摘要
Abstract
Objective:To investigate the predictive value of triglyceride glucose(TyG)index combined with glycated hemoglobin(HbA1c)on left ventricular systolic dysfunction in elderly patients with type 2 diabetes mellitus(T2DM).Methods:The clinical data of 166 elderly patients with T2DM attending Wuhan Fourth Hospital from December 2018 to December 2022 were retrospectively analyzed.The patients were divided into TyG-1 group(TyG≤8.89),TyG-2 group(TyG>8.89～9.44),TyG-3 group(TyG>9.44～9.83)and TyG-4 group(TyG>9.83)according to the quartile values of TyG index.Then we compared the differences in clinical ultrasound characteristics of T2DM patients with different TyG indices and analyzed the predictive value of TyG index combined with HbA1c on left ventricular systolic dysfunction in elderly patients with T2DM.Results:Fasting blood glucose,total cholesterol,triglycerides,apolipoprotein A1,apolipoprotein B(ApoB)and the proportion of hyperten-sion were higher in the TyG-2,TyG-3 and TyG-4 groups compared with the TyG-1 group(P<0.05).Fasting blood glucose,HbA1c,low-density lipoprotein(LDL),triglycerides and ApoB were elevated in patients in the TyG-3 and TyG-4 groups com-pared with the TyG-2 group(P<0.05).Fasting blood glucose,HbA1c,total cholesterol,triglycerides and apolipoprotein A1 were elevated in patients in the TyG-4 group compared with the TyG-3 group(P<0.05).The overall longitudinal peak strain(GLS)values were lower in patients in the TyG-3 and TyG-4 groups compared with the TyG-1 and TyG-2 groups(P<0.05).The re-sults of Logistic regression analysis showed that HbA1c and TyG index were independent risk factors for left ventricular sys-tolic dysfunction in elderly patients with T2DM.The areas under the ROC curves for TyG index and HbA1c predicting left ventricular systolic dysfunction in elderly patients with T2DM was 0.775(P<0.05,95%CI:0.705～0.844),0.758(P<0.05,95%CI:0.684～0.831),respectively.The area under the ROC curve of TyG index combined with HbA1c to predict left ventricular sys-tolic dysfunction in elderly patients with T2DM was 0.801(P<0.05,95%CI:0.733～0.869),with a sensitivity of 73.17%and a specificity of 77.38%when the predictive probability value was taken as the best cutoff value of 0.506.Conclusion:TyG index combined with HbA1c has a good predictive value for left ventricular systolic dysfunction in elderly patients with T2DM.关键词
糖尿病/心室功能障碍,左/超声心动描记术Key words
Diabetes Mellitus/Ventricular Dysfunction,Left/Echocardiography分类
医药卫生
