The impact of the triglyceride-glucose index on cognitive function in Alzheimer's disease patients with comorbid cardiometabolic diseases

doi:10.3969/j.issn.1672-6731.2026.08.008

Abstract

Abstract:

Objective: To investigate the association between the triglyceride-glucose (TyG) index and cognitive dysfunction in patients with Alzheimer's disease (AD) and comorbid cardiometabolic diseases (CMD). Methods: A total of 265 patients with AD diagnosed at The First Affiliated Hospital of Zhengzhou University from June 2020 to September 2025 were retrospectively enrolled. According to the with or without CMD, patients were divided into the CMD group (n= 137) and the non-CMD group (n= 128). Cognitive function was assessed using the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA). Univariable and multivariable Logistic regression analyses were performed to screen factors for moderate-to-severe dementia in AD patients with comorbid CMD. Results: Compared with the non-CMD group, the CMD group had lower MMSE score (t= -4.542, P=0.001) and MoCA score (t= -4.798, P=0.001). Logistic regression analysis showed that an elevated TyG index was independently risk factors for moderate-to-severe dementia in AD patients with comorbid CMD (OR=3.413, 95%CI: 1.242-9.374; P=0.017). Conclusions: An elevated TyG index was associated with moderate-to-severe dementia in AD patients with comorbid CMD, suggesting that the TyG index may serve as a potential biomarker reflecting cognitive dysfunction severity in this population.

Key words: Alzheimer disease, Nutritional and metabolic diseases, Heart, Triglycerides, Glucose, Cognition disorders, Logistic models

摘要：

目的: 探讨甘油三酯-葡萄糖（TyG）指数对阿尔茨海默病合并心脏代谢性疾病患者认知功能障碍的关联性。方法: 纳入2020年6月至2025年9月于郑州大学第一附属医院确诊的265例阿尔茨海默病患者，根据是否合并心脏代谢性疾病（CMD）分为合并CMD组（137例）和未合并CMD组（128例）；采用简易智能状态检查量表（MMSE）和蒙特利尔认知评价量表（MoCA）评估认知功能；采用单因素及多因素Logistic回归分析筛查合并心脏代谢性疾病的阿尔茨海默病患者罹患中至重度痴呆的影响因素。结果: 与未合并CMD组相比，合并CMD组MMSE评分（t= -4.542，P=0.000）和MoCA评分（t= -4.798，P=0.000）较低。Logistic回归分析显示，TyG指数升高是合并心脏代谢性疾病的阿尔茨海默病患者罹患中至重度痴呆的危险因素（OR=3.413，95%CI：1.242~9.374；P=0.017）。结论: TyG指数升高是阿尔茨海默病合并心脏代谢性疾病患者罹患中至重度痴呆的危险因素，提示TyG指数或可作为反映该类人群认知功能障碍严重程度的潜在生物学标志物。

关键词: 阿尔茨海默病, 营养和代谢性疾病, 心脏, 甘油三酯类, 葡萄糖, 认知障碍, Logistic模型

CLC Number:

R741

Can CUI, Yue-lin JIANG, Qian-yi HE, Xin-yu ZHAO. The impact of the triglyceride-glucose index on cognitive function in Alzheimer's disease patients with comorbid cardiometabolic diseases[J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2026, 26(8): 851-857.

崔灿, 江玥霖, 何谦益, 赵莘瑜. 甘油三酯-葡萄糖指数对阿尔茨海默病合并心脏代谢性疾病患者认知功能的影响[J]. 中国现代神经疾病杂志, 2026, 26(8): 851-857.

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URL: https://journal11.magtechjournal.com/cjcnn/EN/10.3969/j.issn.1672-6731.2026.08.008

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References 35

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观察指标	未合并CMD组（n=128）	合并CMD组（n=137）	统计量值	P值
性别[例（%）]			1.754	0.185
男性	55（42.97）	70（51.09）
女性	73（57.03）	67（48.91）
年龄[M（P₂₅，P₇₅），岁]	62.50（57.25，71.00）	68.00（61.00，75.00）	-3.714	0.000
BMI（$\bar x \pm s$，kg/m²）	22.35 ± 2.88	24.00 ± 3.23	-4.375	0.000
受教育程度[例（%）]			0.691	0.406
高中以下	73（57.03）	85（62.04）
高中及以上	55（42.97）	52（37.96）
携带APOE ε4[例（%）]	48（37.50）	60（43.80）	1.086	0.297
吸烟史[例（%）]	17（13.28）	31（22.63）	3.897	0.048
饮酒史[例（%）]	9（7.03）	26（18.98）	8.239	0.004
MMSE（$\bar x \pm s$，评分）	17.75 ± 5.08	14.65 ± 5.94	- 4.542	0.000
MoCA（$\bar x \pm s$，评分）	13.50 ± 5.06	10.35 ± 5.56	- 4.798	0.000
CDR评分[例（%）]			19.517	0.000
0.50	43（33.59）	26（18.98）
1	56（43.75）	45（32.85）
≥2	29（22.66）	66（48.18）
空腹血糖[M（P₂₅，P₇₅），mmol/L]	5.04（4.55，5.36）	5.78（5.10，6.73）	- 7.221	0.000
糖化血红蛋白[M（P₂₅，P₇₅），%]	5.62（5.40，5.90）	5.90（5.50，6.73）	- 4.442	0.000
白蛋白[M（P₂₅，P₇₅），g/L]	44.45（41.93，45.90）	40.40（38.75，43.10）	- 7.584	0.000
总胆固醇（$\bar x \pm s$，mmol/L）	4.55±1.06	4.42±1.15	0.946	0.345
甘油三酯[M（P₂₅，P₇₅），mmol/L]	1.03（0.73，1.28）	1.46（1.12，1.95）	- 6.790	0.000
HDL-C[M（P₂₅，P₇₅），mmol/L]	1.27（1.09，1.54）	1.23（1.00，1.50）	- 1.382	0.167
LDL-C（$\bar x \pm s$，mmol/L）	2.70±0.88	2.61±0.97	0.856	0.393
CRP[M（P₂₅，P₇₅），mg/L]	1.28（0.41，3.10）	1.70（0.72，3.00）	- 1.331	0.183
TyG指数[M（P₂₅，P₇₅）]	8.28（7.95，8.62）	8.87（8.47，9.21）	- 8.091	0.000

