The predictive value of the TyG index for restenosis after interventional treatment in patients with lower extremity arteriosclerotic occlusive disease

doi:10.11958/20252830

Abstract

Abstract:

Objective To explore the predictive value of the triglyceride-glucose (TyG) index for restenosis in patients with lower extremity arteriosclerotic occlusive disease after interventional therapy. Methods A retrospective analysis was conducted on the clinical data of 210 patients with lower extremity arteriosclerotic occlusive disease who received interventional treatment. The patients were divided into the low TyG group (TyG<7.70, n=75), the medium TyG group (7.70≤TyG≤8.50, n=80) and the high TyG group (TyG>8.50, n=55) based on the TyG index. The clinical characteristics of the three groups were compared. Univariate analysis was used to screen the factors related to restenosis, and Cox proportional hazards regression analysis was used to determine the independent influencing factors. The receiver operating characteristic (ROC) curve was drawn to evaluate the predictive efficacy of the TyG index for restenosis, and the Kaplan-Meier method was used to compare the occurrence of restenosis in patients with different TyG levels. Results The patient age, body mass index (BMI), prevalence of diabetes, lesion length and stent implantation rate were higher in the high TyG group compared with those of the low TyG group and the medium TyG group (P<0.05). After 6 to 24 months of postoperative follow-up, with an average of (15.36±4.25) months, the restenosis rate of the entire group was 34.76% (73/210), including 26 cases (35.62%) of mild restenosis, 24 cases (32.88%) of moderate restenosis and 23 cases (31.50%) of severe restenosis. The restenosis rates of the low, medium and high TyG groups increased successively (21.33% vs. 35.00% vs. 52.73%). Cox proportional hazards regression analysis showed that an elevated TyG index (HR=3.245, 95%CI: 1.987-5.316, P<0.001) was an independent risk factor for restenosis. Kaplan-Meier analysis revealed that the restenosis rate of the high TyG group was higher than that of the low TyG group and the medium TyG group (Log-rank χ²=13.951, P<0.01). Conclusion The TyG index can serve as an effective predictor for restenosis in patients with lower extremity arteriosclerotic occlusive disease after interventional treatment. The higher the TyG index, the higher the risk of restenosis after the operation.

Key words: arteriosclerosis obliterans, lower extremity, endovascular procedures, TyG index, restenosis

CLC Number:

R543.5

Figures/Tables 4

References 21

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组别		n		年龄/岁		性别（男/女）		BMI/（kg/m2）		高血压
低TyG组		75		61.89±6.97		46/29		24.92±2.85		53（70.7）
中TyG组		80		66.25±7.83		50/30		25.88±3.29		57（71.2）
高TyG组		55		69.93±8.71^ab		37/18		27.35±3.54^ab		40（72.7）
F或χ2				10.152^＊＊		0.783		5.217^＊＊		0.089
组别			糖尿病		高脂血症		冠心病		吸烟史
低TyG组			34（45.3）		48（64.0）		24（32.0）		36（48.0）
中TyG组			42（52.5）		51（63.8）		26（32.5）		38（47.5）
高TyG组			40（72.7）^ab		39（70.9）		20（36.4）		29（52.7）
F或χ2			12.874^＊＊		0.936		0.358		0.472
组别	病变部位（股浅动脉/ 腘动脉/胫腓干动脉）					病变长度/ cm		介入治疗方式（支架置入/DCB/单纯球囊）
低TyG组	38/22/15					10.56±4.78		33/25/17
中TyG组	41/24/15					12.18±5.32		36/28/16
高TyG组	27/16/12					16.12±6.89^ab		34/4/17
F或χ2	1.532					18.753^＊＊		14.296^＊＊

