Correlation of triglyceride glucose index and monocyte to high-density lipoprotein cholesterol ratio with cardiac function in patients with acute exacerbation of chronic obstructive pulmonary disease

Zhang Sha; Liu Weiying; Wang Juan; Fu Wenli; Li Leping

doi:10.13406/j.cnki.cyxb.003741

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Correlation of triglyceride glucose index and monocyte to high-density lipoprotein cholesterol ratio with cardiac function in patients with acute exacerbation of chronic obstructive pulmonary disease

Clinical research | 更新时间：2025-10-22

- Correlation of triglyceride glucose index and monocyte to high-density lipoprotein cholesterol ratio with cardiac function in patients with acute exacerbation of chronic obstructive pulmonary disease
- Journal of Chongqing Medical University Vol. 50, Issue 7, Pages: 988-994(2025)
- 作者机构：
  
  1.兰州大学第一临床医学院，兰州 730000
  2.兰州大学第一医院呼吸与危重症医学科，兰州 730000
- 作者简介：
- 基金信息：
- DOI：10.13406/j.cnki.cyxb.003741
  CLC： R56
- Received：09 January 2024，
  
  Revised：2024-03-28，
  
  Accepted：22 May 2024，
  
  Published：28 July 2025
- 稿件说明：
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张莎,刘维英,王娟,等.TyG及MHR与慢性阻塞性肺疾病急性加重患者心功能的关系分析[J].重庆医科大学学报,2025,50(7):988-994.

Zhang Sha,Liu Weiying,Wang Juan,et al.Correlation of triglyceride glucose index and monocyte to high-density lipoprotein cholesterol ratio with cardiac function in patients with acute exacerbation of chronic obstructive pulmonary disease[J].Journal of Chongqing Medical University,2025,50(7):988-994.
张莎,刘维英,王娟,等.TyG及MHR与慢性阻塞性肺疾病急性加重患者心功能的关系分析[J].重庆医科大学学报,2025,50(7):988-994. DOI： 10.13406/j.cnki.cyxb.003741.

Zhang Sha,Liu Weiying,Wang Juan,et al.Correlation of triglyceride glucose index and monocyte to high-density lipoprotein cholesterol ratio with cardiac function in patients with acute exacerbation of chronic obstructive pulmonary disease[J].Journal of Chongqing Medical University,2025,50(7):988-994. DOI： 10.13406/j.cnki.cyxb.003741.

摘要

目的

分析甘油三酯葡萄糖指数（triglyceride-glucose，TyG）、单核细胞绝对值/高密度脂蛋白比值（monocyte count to high density lipoprotein cholesterol ratio，MHR）对慢性阻塞性肺疾病急性加重（acute exacerbation of chronic obstructive pulmonary disease，AECOPD）并发心力衰竭（heart failure，HF）的诊断价值，以及TyG、MHR与AECOPD患者心功能参数的相关性。

方法

收集兰州大学第一医院2020年1月至2021年12月收治住院的298例AECOPD患者临床资料进行回顾性分析，根据临床表现、B型钠尿肽/N末端B型钠尿肽前体和超声心动图结果，将298例AECOPD患者分为HF组（

=127例）和非HF组（

=171例），比较2组AECOPD患者各项临床指标的差异，采用回归分析研究AECOPD患者并发HF可能的危险因素，通过受试者工作特征（receiver o

perating characteristic，ROC）曲线分析TyG、MHR分别及联合对AECOPD并发HF的诊断价值；采用相关性分析探讨TyG、MHR与AECOPD患者射血分数、室壁厚度、心腔大小和瓣膜反流速率等心功能参考指标的相关性。

结果

二元logistic回归分析提示空腹血糖、单核细胞绝对值、高密度脂蛋白胆固醇（high density lipoprotein cholesterol，HDL-C）、心律失常、TyG、MHR是AECOPD患者发生HF的危险因素；HF组患者TyG、MHR水平明显高于非HF组（

