1.Inhibitory effect of hydroxy safflower yellow A on neuronal pyroptosis after glucose-oxygen deprivation/reglucose-reoxygenation treatment
Zeqian WANG ; Yanzhe DUAN ; Yige WU ; Dong MA ; Jianjun HUANG ; Yuqing YAN ; Lijuan SONG
Chinese Journal of Tissue Engineering Research 2025;29(19):4044-4051
BACKGROUND:Hydroxy safflower yellow A has anti-ischemia,anti-oxidation,anti-thrombotic and anti-inflammatory effects.Whether it affects neuronal pyroptosis after glucose-oxygen deprivation/reglucose-reoxygenation is still unclear. OBJECTIVE:To investigate the protective effect of hydroxy safflower yellow A on neuronal pyroptosis and its mechanism. METHODS:HT22 cells in logarithmic growth phase were randomly divided into five groups:normal group,model group,hydroxy safflower yellow A group,colivelin group,and colivelin+hydroxy safflower yellow A group.HT22 cells were treated with glucose-oxygen deprivation/reglucose-reoxygenation to establish neuronal pyroptosis model,and then treated with STAT3 agonist Colivelin and hydroxy safflower yellow A.JC-1 probe was employed to assess changes in mitochondrial membrane potential.Reactive oxygen species kit was used to determine the content of reactive oxygen species in cells.GSDMD/TUNEL staining was conducted to observe cell pyroptosis.Immunofluorescence analysis was performed to detect STAT3 and GSDMD protein expression.RT-PCR was utilized for assessing mRNA expression levels of STAT3,NLRP3,and Caspase-1.Western blot assay was utilized to measure the protein expression levels of p-STAT3,NLRP3,GSDMD,Cleaved-caspase-1,and interleukin-1β. RESULTS AND CONCLUSION:(1)Compared with the normal group,the number of pyroptotic cells increased in HT22 cells in the model group along with a significant increase in protein expression levels of p-STAT3,NLRP3,Cleaved-caspase-1,GSDMD,and interleukin-1β.Compared with the model group,the number of pyroptotic cells reduced,and the expression of pyroptosis-related proteins significantly decreased in the hydroxy safflower yellow A group.(2)In comparison with the model group,pyroptosis worsened in the colivelin group where mitochondrial membrane potential decreased along with elevated reactive oxygen species content and increased mRNA expression levels of STAT3,NLRP3,and Caspase-1,as well as increased protein expression levels of p-STAT3,NLRP3,GSDMD,Cleaved-caspase-1,and interleukin-1β.Compared with the Colivelin group,above indexes were improved in the colivelin+hydroxy safflower yellow A group.These results suggest that hydroxy safflower yellow A plays a neuroprotective role through STAT3 signaling pathway to inhibit HT22 pyroptosis after glucose-oxygen deprivation/reglucose-reoxygenation treatment.
2.Exploring on Mechanism of Forsythiae Fructus-Lonicerae Japonicae Flos in Treatment of Acute Lung Injury Based on Serum Metabolomics
Wanshun CHANG ; Kang LI ; Zhaohua CHEN ; Yuqing HAN ; Yanwen CHEN ; Yanhui ZHU ; Zhenyu CHENG ; Haiying HUANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(24):117-125
ObjectiveTo investigate the mechanism of Forsythiae Fructus-Lonicerae Japonicae Flos(FF) in the treatment of acute lung injury(ALI) by investigating the effects of FF on serum metabolomics of rats with ALI. MethodsThirty male SD rats were acclimated for 1 week, and 6 rats were randomly selected as the blank group. The other 24 rats were injected with lipopolysaccharide(LPS) solution by tracheal drip to establish an ALI model. After successful model establishment, the rats were randomly divided into the model group, the FF low-dose group(3.0 g·kg-1), the FF high-dose group(6.0 g·kg-1), and the dexamethasone group(5 mg·kg-1), with six rats in each group. The FF low- and high-dose groups and the dexamethasone group were received daily oral administration of the corresponding drug solution, and the blank group and the model group were gavaged with an equal amount of saline, treatment was administered continuously for 3 d. The pathological conditions of rat lung tissues were evaluated by hematoxylin-eosin(HE) staining, wet/dry mass ratio(W/D) of the lung tissues, and protein concentration in rat bronchoalveolar lavage fluid(BALF). Metabolomic analysis of rat serum was performed by ultra-performance liquid