Trigliserid–Glukoz İndeksi ile Tp-e Aralığı, Tp-e/QT ve Tp-e/QTc Oranları Arasındaki İlişkinin Değerlendirilmesi: Retrospektif Kesitsel Bir Analiz

Öz

Amaç: Bu çalışmanın amacı, insülin direncinin pratik bir biyobelirteci olan trigliserid–glukoz (TyG) indeksinin ventriküler repolarizasyonun elektrokardiyografik göstergeleri olan Tp–e aralığı, Tp–e/QT ve Tp–e/QTc oranları ile ilişkisini değerlendirmektir. Gereç ve Yöntem: Bu retrospektif kesitsel çalışma, 1 Ocak 2024 – 31 Eylül 2025 tarihleri arasında Karamanoğlu Mehmetbey Üniversitesi Tıp Fakültesi Kardiyoloji Anabilim Dalı’nda yürütülmüştür. Çalışmaya dahil edilme kriterlerini karşılayan 200 erişkin bireyin demografik, laboratuvar ve elektrokardiyografik verileri elektronik kayıt sisteminden elde edilmiştir. TyG indeksi açlık glukoz ve trigliserid düzeylerinden hesaplanmış, hastalar TyG değerlerine göre dört çeyreğe (Q1–Q4) ayrılmıştır. Tp–e, Tp–e/QT ve Tp–e/QTc ölçümleri dijital EKG kayıtlarından iki bağımsız gözlemci tarafından yapılmıştır. Gruplar arası farklar ANOVA testiyle, ilişkiler korelasyon ve çok değişkenli regresyon analizleriyle değerlendirilmiştir. Bulgular: Katılımcıların ortalama yaşı 51,5 ± 18,8 yıl olup %51’i erkekti. TyG indeksinin artışıyla birlikte Tp–e süresi (r = 0.558, p < 0.001), Tp–e/QT oranı (r = 0.374, p < 0.001) ve Tp–e/QTc oranı (r = 0.422, p < 0.001) anlamlı şekilde uzamıştır. Çok değişkenli regresyon analizinde TyG indeksi, Tp–e aralığının bağımsız belirleyicisi olarak kalmıştır (β = 0.38, p < 0.001). ROC analizine göre TyG > 8.70 kesme değeri, uzamış Tp–e varlığını %77 duyarlılık ve %72 özgüllükle öngörmüştür (AUC = 0.78, p < 0.001). Sonuç: Bu çalışma, TyG indeksinin Tp–e aralığı, Tp–e/QT ve Tp–e/QTc oranlarıyla bağımsız ilişkisini gösteren literatürdeki ilk çalışmadır. Bulgular, metabolik stresin ventriküler repolarizasyon heterojenitesini artırarak kardiyak elektriksel instabiliteye katkıda bulunabileceğini ortaya koymaktadır. TyG indeksi, kolay hesaplanabilir bir parametre olarak subklinik aritmik riskin erken belirlenmesinde potansiyel bir biyobelirteç olabilir.

Anahtar Kelimeler

• Trigliserd-glukoz indeksi
• Tp–e aralığı
• Tp–e/QT oranı
• Tp–e/QTc oranı
• ventriküler repolarizasyon
• aritmojenik risk

Destekleyen Kurum

yok

Etik Beyan

Bu çalışma, ilgili tüm ulusal düzenlemelere, kurumsal politikalara ve Helsinki Bildirgesi ilkelerine uygun olup, Karamanoğlu Mehmetbey Üniversitesi Tıp Fakültesi Klinik Araştırmalar Etik Kurulu tarafından onaylanmıştır (16.10.2025 tarihli, onay numarası: 24-2025/20).

Teşekkür

yok

Association of Tp-e Interval, Tp-e/QT and Tp-e/QTc Ratios With the Triglyceride–Glucose Index: A Retrospective Cross-Sectional Study

Öz

Objective: The aim of this study was to evaluate the relationship between the triglyceride glucose (TyG) index, a practical biomarker of insulin resistance, and the electrocardiographic indicators of ventricular repolarisation, namely the Tp–e interval, Tp–e/QT, and Tp–e/QTc ratios. Materials and Methods: This retrospective cross-sectional study was conducted at the Department of Cardiology, Faculty of Medicine, Karamanoğlu Mehmetbey University, between 1 January 2024 and 31 September 2025. The demographic, laboratory, and electrocardiographic data of 200 adult individuals who met the inclusion criteria were retrieved from the electronic record system. The TyG index was calculated from fasting glucose and triglyceride levels, and patients were divided into four quartiles (Q1–Q4) according to their TyG values. Tp–e, Tp–e/QT, and Tp–e/QTc measurements were performed by two independent observers from digital ECG recordings. Intergroup differences were evaluated using the ANOVA test, and relationships were assessed using correlation and multivariate regression analyses. Results: The mean age of participants was 51.5 ± 18.8 years, and 51% were male. With an increase in the TyG index, the Tp–e duration (r = 0.558, p < 0.001), Tp–e/QT ratio (r = 0.374, p < 0.001), and Tp–e/QTc ratio (r = 0.422, p < 0.001) significantly increased. In multivariate regression analysis, the TyG index remained an independent predictor of the Tp–e interval (β = 0.38, p < 0.001). According to ROC analysis, a TyG cutoff value > 8.70 predicted the presence of prolonged Tp–e with 77% sensitivity and 72% specificity (AUC = 0.78, p < 0.001). Conclusion: This study is the first to demonstrate an independent association between the TyG index and the Tp–e interval, Tp–e/QT, and Tp–e/QTc ratios. These findings suggest that metabolic stress may contribute to cardiac electrical instability by increasing the heterogeneity of ventricular repolarisation. The TyG index, as an easily calculable parameter, may be a potential biomarker for early detection of subclinical arrhythmic risk.

Anahtar Kelimeler

• Trigliserde-glucose index
• Tp–e interval
• Tp–e/QT ratio
• Tp–e/QTc ratio
• ventricular repolarisation
• arrhythmogenic risk

Destekleyen Kurum

none

Etik Beyan

This study complies with all relevant national regulations, institutional policies, and the principles of the Declaration of Helsinki and has been approved by the Clinical Research Ethics Committee of Karamanoğlu Mehmetbey University Faculty of Medicine (dated 16 October 2025, approval number: 24-2025/20).

Teşekkür

none

Kaynakça

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