近日，杭州师范大学附属医院科研部主任王明伟及其团队在Cardiovascular Diabetology杂志发表题为"Triglyceride-glucose-body mass index and the incidence of cardiovascular diseases: a meta-analysis of cohort studies"（甘油三酯-葡萄糖-体重指数与心血管疾病发病率：队列研究的荟萃分析）的研究成果。

Cardiovascular Diabetology 是一份高水平的国际权威期刊，聚焦糖尿病与心血管疾病的研究前沿。近年来，该刊影响因子呈现稳步上升趋势，从2015年的4分+逐渐攀升至2020年的9分+。2021年至2023年间影响因子在8-9分区间徘徊，2023年影响因子为8.5，实时因子已达10.19。根据预测，影响因子有望突破11.124，实现新的高点，显示其在学术界的持续影响力。该期刊目前位于中科院分区的大类和小类1区Top，在JCR分区中稳居Q1。

背景：大量研究表明，胰岛素抵抗（IR）与心血管疾病（CVD）的发病密切相关。本研究旨在通过荟萃分析总结基线时无CVD的患者中，胰岛素抵抗的新替代指标胰岛素-葡萄糖-体重指数（TyG-BMI指数）与CVD发生率之间的相关性。

方法：通过检索PubMed、科克伦图书馆、EMBASE和Web of Science获得队列研究，评估TyG-BMI指数与心血管疾病（CVD）之间相关性的多变量校正风险比（HR）。使用随机效应模型合并结果，以解释纳入研究之间的异质性。稳健误差元回归用于拟合非线性剂量-反应关系。使用Review Manager 5.4和STATA 18.0进行统计分析。

结果：纳入了10项队列研究，共涉及871，728例受检者。结果表明，与TyG-BMI指数最低的人群相比，TyG-BMI指数最高的人群心血管疾病（CVD）发病率较高（HR = 1.62; 95%置信区间（CI）：1.35-1.95; I2 = 94%）、冠状动脉疾病（CAD）（HR = 1.69; 95%置信区间（CI）：1.23-2.31; I2 = 94%）。中风（2）两组间差异有统计学意义（P < 0.05）。在剂量-反应分析中，TyG-BMI指数与CVD风险呈线性相关（P非线性= 0.223），CAD（P非线性= 0.693），脑卒中性别、随访时间、样本量和平均年龄对受试者的影响无统计学意义（P > 0.05）。

结论：TyG-BMI较高可能与基线时无CVD的个体中CVD风险增加独立相关。需要大量队列研究来进一步验证和阐明Tyg-BMI与CVD之间的病理学作用，并确定是否可以将其纳入CVD风险预测工具以提高预测准确性。

Oraginal

Background：

Numerous studies have shown that insulin resistance (IR) is closely related to the pathogenesis of cardiovascular disease (CVD). This study aims to summarize the correlation between the triglyceride-glucose-body mass index (TyG-BMI index), a novel surrogate indicator of insulin resistance, and the incidence of CVD in patients without CVD at baseline through meta-analysis.

Methods：

Cohort studies assessing multivariate-corrected hazard ratios (HRs) for associations between the TyG-BMI index and cardiovascular disease (CVD) were obtained by searching PubMed, Cochrane Library, EMBASE, and Web of Science. Results were combined using a random-effects model to account for heterogeneity among the included studies. Robust error meta-regression was used to fit the nonlinear dose–response relationship. Statistical analysis was performed using Review Manager 5.4 and STATA 18.0.

Results：

Ten cohort studies involving a total of 871,728 subjects were included. The results indicated that Compared with the lowest TyG-BMI index category, the highest TyG-BMI index was related to a higher incidence of cardiovascular diseases (CVD) (HR = 1.62; 95% confidence interval (CI): 1.35–1.95; I2 = 94%),coronary artery disease (CAD) (HR = 1.69;95% (CI): 1.23–2.31; I2 = 94%). stroke(HR = 1.57; 95% (CI): 1.11–2.23; I2 = 94%).In the dose–response analysis, there was a linear association of the TyG-BMI index with the risk of CVD (Pnonlinear = 0.223), CAD (Pnonlinear = 0.693), and stroke(Pnonlinear = 0.122)No significant effects were observed regarding participants’ gender, length of follow-up, sample size or mean age(P > 0.05).

Conclusions：

Higher TyG-BMI may be independently associated with an increased risk of CVD in individuals without CVD at baseline. Numerous cohort studies are needed to further validate and elucidate the pathologic role between Tyg-BMI and CVD and to determine whether it can be incorporated into CVD risk prediction tools to enhance predictive accuracy.

原文链接

Rao, X., Xin, Z., Yu, Q. et al. Triglyceride-glucose-body mass index and the incidence of cardiovascular diseases: a meta-analysis of cohort studies. Cardiovasc Diabetol 24, 34 (2025). https://doi.org/10.1186/s12933-025-02584-0

专家介绍/ Expert introduction

王明伟，医学博士，副主任医师，硕士研究生导师，浙江省医坛新秀，杭州市心血管病研究所副所长，杭州市马拉松研究所副所长，建德市第一人民医院副院长，杭州师范大学附属医院科研部主任，杭州市博士创新站负责人（临安区第四人民医院），杭州师范大学十佳研究生优良学风示范团队。擅长疑难心血管病，尤其是冠状动脉复杂、急性或慢性闭塞性病变的介入手术治疗。熟练开展急诊经皮冠状动脉球囊成形术、冠脉内超声术、主动脉内气囊反搏术、冠脉内血栓抽吸术，完成各类冠心病手术2000余例。主持各类课题8项，发表论文50余篇，专利5项，SCI收录30余篇。致力于脂肪肝心脏病学的研究和传播。任中国医药教育协会心血管内科专业委员会副主任委员，浙江省医学会心血管病学分会青年委员，浙江省医学会科研管理分会委员，浙江省医学会临床试验和伦理分会委员。

门诊时间：周六上午精英门诊（杭师大附院门诊楼六楼名医门诊）