联合观察性研究与孟德尔随机化分析验证甘油三酯-葡萄糖指数与冠心病的关联

doi:10.3969/j.issn.1006-5725.2026.12.019

Abstract

Abstract:

Objective To investigate the relationship between the triglyceride-glucose index （TyG index） and coronary heart disease （CHD）. Methods Clinical data were collected from patients who were admitted to the Department of Cardiology of our hospital because of chest tightness and pain with suspected CHD and underwent coronary angiography between January 2019 and February 2025. Based on the angiography results， the participants were classified into a CHD group and a non-CHD group. According to the quartiles of the TyG index， the participants were further divided into Q1， Q2， Q3， and Q4 groups. Multivariate logistic regression and restricted cubic spline models were used to evaluate the correlation and trend between the clinical TyG levels and the risk of CHD. After adjusting for multiple covariates， smooth curve analysis was carried out to assess the risk of CHD. Meanwhile， based on the summary data from large-scale genome-wide association studies， a two-sample Mendelian randomization （MR） analysis was conducted to prospectively explore the causal effect of the TyG index on CHD. The inverse variance weighting method was used as the primary analytical approach， and multiple sensitivity analyses were conducted to verify the robustness of the causal relationship. Results Clinical data analysis revealed that participants in the CHD group had age， fasting blood glucose levels， triglycerides， TyG index， creatinine AST， patients with diabetes， taking antihypertensive drugs and hypoglycemic drugs were significantly higher than those in the non CHD group， while high-density lipoprotein was lower than that in the non CHD group （P < 0.05）. After adjusting for traditional cardiovascular risk factors， patients in the Q1 and Q4 groups of the TyG index had a significantly increased risk of developing CHD （OR=3.41， 95%CI = 1.41 - 8.26， P = 0.006 6）. Trend analysis further revealed a positive dose-response relationship between the TyG index and the risk of CHD. MR analysis demonstrated a causal association between a higher TyG index and an increased risk of CHD （OR = 2.00， 95%CI： 1.64 - 2.45， P < 0.001）. Conclusions This study confirms， via both clinical data analysis and MR， that a higher TyG index is positively and causally associated with an elevated risk of CHD. These findings imply that the TyG index could act as a biomarker for identifying individuals at a greater risk of CHD.

Key words: triglyceride-glucose index, coronary heart disease, Mendelian randomization, causal relationship, correlation

CLC Number:

R541.4

Yingtao YU,jinyan SU,Xiulong ZHU. Integrating observational and Mendelian randomization analyses to investigate the association between the triglyceride-glucose index and coronary heart disease[J]. The Journal of Practical Medicine, 2026, 42(12): 2230-2237.

Figures/Tables 5

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References 30

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参与者特征	非CHD组（n = 149）	CHD组（n = 144）	P值
年龄/岁	59.6 ± 10.3	66.0 ± 11.1	< 0.001
FPG/（mg/dL）	113.7 ± 42.3	135.1 ± 67.2	0.001
TG/（mg/dL）	143.3 ± 88.3	174.0 ± 120.5	0.008
TyG指数	8.8 ± 0.7	9.1 ± 0.8	< 0.001
肌酐/（μmol/L）	72.5 ± 19.6	82.2 ± 36.7	0.040
尿酸/（μmol/L）	362.7 ± 91.7	381.6 ± 100.1	0.197
总胆固醇/（mmol/L）	5.5 ± 1.1	5.5 ± 1.4	0.959
低密度脂蛋白/（mmol/L）	3.5 ± 0.8	3.6 ± 1.0	0.913
高密度脂蛋白/（mmol/L）	1.3 ± 0.3	1.2 ± 0.3	< 0.001
ALT/（U/L）	26.8 ± 23.3	26.1 ± 16.4	0.293
AST/（U/L）	28.6 ± 13.1	35.9 ± 45.3	< 0.001
BMI/（kg/m²）	23.7 ± 3.8	24.0 ± 3.7	0.782
性别/［例（%）］			0.108
女	75（50.3）	59（41.0）
男	74（49.7）	85（59.0）
高血压病/［例（%）］			0.337
否	110（73.8）	99（68.8）
是	39（26.2）	45（31.2）
糖尿病/［例（%）］			0.007
否	134（89.9）	113（78.5）
是	15（10.1）	31（21.5）
吸烟/［例（%）］			0.064
否	130（87.2）	114（79.2）
是	19（12.8）	30（20.8）
降脂药/［例（%）］			0.002
否	119（79.9）	91（63.2）
是	30（20.1）	53（36.8）
降糖药/［例（%）］			0.012
否	133（89.3）	113（78.5）
是	16（10.7）	31（21.5）

暴露因素	模型Ⅰ		模型Ⅱ		模型Ⅲ
暴露因素	OR（95%CI）	P值	OR（95%CI）	P值	OR（95%CI）	P值
TyG指数	1.92（1.36 ~ 2.70）	0.000 2	2.47（1.64 ~ 3.73）	< 0.000 1	1.72（1.09 ~ 2.71）	0.018 9
TyG指数（四分位数）
Q1	1.0		1.0		1.0
Q2	1.88（0.96 ~ 3.68）	0.064 8	2.17（1.03 ~ 4.59）	0.042 4	2.24（1.00 ~ 5.04）	0.050 5
Q3	1.99（1.02 ~ 3.88）	0.044 7	2.84（1.35 ~ 6.01）	0.006 1	2.10（0.92 ~ 4.78）	0.079 2
Q4	4.00（2.02 ~ 7.95）	< 0.000 1	6.08（2.75 ~ 13.43）	< 0.000 1	3.41（1.41 ~ 8.26）	0.006 6
P值（趋势性分析）	1.52（1.23 ~ 1.88）	0.000 1	1.77（1.37 ~ 2.27）	< 0.000 1	1.44（1.08 ~ 1.90）	0.011 9

Integrating observational and Mendelian randomization analyses to investigate the association between the triglyceride-glucose index and coronary heart disease

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