甘油三酯葡萄糖指数和甘油三酯葡萄糖体重指数与慢性阻塞性肺疾病风险和预后的关系：系统综述和荟萃分析

摘要(中文译文)

甘油三酯-葡萄糖（TyG）指数及甘油三酯-葡萄糖体重指数（TyG-BMI）与慢性阻塞性肺疾病（COPD）患者发病风险及预后之间的关联尚不明确。本研究旨在分别评估TyG指数和TyG-BMI与非COPD人群发生COPD的风险以及已确诊COPD患者临床结局之间的关联。检索了PubMed、中国知网（CNKI）和Web of Science数据库，检索截止日期为2026年2月21日。分别针对评估非COPD人群COPD发病风险的研究以及评估已确诊COPD患者死亡率和其他不良临床结局的研究，计算合并比值比（OR）和95%置信区间（CI）。进一步基于糖尿病（DM）合并症进行亚组分析。共纳入11项研究，涉及488,622名参与者。在评估COPD发病风险的研究中，较高的TyG指数（OR=1.30，P=0.008）和TyG-BMI指数（OR=1.004，P=0.002）与COPD风险增加显著相关。在纳入已确诊COPD患者的研究中，TyG指数升高与全因死亡率（OR=1.20，P<0.001）、重症监护病房（ICU）死亡率（OR=1.84，P<0.001）、院内死亡率（OR=1.48，P=0.031）、呼吸衰竭（OR=2.03，P<0.001）、急性肾损伤（AKI）（OR=1.45，P=0.003）、脓毒症（OR=1.51，P=0.001）、慢性肺源性心脏病（CPHD）（OR=2.84，P<0.001）、严重通气功能障碍（SVD）（OR=2.82，P=0.001）及心力衰竭（HF）（OR=12.393，P<0.001）的发生率升高相关。基于DM合并症的亚组分析显示出一致的结果。TyG-BMI指数还与心血管疾病（CVD）相关死亡率相关（OR=1.002，P<0.05）。现有证据表明，较高的TyG和TyG-BMI指数与COPD风险增加相关。在已确诊COPD患者中，TyG相关指数升高还与多种不良临床结局相关。

Abstract

The association of triglyceride-glucose (TyG) index and triglyceride-glucose body mass (TyG-BMI) index with the risk and prognosis among patients with chronic obstructive pulmonary disease (COPD) remains unclear. This study aimed to separately evaluate the associations of the TyG index and TyG-BMI with the risk of developing chronic obstructive pulmonary disease (COPD) and clinical outcomes among patients with established COPD. PubMed, Chinese National Knowledge Infrastructure (CNKI) and Web of Science databases were searched up to February 21, 2026. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated separately for studies evaluating COPD risk in non-COPD populations and for studies evaluating mortality and other adverse clinical outcomes among patients with established COPD. Subgroup analysis based on the comorbidity of diabetes mellitus (DM) was further performed. Eleven studies with 488,622 participants were included. Among studies evaluating COPD risk, higher TyG index (OR =1.30, P=0.008) and TyG-BMI index (OR =1.004, P=0.002) was significantly related to increased risk of COPD. Among studies including patients with established COPD, elevated TyG index was association with higher incidence of all-cause mortality (OR =1.20, P<0.001), intensive care unit (ICU) mortality (OR =1.84, P<0.001), in-hospital mortality (OR =1.48, P=0.031), respiratory failure (OR =2.03, P<0.001), acute kidney injury (AKI) (OR =1.45, P=0.003), sepsis (OR =1.51, P=0.001), chronic pulmonary heart disease (CPHD) (OR =2.84, P<0.001), severe ventilation disorder (SVD) (OR =2.82, P=0.001) and heart failure (HF) (OR =12.393, P<0.001). Subgroup analysis based on the comorbidity of DM manifested consistent results. TyG-BMI index was also associated with cardiovascular disease (CVD)-related mortality (OR =1.002, P<0.05). Available evidence suggests that higher TyG and TyG-BMI indices are associated with an increased risk of COPD. In patients with established COPD, elevated TyG-related indices were also associated with several adverse clinical outcomes.

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