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Mối liên hệ giữa chỉ số triglyceride-glucose và sự khởi phát rung tâm nhĩ ở bệnh nhân mắc bệnh gan nhiễm mỡ không do rượu
Tóm tắt
Bệnh gan nhiễm mỡ không do rượu (NAFLD) có liên quan đến rung tâm nhĩ (AF). Kháng insulin (IR) là nguyên nhân chính dẫn đến tỷ lệ mắc AF cao ở bệnh nhân NAFLD. Chỉ số triglyceride-glucose (TyG) là một chỉ số mới liên quan đến IR có vai trò trong việc xác định tỷ lệ mắc và mức độ nghiêm trọng của NAFLD. Tuy nhiên, vai trò của TyG trong việc xác định nguy cơ AF ở bệnh nhân NAFLD vẫn chưa được làm rõ. Một nghiên cứu hồi cứu đã được tiến hành trên 912 bệnh nhân được chẩn đoán mắc NAFLD qua siêu âm. Những bệnh nhân này được chia thành hai nhóm: (1) NAFLD+ AF và (2) NAFLD+ không AF. Phân tích hồi quy Least Absolute Shrinkage and Selection Operator (LASSO) được sử dụng để đánh giá mối tương quan giữa chỉ số TyG và nguy cơ cao mắc AF. Một đường cong đặc trưng hoạt động nhận diện (ROC) đã được xây dựng để đánh giá giá trị dự đoán của chỉ số TyG đối với AF. Các splines hình chóp bị hạn chế (RCS) được sử dụng để kiểm tra mối tương quan tuyến tính giữa TyG và nguy cơ AF. Tổng cộng có 204 bệnh nhân bị AF và 708 bệnh nhân không bị AF được đưa vào nghiên cứu này. Phân tích hồi quy logistic LASSO cho thấy rằng TyG là một yếu tố nguy cơ độc lập đối với AF (tỷ lệ odds [OR] = 4.84, khoảng tin cậy [CI] 95% 2.98–7.88, P < 0.001). RCS cho thấy nguy cơ AF tăng lên một cách tuyến tính với TyG trên toàn bộ khoảng TyG; nguy cơ này cũng rõ ràng khi bệnh nhân được phân tích theo giới tính (P cho phi tuyến tính > 0.05). Thêm vào đó, mối tương quan giữa TyG và AF là một phát hiện nhất quán trong phân tích nhóm con. Hơn nữa, phân tích đường cong ROC cho thấy mức độ TyG kết hợp với các yếu tố nguy cơ truyền thống đã cải thiện giá trị dự đoán cho rung tâm nhĩ. Chỉ số TyG hữu ích trong việc đánh giá nguy cơ rung tâm nhĩ ở bệnh nhân NAFLD. Những bệnh nhân mắc NAFLD và có chỉ số TyG cao có nguy cơ rung tâm nhĩ cao hơn. Do đó, chỉ số TyG nên được đánh giá khi quản lý bệnh nhân mắc NAFLD.
Từ khóa
#bệnh gan nhiễm mỡ không do rượu #rung tâm nhĩ #kháng insulin #chỉ số triglyceride-glucoseTài liệu tham khảo
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