Association Between Triglyceride-Glucose Index, Blood Pressure Status, and Coronary Heart Disease Risk Among Chinese Adults With Disabilities: 10-Year Disability Health Survey Cohort Study
Notice bibliographique
Résumé
Background: The triglyceride-glucose (TyG) index and blood pressure (BP) status are key indicators associated with coronary heart disease (CHD). However, limited research has focused on individuals with disabilities. Objective: This study explores the potential combined effects of the TyG index and BP status on CHD risk in groups with varying disability characteristics. Methods: This study analyzed data from the Shanghai Disability Health Survey, conducted between January 2012 and December 2022. Participants were then categorized into 3 BP status groups: nonelevated BP, elevated BP, and hypertension. Cox proportional hazards regression models were used to assess the associations between BP status, the TyG index, and CHD incidence. Additionally, the mediating, interaction, and combined effects of these factors on CHD risk were examined. A stratified analysis was performed based on participants' disability characteristics, including disability type and severity, to explore potential variations in the associations. Results: Among the 21,628 participants, the mean age was 53.30 (SD 10.57) years, and 50.89% (11007/21628) were male. In a follow-up of 77.45 months, CHD events occurred in 2312 participants (10.69%). The TyG index and BP status were independently associated with an increased risk of CHD. Mediation analysis showed that TyG explained 20.5% (95% CI 13.6%-22.0%) of the BP and CHD association. Significant multiplicative interactions were identified (hazard ratio [HR] 1.41, 95% CI 1.02-1.94), and joint analysis indicated the highest CHD risk in those with both hypertension and elevated TyG (HR 1.92, 95% CI 1.52-2.42). Stratified analyses revealed stronger mediation in participants with physical disabilities (22.6%, 95% CI 9.0%-60%) or visual disabilities (16.6%, 95% CI 4.8%-51%), while this was not significant in those with hearing or speech (P=.07) or intellectual or mental disabilities (P=.13). By disability grading, the mediated proportion was 22.3% (95% CI 9.2%-59.4%) in mild or moderate and 18.8% (95% CI 15.7%-29%) in severe or very severe groups. Joint associations showed consistently higher CHD risk across most disability classifications, with particularly elevated risk in people with intellectual or mental disabilities (HR 3.51, 95% CI 1.89-6.50). Conclusions: BP and the TyG index were significantly associated with CHD risk in individuals with disabilities, with TyG mediating a part of this association and showing stronger effects in physical and mild to moderate disabilities. Significant interactions between BP and TyG further highlight their combined impact, underscoring the need for integrated interventions targeting both factors.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».