观察指标	未合并CMD组（n=128）	合并CMD组（n=137）	统计量值	P值
性别[例（%）]			1.754	0.185
男性	55（42.97）	70（51.09）
女性	73（57.03）	67（48.91）
年龄[M（P₂₅，P₇₅），岁]	62.50（57.25，71.00）	68.00（61.00，75.00）	-3.714	0.000
BMI（$\bar x \pm s$，kg/m²）	22.35 ± 2.88	24.00 ± 3.23	-4.375	0.000
受教育程度[例（%）]			0.691	0.406
高中以下	73（57.03）	85（62.04）
高中及以上	55（42.97）	52（37.96）
携带APOE ε4[例（%）]	48（37.50）	60（43.80）	1.086	0.297
吸烟史[例（%）]	17（13.28）	31（22.63）	3.897	0.048
饮酒史[例（%）]	9（7.03）	26（18.98）	8.239	0.004
MMSE（$\bar x \pm s$，评分）	17.75 ± 5.08	14.65 ± 5.94	- 4.542	0.000
MoCA（$\bar x \pm s$，评分）	13.50 ± 5.06	10.35 ± 5.56	- 4.798	0.000
CDR评分[例（%）]			19.517	0.000
0.50	43（33.59）	26（18.98）
1	56（43.75）	45（32.85）
≥2	29（22.66）	66（48.18）
空腹血糖[M（P₂₅，P₇₅），mmol/L]	5.04（4.55，5.36）	5.78（5.10，6.73）	- 7.221	0.000
糖化血红蛋白[M（P₂₅，P₇₅），%]	5.62（5.40，5.90）	5.90（5.50，6.73）	- 4.442	0.000
白蛋白[M（P₂₅，P₇₅），g/L]	44.45（41.93，45.90）	40.40（38.75，43.10）	- 7.584	0.000
总胆固醇（$\bar x \pm s$，mmol/L）	4.55±1.06	4.42±1.15	0.946	0.345
甘油三酯[M（P₂₅，P₇₅），mmol/L]	1.03（0.73，1.28）	1.46（1.12，1.95）	- 6.790	0.000
HDL-C[M（P₂₅，P₇₅），mmol/L]	1.27（1.09，1.54）	1.23（1.00，1.50）	- 1.382	0.167
LDL-C（$\bar x \pm s$，mmol/L）	2.70±0.88	2.61±0.97	0.856	0.393
CRP[M（P₂₅，P₇₅），mg/L]	1.28（0.41，3.10）	1.70（0.72，3.00）	- 1.331	0.183
TyG指数[M（P₂₅，P₇₅）]	8.28（7.95，8.62）	8.87（8.47，9.21）	- 8.091	0.000

变量	赋值
变量	0	1
中至重度痴呆	否	是
性别	女性	男性
受教育程度	高中以下	高中及以上
携带APOE ε4	无	有
吸烟史	无	有
饮酒史	无	有

变量	赋值
变量	0	1
中至重度痴呆	否	是
性别	女性	男性
受教育程度	高中以下	高中及以上
携带APOE ε4	无	有
吸烟史	无	有
饮酒史	无	有

变量	b	SE	Wald χ²	P值	OR值	OR95%CI
性别	0.198	0.344	0.332	0.564	1.219	0.621 ~ 2.391
年龄	- 0.033	0.020	2.815	0.093	0.967	0.931 ~ 1.006
BMI	- 0.035	0.053	0.417	0.518	0.966	0.870 ~ 1.073
高中及以上	- 0.058	0.354	0.027	0.869	0.943	0.472 ~ 1.886
携带APOE ε4	0.501	0.350	2.053	0.152	1.651	0.832 ~ 3.278
吸烟史	0.174	0.413	0.178	0.673	1.190	0.530 ~ 2.673
饮酒史	0.546	0.454	1.446	0.229	1.726	0.709 ~ 4.202
空腹血糖	0.070	0.122	0.323	0.570	1.072	0.843 ~ 1.363
糖化血红蛋白	- 0.041	0.127	0.105	0.746	0.960	0.749 ~ 1.230
白蛋白	- 0.155	0.056	7.614	0.006	0.856	0.767 ~ 0.956
总胆固醇	0.097	0.151	0.411	0.521	1.101	0.820 ~ 1.480
甘油三酯	0.278	0.207	1.801	0.180	1.321	0.880 ~ 1.983
HDL-C	0.208	0.427	0.238	0.626	1.232	0.533 ~ 2.846
LDL-C	0.100	0.179	0.315	0.574	1.106	0.779 ~ 1.569
CRP	0.359	0.125	8.282	0.004	1.433	1.121 ~ 1.830
TyG指数	1.510	0.391	14.899	0.000	4.528	2.103 ~ 9.749

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