血糖状况改变了心脏代谢指数和心脏-脏结果之间的关联:多队列分析
Yingyi Xie1,2, Yanjun Song1,2, Shanshan Shi1,2
1Cardiometabolic Medicine Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Diabetes/metabolism research and reviews
|January 17, 2026
概括
心脏代谢指数 (CMI) 有效地预测心脏风险和死亡率,特别是在血糖水平正常的个体中. 这种简单的指标提供了强大的预后价值,特别是在较早的代谢阶段.
科学领域:
- 心脏病学 心脏病学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 代谢健康 代谢健康
- 生物统计学 生物统计学
背景情况:
- 心血管和脏疾病对全球健康构成重大挑战.
- 早期识别有风险的个体对于及时干预至关重要.
- 现有的风险评分可能无法完全捕捉不同代谢状态的结合心脏-风险.
研究的目的:
- 评估心脏代谢指数 (CMI) 作为心脏风险的早期预测指标.
- 评估CMI的预测值是否在不同的血糖状况 (常态血糖,糖尿病前期,糖尿病) 中有所不同.
- 通过外部队列和机器学习模型验证CMI的预测性能.
主要方法:
- 分析了来自英国生物库的327,902名成年人.
- 检查了CMI与基线心脏并发症和心脏事件 (CKE) 的关联.
- 使用后勤回归,考克斯模型,受限立方线和机器学习生存模型;在CHARLS和NHANES中进行外部验证.
主要成果:
- 较高的CMI与基线心脏并发症有很强的关联 (OR 2.25).
- 在14.3 - 15.8年的中位随访期内,CMI预测了事件CKE (HR 2.18),全因死亡 (HR 1.10) 和心脏死亡 (HR 1.55).
- 预测强度在正常血糖症中最高,在糖尿病前期和糖尿病下降;观察到非线性剂量反应关系.
结论:
- 心脏代谢指数 (CMI) 是心脏风险的简单而强大的预测指标.
- 在正常血糖症患者中,CMI表现出特别强大的预后价值.
- 这些发现强调了CMI对早期风险分层的有用性,特别是在正常血糖状况的个体中.
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