窦开鑫,周 鑫,钱 成,钟 毅

背景：甘油三酯/高密度脂蛋白胆固醇（TG/HDL-C）比值作为一种新的胰岛素抵抗标志物，近年来被报道与冠状动脉疾病的发生有关。然而，目前尚无临床随机对照研究表明TG/HDL-C比值是否影响冠心病以及如何影响冠心病。目的：本研究探讨TG/HDL-C比值与冠心病的关系。方法：数据是来自英国生物样本库，基因工具是来自网址GWAS catalog。我们使用的分析方法包括逆方差加权法、加权中位数法、MR Egger法、简单模式法、加权模式法、MR-多能性残差法和离群值检测（PRESSO），并采用Cochran's Q检验、leave one out分析、漏斗图、MR-Egger截距分析等方法评估结果是否可靠。结果：逆方差加权法显示随着甘油三酯与高密度脂蛋白胆固醇的比值升高，冠心病的患病也随之增高（OR值为1.196，95%置信区间为1.081-1.324），并且此结果已通过敏感性分析检验。多变量孟德尔随机化分析显示甘油三酯与胆固醇比值的升高独立于糖尿病影响冠心病的患病风险（OR值为1.2936，95%置信区间为1.2233-1.3680），双向孟德尔随机化分析显示冠心病不会影响甘油三酯与高密度脂蛋白胆固醇的比值。讨论：这项研究为甘油三酯与高密度脂蛋白胆固醇的比值提高冠心病患病风险这一结论提供了证据。

孟德尔随机化分析；冠状动脉粥样硬化性心脏病；2型糖尿病；甘油三酯与高密度脂蛋白胆固醇的比值

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