chromatography-quadrupole-time-of-flight mass spectrometry(UPLC-Q-TOF-MS), combined with multivariate statistical analysis, the potential biomarkers of FF in treating ALI were screened by variable importance in the projection(VIP) value>1, P<0.05 from t-test, and log2fold change(FC)>1 or log2FC<-1. Kyoto Encyclopedia of Genes and Genomes(KEGG) database combined with MetaboAnalyst were used for pathway analysis of the screened differential metabolites. The protein expression levels of sphingosine-1-phosphate(S1P), phosphatidylinositol 3-kinase(PI3K), protein kinase B1(Akt1), and phosphorylated Akt1(p-Akt1) were examined by Western bolt. The expression levels of interleukin(IL)-6, IL-1β, and tumor necrosis factor(TNF)-α in BALF were detected by enzyme-linked immunosorbent assay(ELISA). ResultsCompared with the blank group, rats in the model group showed ALI pathological features such as alveolar lumen dilatation, interstitial hemorrhage and massive inflammatory cell infiltration, and the protein concentration in BALF and W/D of the lung tissues were significantly elevated(P<0.01). Compared with the model group, the low- and high-dose groups of FF as well as the dexamethasone group exhibited reduced pulmonary bronchial hemorrhage in rats, and the protein concentration in BALF and W/D were significantly decreased(P<0.05), and the lung injury was significantly alleviated. Analysis of rat serum metabolomics revealed that FF downregulated 38 biomarkers. Pathway enrichment analysis showed that FF primarily exerted therapeutic effects through 7 key metabolic pathways, including arginine biosynthesis, sphingomyelin metabolism, alanine, aspartate and glutamate metabolism, taurine and hypotaurine metabolism, α-linolenic acid metabolism, niacin and nicotinamide metabolism, and retinol metabolism. The results of Western bolt and ELISA showed that, compared with the blank group, the model group exhibited significantly elevated expression levels of S1P, PI3K, Akt1 and p-Akt1 proteins in the lung tissues, as well as increased expression levels of IL-6, IL-1β and TNF-α in BALF(P<0.01). Compared with the model group, the expression levels of the aforementioned indicators were significantly downregulated in the low- and high-dose FF groups as well as the dexamethasone group(P<0.05, P<0.01). ConclusionFF may play a role in ALI by regulating amino acid metabolism and lipid metabolism, and its mechanism may be related to the inhibition of S1P/PI3K/Akt1 signaling pathway to attenuate the inflammatory response caused by ALI.
3.Analysis and clinical characteristics of SLC26A4 gene mutations in 72 cases of large vestibular aqueduct syndrome.
Yuqing LIU ; Wenyu XIONG ; Yu LU ; Lisong LIANG ; Kejie YANG ; Li LAN ; Wei HAN ; Qing YE ; Min WANG ; Yuan ZHANG ; Fangying TAO ; Zuwei CAO ; Wei HUANG ; Xue YANG
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2025;39(7):603-609
Objective:To explore the genetic and clinical characteristics of Guizhou patients with enlarged vestibular aqueduct(EVA) syndrome through combined SLC26A4 variant analysis and clinical phenotype analysis. Methods:Seventy-two EVA patients underwent comprehensive genetic testing using a multiplex PCR-based deafness gene panel and next-generation sequencing(NGS). The audiological and temporal bone imaging characteristics were compared across mutation subtypes. Results:A total of 27 pathogenic loci of SLC26A4 were detected in 72 patients, including c.919-2A>G in 79.2%(57/72). A novel deletion(c.1703_1707+6del) was discovered. Among 65 cases, truncated mutations were 89.2%(58/65), 52.3%(34/65), 28(43.1%) and 7(10.8%). No significant differences were observed in the midpoint diameter of the vestibular aqueduct and the incidence of incomplete partitioning typeⅡ(IP-Ⅱ) of the cochlea among the three groups of patients. Moreover, there was no difference in the midpoint diameter of different vestibular pipes or the combination with IP-Ⅱ. Conclusion:The most common mutation site of SLC26A4 in EVA patients in Guizhou is c.919-2A>G, though genotype-phenotype correlations remain elusive. The detection of 27 mutation sites and the discovery of new mutation sites suggested the precise diagnostic significance of NGS technology in EVA patients in Guizhou.