0.001），TyG诊断AECOPD合并HF曲线下面积为0.805（95%CI=0.754~0.856，

0.001），MHR诊断AECOPD合并HF曲线下面积为0.762（95%CI=0.707~0.817，

0.001），TyG联合MHR诊断AECOPD合并HF曲线下面积为0.870（95%CI=0.828~0.912，

0.001）；相关性分析提示TyG与左心室射血分数、左心室短轴缩短率呈负相关，与舒张末期室间隔厚度、二尖瓣反流速率、舒张末期左心室后壁厚度呈正相关；MHR与左心室每搏输出量、左心室短轴缩短率呈负相关，与舒张末期室间隔厚度、右室前后径、右室上下径、右室横径、三尖瓣反流速率、舒张末期左心室后壁厚度、肺动脉压力呈正相关。

结论

空腹血糖、单核细胞绝对值、HDL-C、心律失常、TyG、MHR是AECOPD患者并发HF的危险因素；TyG、MHR均对HF有诊断价值，2者联合对AECOPD伴HF诊断效力优于单项指标；TyG与AECOPD患者左心室射血分数、室壁厚度和二尖瓣反流速率等心功能指标具有相关性，可能与左心室功能参数相关性更大；MHR与右室心腔大小、三尖瓣反流速率和肺动脉压力等具有相关性，可能与右心室功能参数相关性更大。

Abstract

Objective

To investigate the value of triglyceride glucose index（TyG） and monocyte to high-density lipoprotein cholesterol ratio（MHR） in the diagnosis of acute exacerbation of chronic obstructive pulmonary disease（AECOPD） complicated by heart failure（HF），as well as the correlation of TyG and MHR with cardiac function in AECOPD patients.

Methods

A retrospective analysis was performed for the clinical data of 298 AECOPD patients who were admitted to The First Hospital of Lanzhou University from January 2020 to December 2021，and according to the clinical manifestation，B-type natriuretic peptide/N-terminal B-type natriuretic peptide precursor，and echocardiography，the 298 AECOPD patients were divided into HF group with 127 patients and non-HF group with 171 patients. Related clinical indicators were compared between the two groups，and a regression analysis was used to identify the possible risk factors for HF in AECOPD patients. The receiver operating characteristic（ROC） curve analysis was used to investigate the value of TyG and MHR alone or in combination in the diagnosis of AECOPD complicated by HF，and a correlation analysis was used to investigate the correlation of TyG and MHR with cardiac function parameters（ejection fraction，ventricular wall thickness，cardiac chamber size，and valve regurgitation velocity） and pulmonary artery pressure in AECOPD patients.

Results

The binary logistic regression analysis showed that fasting blood glucose，absolute monocyte count，high-density lipoprotein cholesterol（HDL-C），arrhythmia，TyG，and MHR were independent risk factors for HF in AECOPD patients，and the HF group had significantly higher levels of TyG and MHR than the non-HF group（

0.001）. TyG had an area under the ROC curve（AUC） of 0.805（95%CI=0.754-0.856，

0.001） in the diagnosis of AECOPD complicated by HF，and MHR had an AUC of 0.762（95%CI=0.707-0.817，

0.001），while TyG combined with MHR had an AUC of 0.870（95%CI=0.828-0.912，

0.001）. The correlation analysis showed that TyG was negatively correlated with left ventricular ejection fraction and left ventricular fractional shortening and was positively correlated with end-diastolic interventricular septal thickness，mitral regurgitation velocity，and left ventricular end-diastolic posterior wall thickness，while MHR was negatively correlated with left ventricular stroke volume and left ventricular fractional shortening and was positively correlated with end-diastolic interventricular septal thickness，right ventricular anteroposterior diameter，right ventricular superior-inferior diameter，right ventricular transverse diameter，tricuspid regurgitation velocity，left ventricular end-diastolic posterior wall thickness，and pulmonary artery pressure.

Conclusion

Fasting blood glucose，absolute monocyte count，HDL-C，arrhythmia，TyG，and MHR are independent risk factors for AECOPD complicated by HF. Both TyG and MHR have a certain value in the diagnosis of HF，and the combination of TyG and MHR has a better efficacy than each indicator alone in the diagnosis of AECOPD complicated by HF. TyG is correlated with the cardiac function parameters such as left ventricular ejection fraction，ventricular wall thickness，and mitral regurgitation velocity in patients with AECOPD and may have a stronger correlation with the left ventricle； MHR is correlated with right ventricular chamber size，tricuspid regurgitation velocity，and pulmonary artery pressure and may have a stronger correlation with the right ventricle.

关键词

Keywords

references

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