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Updated: Feb 28, 2026

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TyG-脂肪性复合物预测CABG后的长期MACCE:证据表明CRP的部分调解

Yingying Xie¹, Hao Chen², Yanxiang Gao³

¹Department of Cardiology, China-Japan Friendship Hospital (Institute of Clinical Medical Sciences), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China; Department of Cardiology, The Second Xiangya Hospital of Central South University, Changsha, China.

Heart & lung : the journal of critical care

|February 26, 2026

概括

新的甘油三糖 (TyG) 脂肪指数,特别是TyG-BRI,预测冠状动脉旁路移植 (CABG) 后的主要不良心血管和脑血管事件 (MACCE). 这些标志物可以改善风险评估,超越传统的措施,炎症起着调解作用.

科学领域:

心脏病学心脏病学
代谢综合征是代谢综合征的一种.
医疗信息学医疗信息学

背景情况:

冠状动脉旁路移植 (CABG) 具有重大心血管和脑血管重大不良事件 (MACCE) 的长期风险.
甘油三糖 (TyG) 指数是胰岛素耐药性的标志物,具有对心血管结果的预测价值.
目前的风险分层方法不能完全捕捉肥胖现象型的异质性,需要新的方法.

研究的目的:

系统地评估和比较四个新的TyG脂肪指数 (TyG-CVAI,TyG-BRI,TyG-LAP,TyG-ABSI) 以预测CABG后的长期MACCE.
探索系统性炎症在这些指数和MACCE之间的关联中的潜在调解作用.
为了确定这些复合指数是否提供了与单独的TyG指数或简单的人类指数相比更好的风险分层.

主要方法:

一个回顾性队列研究2547患者接受CABG.
从基线数据计算四个TyG脂肪指数.
使用多变量考克斯回归,受限立方线和中介分析评估MACCE发生率.
通过Uno的C指数,时间依赖ROC曲线和决策曲线分析评估模型性能.

主要成果:

在4.25年的中位数随访期间,发生了667起MACCE事件.
在经历MACCE的患者中,所有四个TyG脂肪指数都显著高于MACCE,并独立预测增加风险.
TyG-BRI表现出最高的歧视能力 (联合国C指数为0.709),超过其他指数和单独的TyG指数.
在指数与MACCE风险之间的关联中,C-反应蛋白占12.26%-24.20%.

结论:

TyG-脂肪综合指数,特别是TyG-BRI,独立地与CABG后的长期MACCE风险相关.
这些新型指数提供了超出TyG指数或基本人体测量指标的增量预测值.
系统性炎症部分调解了这种关系,这表明这些指数可以完善风险分层,并识别高风险患者进行密集管理.

关键词:

冠状动脉绕道移植冠状动脉绕道移植胰岛素耐药性胰岛素耐药性是一种主要不良心血管和脑血管事件风险分层是指风险的分层.系统性炎症是一种系统性炎症.的TyG-脂肪指数.内在的肥胖症是什么意思

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