RESUMEN
BACKGROUND: Studies have shown that insulin resistance is strongly associated with the development of cardiovascular disease, and the triglyceride glucose-body mass index (TyG-BMI index) is considered to be a reliable surrogate marker of insulin resistance. There are limited studies on the relationship between TyG-BMI index and the extent of coronary artery disease in patients with acute coronary syndrome (ACS). This study aimed to investigate the relationship between TyG-BMI index and the extent of coronary artery disease in patients with ACS. METHODS: Overall, 2,317 patients with ACS who underwent percutaneous coronary intervention at the Affiliated Hospital of Zunyi Medical University were included in this study. The TyG-BMI index was grouped according to the tertile method. The extent of coronary artery disease in patients with ACS was quantitatively assessed using the SYNTAX score, which was categorised as low (≤ 22), intermediate (23-32), and high risk (≥ 33). RESULTS: In the overall population, multivariate logistic regression analyses showed that TyG-BMI index was associated with mid/high SYNTAX score in patients with ACS (odds ratio [OR] = 1.0041; 95% confidence interval [CI] = 1.0000-1.0079; p = 0.0310). Subgroup analyses showed that TyG-BMI index was an independent risk factor for mid/high SYNTAX score in female ACS patients after adjusting for multiple confounders (OR = 1.0100; 95% CI = 1.0000-1.0200; p = 0.0050), and that the risk of mid/high SYNTAX score was 2.49 times higher in the T3 group (OR = 2.4900; 95% CI = 1.2200-5.0600; p = 0.0120). Restricted cubic spline analysis showed a linear correlation between TyG-BMI index and complex coronary artery disease (SYNTAX score > 22) in women with ACS. In female ACS patients, inclusion of the TyG-BMI index did not improve the predictive power of the underlying risk model (net reclassification improvement: 0.0867 [-0.0256-0.1989], p = 0.1301; integrated discrimination improvement: 0.0183 [0.0038-0.0329], p = 0.0135). CONCLUSIONS: TyG-BMI index is linearly associated with the degree of complex coronary artery disease in female ACS patients. However, the inclusion of the TyG-BMI index did not improve the predictive power of the underlying risk model for female ACS patients.
Asunto(s)
Síndrome Coronario Agudo , Enfermedad de la Arteria Coronaria , Resistencia a la Insulina , Humanos , Femenino , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Enfermedad de la Arteria Coronaria/terapia , Índice de Masa Corporal , Síndrome Coronario Agudo/diagnóstico , Síndrome Coronario Agudo/terapia , Glucosa , Factores de Riesgo , Triglicéridos , Glucemia , BiomarcadoresRESUMEN
Water-sediment regulation (WSR) of the Xiaolangdi Reservoir in the Yellow River is different from other water conservancy projects, with sediment resuspending along the river downstream of the reservoir during water regulation while some suspended sediment depositing during sediment regulation. In this study, samples were collected before, during, and after WSR to investigate the effect of WSR on the suspended sediment and organic carbon downstream of the reservoir. The suspended sediment concentration ([SPS]) increased with the river flow velocity (V) as a power function ([SPS]=1.348V(2.519)) during the three periods. The suspended sediment grain size decreased along the river during water and sediment regulations and after WSR; they were generally below 200µm with the fine particles (<50µm) of 68.0%-93.7% and positively correlated with the flow velocity. The black carbon content in suspended sediment elevated along the river during both water and sediment regulations, and it increased with 2-50µm fraction during water regulation and with <2µm fraction during sediment regulation, suggesting that black carbon mainly exists in fine particles and is influenced by both suspended sediment source and characteristics. There was no significant difference in dissolved organic carbon (DOC) concentration during water regulation, sediment regulation, and after WSR, inferring that the effect of sediment resuspension/deposition on DOC concentration was insignificant. The contribution of DOC flux (27.3%) during WSR period to the annual flux was comparable to that (22.6%) of water, but lower than the sediment (32.5%) and particulate organic carbon (POC) (49.5%). This study suggests that WSR will exert significant influence on the concentrations, characteristics and fluxes of POC (p<0.05) and sediment (p<0.05) but have no significant influence on DOC (p>0.1) of the Yellow River.