| TAZ-TFM-2018-616 |
Análisis del índice Triglicéridos/Glucosa en una muestra de pacientes ingresados por descompensación de insuficiencia cardíaca
Alda Lozano, Alicia
Garcés Horna, Vanesa (dir.)
Universidad de Zaragoza,
MED,
2018
Medicina, Psiquiatría y Dermatología department, Medicina area
Máster Universitario en Iniciación a la Investigación en Medicina
Tipo de Trabajo Académico: Trabajo Fin de Master
Notas: Introduction: Heart Failure (HF) is a health public problem, and its prevalence is around 1-2% in developed countries. It has a high mortality rate despite therapeutic developments. Many biomarkers, which have prognostic and therapeutic usefulness, have been studied in HF. The B type natriuretic peptide (BNP) has the mayor clinically significance. Then, there are many other biomarkers with potential physiopathological usefulness, but they have little practical application, so that new biomarkers are still needed to help in the management of HF. Diabetes and insulin resistance are risk factor independent for development of HF. Several new methods for measuring insulin resistance are been developed, one of them is the Triglycerides-Glucose index. Hypothesis: DM and insulin resistance have a high prevalence in patients with HF, so we hypothesized whether the TyG index could be used as a prognostic marker in patients with HF. Objective: Calculate the TyG index in a cohort of patients with HF. And then valuate the potential association between TyG index and HF. Material and methods: Observational and retrospective study, constituted by a sample of 278 patients who had suffered an episode of HF decompensation due to it, they had admitted to the Internal Medicine service of HCU Lozano Blesa from 2010 to February 2018. Several baseline variables of the patients were analyzed. Then, a follow-up was carried out with a control at month and year of the first episode of decompensation. We relate the TyG index with the risk of death and decompensation during the period of time analyzed. Results: The TyG index was calculated, obtaining an average value of 8.56 ± 0.57. The differences which we found, weren’t statistically significant neither according to sex nor according to EF. On the other hand, the differences found in the percentage of death per month were significant, being higher in patients with lower values (p: 0.045). In the analysis of survival, a greater survival was observed in a significant way in the group with higher levels (log-rank: 0.035). Discussion: The results which we had obtained can be explained with the obesity paradox, in the setting of chronic HF, overweight and mild to moderate obesity is associated with substantially improved survival compared to normal-weight patients. Conclusion: The TyG index is a subrogated marker of insulin resistance that has been found to be highest in individuals with diabetes and obesity. In the sample studied, it was observed that those patients with higher values had a lower rate of death at one month and a higher survival during one year of follow-up. It seems convenient given the simplicity for its calculation in continuing to investigate its potential value as a biomarker in HF, as well as to analyze whether variations in its value provide more prognostic information.
Notas: Introduction: Heart Failure (HF) is a health public problem, and its prevalence is around 1-2% in developed countries. It has a high mortality rate despite therapeutic developments. Many biomarkers, which have prognostic and therapeutic usefulness, have been studied in HF. The B type natriuretic peptide (BNP) has the mayor clinically significance. Then, there are many other biomarkers with potential physiopathological usefulness, but they have little practical application, so that new biomarkers are still needed to help in the management of HF. Diabetes and insulin resistance are risk factor independent for development of HF. Several new methods for measuring insulin resistance are been developed, one of them is the Triglycerides-Glucose index. Hypothesis: DM and insulin resistance have a high prevalence in patients with HF, so we hypothesized whether the TyG index could be used as a prognostic marker in patients with HF. Objective: Calculate the TyG index in a cohort of patients with HF. And then valuate the potential association between TyG index and HF. Material and methods: Observational and retrospective study, constituted by a sample of 278 patients who had suffered an episode of HF decompensation due to it, they had admitted to the Internal Medicine service of HCU Lozano Blesa from 2010 to February 2018. Several baseline variables of the patients were analyzed. Then, a follow-up was carried out with a control at month and year of the first episode of decompensation. We relate the TyG index with the risk of death and decompensation during the period of time analyzed. Results: The TyG index was calculated, obtaining an average value of 8.56 ± 0.57. The differences which we found, weren’t statistically significant neither according to sex nor according to EF. On the other hand, the differences found in the percentage of death per month were significant, being higher in patients with lower values (p: 0.045). In the analysis of survival, a greater survival was observed in a significant way in the group with higher levels (log-rank: 0.035). Discussion: The results which we had obtained can be explained with the obesity paradox, in the setting of chronic HF, overweight and mild to moderate obesity is associated with substantially improved survival compared to normal-weight patients. Conclusion: The TyG index is a subrogated marker of insulin resistance that has been found to be highest in individuals with diabetes and obesity. In the sample studied, it was observed that those patients with higher values had a lower rate of death at one month and a higher survival during one year of follow-up. It seems convenient given the simplicity for its calculation in continuing to investigate its potential value as a biomarker in HF, as well as to analyze whether variations in its value provide more prognostic information.
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