组别		n		年龄/岁		性别（男/女）		BMI/（kg/m2）		高血压
低TyG组		75		61.89±6.97		46/29		24.92±2.85		53（70.7）
中TyG组		80		66.25±7.83		50/30		25.88±3.29		57（71.2）
高TyG组		55		69.93±8.71^ab		37/18		27.35±3.54^ab		40（72.7）
F或χ2				10.152^＊＊		0.783		5.217^＊＊		0.089
组别			糖尿病		高脂血症		冠心病		吸烟史
低TyG组			34（45.3）		48（64.0）		24（32.0）		36（48.0）
中TyG组			42（52.5）		51（63.8）		26（32.5）		38（47.5）
高TyG组			40（72.7）^ab		39（70.9）		20（36.4）		29（52.7）
F或χ2			12.874^＊＊		0.936		0.358		0.472
组别	病变部位（股浅动脉/ 腘动脉/胫腓干动脉）					病变长度/ cm		介入治疗方式（支架置入/DCB/单纯球囊）
低TyG组	38/22/15					10.56±4.78		33/25/17
中TyG组	41/24/15					12.18±5.32		36/28/16
高TyG组	27/16/12					16.12±6.89^ab		34/4/17
F或χ2	1.532					18.753^＊＊		14.296^＊＊

组别			n	年龄/岁		性别（男/女）				BMI/（kg/m2）			高血压
非再狭窄组			137	63.58±7.12		84/53				25.36±3.11			95（69.3）
再狭窄组			73	69.87±8.45		49/24				26.98±3.42			55（75.3）
t或χ2				5.924^＊＊		0.692				3.107^＊＊			0.876
组别		糖尿病			高脂血症		冠心病		吸烟史		病变长度/cm
非再狭窄组		58（42.3）			85（62.0）		42（30.7）		66（48.2）		11.56±5.23
再狭窄组		58（79.5）			53（72.6）		28（38.4）		37（50.7）		15.97±6.71
t或χ2		26.534^＊＊			2.357		0.075		0.125		6.215^＊＊
组别	病变部位（股浅动脉/ 腘动脉/胫腓干动脉）							介入治疗方式（支架置入/DCB/单纯球囊）				TyG 指数
非再狭窄组	69/38/30							66/40/31				7.85±0.82
再狭窄组	37/24/12							37/17/19				8.92±1.03
t或χ2	1.325							21.367^＊＊				7.032^＊＊

组别			n	年龄/岁		性别（男/女）				BMI/（kg/m2）			高血压
非再狭窄组			137	63.58±7.12		84/53				25.36±3.11			95（69.3）
再狭窄组			73	69.87±8.45		49/24				26.98±3.42			55（75.3）
t或χ2				5.924^＊＊		0.692				3.107^＊＊			0.876
组别		糖尿病			高脂血症		冠心病		吸烟史		病变长度/cm
非再狭窄组		58（42.3）			85（62.0）		42（30.7）		66（48.2）		11.56±5.23
再狭窄组		58（79.5）			53（72.6）		28（38.4）		37（50.7）		15.97±6.71
t或χ2		26.534^＊＊			2.357		0.075		0.125		6.215^＊＊
组别	病变部位（股浅动脉/ 腘动脉/胫腓干动脉）							介入治疗方式（支架置入/DCB/单纯球囊）				TyG 指数
非再狭窄组	69/38/30							66/40/31				7.85±0.82
再狭窄组	37/24/12							37/17/19				8.92±1.03
t或χ2	1.325							21.367^＊＊				7.032^＊＊

自变量	B	SE	Wald χ2	P	HR（95%CI）
年龄	0.124	0.063	3.876	0.052	1.132（1.001~1.280）
糖尿病	0.985	0.382	6.741	0.003	2.678（1.403~5.114）
BMI	0.156	0.061	6.452	0.011	1.169（1.038~1.316）
病变长度	0.372	0.109	11.582	<0.001	1.450（1.189~1.772）
介入治疗方式			14.328	<0.001
DCB	0.125	0.218	0.328	0.567	1.133（0.725~1.768）
支架置入	1.508	0.412	13.364	<0.001	4.512（2.189~9.307）
TyG指数	1.176	0.295	15.897	<0.001	3.245（1.987~5.316）