Humans
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Sulfate Transporters
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Vestibular Aqueduct/abnormalities*
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Mutation
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Membrane Transport Proteins/genetics*
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Hearing Loss, Sensorineural/genetics*
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Male
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Female
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Child
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Adolescent
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Child, Preschool
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Adult
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Young Adult
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Phenotype
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High-Throughput Nucleotide Sequencing
4.Discovery of a novel thiophene carboxamide analogue as a highly potent and selective sphingomyelin synthase 2 inhibitor for dry eye disease therapy.
Jintong YANG ; Yiteng LU ; Kexin HU ; Xinchen ZHANG ; Wei WANG ; Deyong YE ; Mingguang MO ; Xin XIAO ; Xichen WAN ; Yuqing WU ; Shuxian ZHANG ; He HUANG ; Zhibei QU ; Yimin HU ; Yu CAO ; Jiaxu HONG ; Lu ZHOU
Acta Pharmaceutica Sinica B 2025;15(1):392-408
Dry eye disease (DED) is a prevalent and intractable ocular disease induced by a variety of causes. Elevated sphingomyelin (SM) levels and pro-inflammatory cytokines were detected on the ocular surface of DED patients, particularly in the meibomian glands. Sphingomyelin synthase 2 (SMS2), one of the proteins involved in SM synthesis, would light a novel way of developing a DED therapy strategy. Herein, we report the design and optimization of a series of novel thiophene carboxamide derivatives to afford 14l with an improved highly potent inhibitory activity on SM synthesis (IC50, SMS2 = 28 nmol/L). Moreover, 14l exhibited a notable protective effect of anti-inflammation and anti-apoptosis on human corneal epithelial cells (HCEC) under TNF-α-hyperosmotic stress conditions in vitro, with an acceptable ocular specific distribution (corneas and meibomian glands) and pharmacokinetics (PK) profiles (t 1/2, cornea = 1.11 h; t 1/2, meibomian glands = 4.32 h) in rats. Furthermore, 14l alleviated the dry eye symptoms including corneal fluorescein staining scores and tear secretion in a dose-dependent manner in mice. Mechanically, 14l reduced the mRNA expression of Tnf-α, Il-1β and Mmp-9 in corneas, as well as the proportion of very long chain SM in meibomian glands. Our findings provide a new strategy for DED therapy based on selective SMS2 inhibitors.
5.Small-sized twin-nanoparticles normalize tumor vasculature to enhance tumor accumulation and penetration for potent eradication of cancer stem-like cells.
Changshun ZHAO ; Wei WANG ; Zhengchun HUANG ; Yuqing WAN ; Rui XU ; Junmei ZHANG ; Bingbing ZHAO ; Ke WANG ; Suchen WEN ; Yinan ZHONG ; Dechun HUANG ; Wei CHEN
Acta Pharmaceutica Sinica B 2025;15(10):5458-5473
Cancer stem cells (CSCs) are proposed to account for the progression, metastasis, and recurrence of diverse malignancies. However, the disorganized vasculars in tumors hinder the accumulation and penetration of nanomedicines, posing a challenge in eliminating CSCs located distantly from blood vessels. Herein, a pair of twin-like small-sized nanoparticles, sunitinib (St)-loaded ROS responsive micelles (RM@St) and salinomycin (SAL)-loaded GSH responsive micelles (GM@SAL), are developed to normalize disordered tumor vessels and eradicate CSCs. RM@St releases sunitinib in response to the abundant ROS in the tumor extracellular microenvironment for tumor vessel normalization, which improved intratumor accumulation and homogeneous distribution of small-sized GM@SAL. Sequentially, GM@SAL effectively accesses CSCs and achieves reduction-responsive drug release at high GSH concentrations within CSCs. More importantly, RM@St significantly extends the window of vessel normalization and enhances vessel integrity compared to free sunitinib, thus further amplifying the anti-tumor effect of GM@SAL. The combination therapy of RM@St plus GM@SAL produces considerable depression of tumor growth, drastically reducing CSCs fractions to 5.6% and resulting in 78.4% inhibition of lung metastasis. This study offers novel insights into rational nanomedicines designed for superior therapeutic effects by vascular normalization and anti-CSCs therapy.
