diabetes,etc.and TC level,TG level,HDL-C level,LDL-C level,Lp(a)level,Apo-A1 level,Apo-B level,GLU level,etc.and the Gensini score.Analyze the collected data with IBM SPSS Statistics 26 software.P<0.05 indicates that the difference is statistically significant.Result:1.Compared with the CHD-group,the differences in gender,hypertension,smoking history,drinking history,TG,HDL-C,Apo-A1 and Apo-B were statistically significant(P<0.05),and there were no statistically significant differences in TC,LDL-C,Lp(a),age and BMI(P>0.05).2.There were statistical differences in drinking history,smoking history,hypertension,TG,HDL-C,Apo-A1,Apo-B,and GLU among subgroups(P<0.05),but there were no statistical differences in age,gender,BMI,TC,LDL-C,Lp(a)(P>0.05).Among them,TG levels in CHD+DM+ and CHD+DM-group were significantly higher than those in CHD-DM-group,and the difference was statistically significant(P<0.01).However,there was no significant difference in TG level between CHD+DM+ group and CHD+DM-group.There was statistical difference in HDL-C level among groups(P<0.01).HDL-C level in CHD+DM+ group was lower than that in CHD+DM-group,and CHD+DM-group was lower than that of control group(P<0.01).Compared with CHD+DM-group and CHD-DM-group,the level of Apo-A1 in CHD+DM+ group was lower,with statistical difference(P<0.01).The level of Apo-B in CHD+DM-group was higher than that in CHD-DM-group(P<0.01),but there was no significant difference in other groups.Compared with CHD+DM-group and CHD-DM-group,the level of GLU in CHD+DM+ group was higher,with significant difference(P<0.01),but there was no significant difference between CHD+DM-group and CHD-DM-group(P>0.05).3.The Gensini score of patients in DM+ group was significantly higher than that in DM-group(P<0.01).There were significant differences in Gensini scores among the subgroups(P<0.05),among which the scores in CHD+DM+ group were higher than those in CHD+DM-group,and the scores in CHD+DM-group were higher than those in CHD-DM-group.4.TyG index and TG/HDL-C in CHD+ group were significantly higher than those in CHD-group(P<0.01).TyG index and TG/HDL-C in CHD+DM+ group and CHD+DM-group were higher than those in CHD-DM-group(P<0.01).TyG index and TG/HDL-C were positively correlated with the severity of coronary artery disease.Multivariate Logistic regression showed that TyG index,TG/HDL-C,smoking,hypertension and GLU level were independent risk factors of CHD.5.The ROC curve analysis of TyG index and TG/HDL-C predicting coronary heart disease shows that TyG index: AUC=0.792(95% CI: 0.729～0.855,P<0.01),and its sensitivity to predicting coronary heart disease is 88.2% while the specificity is 62%;TG/HDL-C: AUC=0.728(95% CI: 0.657～0.798,P<0.01),its sensitivity to predict coronary heart disease is 81.3%,and the specificity is 63.3%.Conclusion:1.TyG index,TG/HDL-C are independent risk factors of CHD;TyG index,TG/HDL-C are positively correlated with the degree of coronary artery disease,the higher the value,the coronary artery stenosis disease More serious.2.TyG index and TG/HDL-C can be used to predict the occurrence of coronary artery disease.The prediction sensitivity of TyG index is 88.2% while the specificity is 62%;the sensitivity of TG/HDL-C is 81.3% and the specificity is 63.3%.