6.Anti-cancer and anti-inflammatory effects of flavan-4-ol and flavan glycosides from the roots of Pronephrium penangianum.
Feibing HUANG ; Yong YANG ; Qingling XIE ; Hanwen YUAN ; Muhammad AAMER ; Yuqing JIAN ; Ye ZHANG ; Wei WANG
Chinese Journal of Natural Medicines (English Ed.) 2025;23(5):593-603
Five new flavan-4-ol glycosides jixueqiosides A-E (1-5) and two new flavan glycosides jixueqiosides F and G (6 and 7), along with twelve known flavan-4-ol glycosides (8-19), were isolated from the roots of Pronephrium penangianum. Comprehensive spectral analyses, X-ray single-crystal diffraction, and theoretical electronic circular dichroism (ECD) calculations established structures and absolute configurations. A single crystal structure of flavan-4-ol glycoside (14) was reported for the first time, while the characteristic ECD and NMR data for all isolated flavan-4-ol glycosides (1-5 , 8-19) were analyzed, establishing a set of empirical rules. Activity screening of these isolates showed that 8 and 9 could inhibit the proliferation of MDA-MB-231 and MCF-7 cells with IC50 values of 7.93 ? 2.85 ?mol?L-1 and 5.87 ? 1.58 ?mol?L-1 (MDA-MB-231), and 2.21 ? 1.38 ?mol?L-1 and 3.52 ? 1.55 ?mol?L-1 (MCF-7), respectively. Western blotting and flow cytometry analyses demonstrated that 8 and 9 dose-dependently induced apoptosis in MDA-MB-231 cells by up-regulating BAX, activating caspase-3 and down-regulating BCL-2. Additionally, compound 8 affected autophagy-related proteins, increasing the ratio of LC3-II/LC3-I and Beclin-1 levels to inhibit MDA-MB-231 cell proliferation. Moreover, anti-inflammatory studies indicated that 2, 3, 7, 13, 14, and 18 moderately inhibited tumor necrosis factor-a (TNF-a), interleukin-6 (IL-6), and nitric oxide (NO) release.
Humans
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Plant Roots/chemistry*
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Glycosides/isolation & purification*
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Anti-Inflammatory Agents/isolation & purification*
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Flavonoids/isolation & purification*
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Cell Proliferation/drug effects*
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Antineoplastic Agents, Phytogenic/isolation & purification*
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Molecular Structure
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Apoptosis/drug effects*
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Cell Line, Tumor
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Tumor Necrosis Factor-alpha/immunology*
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Drugs, Chinese Herbal/pharmacology*
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Interleukin-6/immunology*
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Animals
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Mice
7.Tongxie Yaofang Regulates Expression of NKG2DL to Enhance Anti-tumor Effect of NK Cells in Colon Cancer under Chronic Stress
Yan'e HU ; Yuqing HUANG ; Yi YANG ; Yifang JIANG ; Xi FU ; Fengming YOU
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(1):103-111
ObjectiveTo observe the effect of Tongxie Yaofang on the function of tumor-related natural killer (NK) cells under chronic stress and explore the possible molecular mechanism. MethodFifty SPF-grade BABL/C male mice were randomized into normal, model, and low-, medium-, and high-dose (6.825, 13.65, and 27.3 g·kg-1, respectively) Tongxie Yaofang groups, with 10 mice in each group. Other groups except the blank group were subjected to 7 days of chronic restraint stress, and then forced swimming and tail suspension tests were carried out to evaluate the modeling performance. After the successful modeling, rats in Tongxie Yaofang groups were administrated with low-, medium-, and high-doses of Tongxie Yaofang by gavage, while those in the other groups were administrated with normal saline by gavage. After 14 days, each group of mice was inoculated with subcutaneous colon cancer to establish the model of colon cancer under chronic stress. The pathological changes of the tumor tissue in each group of mice were observed using hematoxylin-eosin (HE) staining. The content of CD49b-positive cells in the peripheral blood and tumor tissue of mice was measured by flow cytometry. Enzyme-linked immunosorbent assay (ELISA) was employed to measure the content of molecules associated with NK cell activation in the peripheral blood. Western blot was employed to determine the protein levels of major histocompatibility complex class Ⅰ polypeptide-related sequences A and B (MICA+MICB) and UL-16-binding protein 1 (ULBP1) in the tumor tissue. ResultCompared with the normal group, the model group showed a decrease in 5-hydroxytryptamine (5-HT) content and an increase in corticosterone (CORT) content in the serum (P<0.05). Compared with the model group, Tongxie Yaofang increased the 5-HT content and decreased the CORT content (P<0.05, P<0.01). Compared with the normal group, the modeling increased the tumor volume and weight (P<0.05), while Tongxie Yaofang inhibited such increases with no statistical significance. The tumor cells in the model group presented neat arrangement, irregular shape, uneven size, obvious atypia, common nuclear division, and small necrotic area, and blood vessels were abundant surrounding the tumor cells. Compared with the model group, Tongxie Yaofang groups showed sparse arrangement of tumor cells, different degrees of patchy necrosis areas in the tumor, and karyorrhexis, dissolution, and nuclear debris in the necrotic part. Compared with the normal group, the model group showed reduced CD49b-positive cells in the peripheral blood and tumor tissue (P<0.01). Compared with the model group, Tongxie Yaofang increased CD49b-positive cells (medium dose P<0.01, high dose P<0.05, P<0.01). Compared with the normal group, the modeling lowered the serum levels of granzymes-B (Gzms-B), perforin (PF), interferon (IFN)-γ, and tumor necrosis factor (TNF)-α (P<0.05, P<0.01). Compared with the model group, low-dose Tongxie Yaofang elevated the serum levels of PF, Gzms-B, and TNF-α (P<0.05, P<0.01), and medium-dose Tongxie Yaofang elevated the serum levels of Gzms-B, PF, IFN-γ, and TNF-α (P<0.05, P<0.01). In addition, high-dose Tongxie Yaofang elevated the serum levels of PF, IFN-γ, and TNF-α (P<0.01). Compared with the normal group, the model group presented down-regulated protein level of ULBP1 (P<0.05). Compared with the model group, low-, medium-, and high-dose Tongxie Yaofang up-regulated the protein level of ULBP1 (P<0.05, P<0.01), and medium- and high-dose Tongxie Yaofang up-regulated the protein level of MICA+MICB (P<0.05, P<0.01). ConclusionTongxie Yaofang may promote NK cell activation by up-regulating the expression of MICA+MICB and ULBP1, thereby delaying the progression of colon cancer under chronic stress.
8.Application of multi-disciplinary team mode in prevention and control of multidrug resistant organism infection in lung transplant recipients
Sangsang QIU ; Qinfen XU ; Qinhong HUANG ; Yuqing GONG ; Jingyu CHEN ; Bo WU
Organ Transplantation 2024;15(3):443-448
Objective To evaluate the effectiveness of multi-disciplinary team (MDT) mode in the prevention and control of multidrug resistant organism (MDRO) infection in lung transplant recipients. Methods Lung transplant recipients admitted to the hospital from 2019 to 2022 were enrolled. MDT expert group was established in January, 2020. A series of prevention and control measures were conducted. The implementation rate of MDRO prevention and control measures and the detection rate of MDRO on the environmental surface from 2020 to 2022, and the detection rate of MDRO in lung transplant recipients from 2019 to 2022 were analyzed. Results The overall implementation rate of MDRO prevention and control measures for medical staff was increased from 64.9% in 2020 to 91.6% in 2022, showing an increasing trend year by year (P<0.05). The detection rate of MDRO on the environmental surface was decreased from 28% in 2020 to 9% in 2022, showing a downward trend year by year (P<0.05). The detection rate of MDRO in lung transplant recipients was decreased from 66.7% in 2019 to 44.3% in 2022, showing a decreasing trend year by year (P<0.001). Conclusions MDT mode management may enhance the implementation of MDRO prevention and control measures for medical staff, effectively reduce the infection rate of MDRO in lung transplant recipients and the detection rate of MDRO on the environmental surface, which is worthy of widespread application.
9.Analysis of Color and Odor Changes of Different Processed Products of Paeoniae Radix Alba Based on HS-GC-MS and Electronic Sensory Techniques
Jiayu PENG ; Yuzhen HUANG ; Jiawen WEN ; Yuqing ZHENG ; Ming YANG ; Jinlian ZHANG ; Yufan CHEN
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(20):141-150
ObjectiveTo investigate the correlation between the color, odor and volatile components of Paeoniae Radix Alba(PRA) and its processed products, and to examine the effects of different processing methods on the odor and color formation of PRA. MethodThe odor and chromaticity information of PRA, honey chaff-fried PRA and honey bran-fried PRA were identified by electronic nose and colorimeter, and the volatile components in the different processed products of PRA were identified and relatively quantified by headspace gas chromatography-mass spectrometry(HS-GC-MS), and analyzed using principal component analysis(PCA) and orthogonal partial least squares-discriminant analysis(OPLS-DA), then the differential key flavor components among the three were screened according to the principles of variable importance in the projection(VIP) value>1 and relative odor activity value(ROAV)≥1. Pearson correlation analysis was used to investigate the association between the differential flavor components and the colorimetric values and electronic nose sensors, respectively. ResultAfter being fried with honey chaff and honey bran, the lightness value(L*) of PRA decreased, and red-green value(a*) and yellow-blue value(b*) increased significantly(P<0.05, P<0.01). The odor differences were mainly reflected in the S1, S2, S4, S5, S6, S8 and S11 sensors, and the results of PCA of the electronic nose indicated that the odor differences among PRA, honey chaff-fried PRA and honey bran-fried PRA were obvious, among which the overall odor intensity of honey bran-fried PRA was higher than that of honey chaff-fried PRA. A total of 47 volatile components were identified from PRA and its processed products, including 21 for PRA, 36 for honey chaff-fried PRA, and 37 for honey bran-fried PRA. Odor analysis revealed that 12, 24 and 22 volatile components may be the key flavor components in PRA, honey chaff-fried PRA and honey bran-fried PRA, respectively. Correlation analysis showed that the L* of the decoction pieces was negatively correlated with the content of the Maillard reaction products, the a* and b* were positively correlated with the content of the Maillard reaction products, the S1 and S8 sensors were negatively correlated with the content of the Maillard reaction products, and the S2, S4, S5, S6 and S11 sensors were positively correlated with the Maillard reaction products. ConclusionThe color of PRA is deepened after being stir-fried with honey chaff and honey bran, and 5-hydroxymethylfurfural, furfural and other components are generated at the same time, which is in line with the theory of burning aroma strengthens the spleen of stir-fried with honey chaff and honey bran. Honey bran-fried PRA has a stronger Maillard reaction than honey chaff-fried PRA, which makes honey bran-fried PRA with a burnt flavor and a dark yellow color, while honey chaff-fried PRA has a sweet flavor and a bright yellow color.
10.Association between Triglyceride-Glucose Index and Major Adverse Cardiovascular Events Risk in Coronary Heart Disease Patients with Blood Stasis Syndrome after Percutaneous Coronary Intervention
Shiyi TAO ; Lintong YU ; Jun LI ; Li HUANG ; Zicong XIE ; Deshuang YANG ; Tiantian XUE ; Yuqing TAN
Journal of Traditional Chinese Medicine 2024;65(17):1784-1793
ObjectiveTo explore the association between triglyceride-glucose (TyG) index and major adverse cardiovascular events (MACEs) risk in coronary heart disease (CHD) patients with blood stasis syndrome after percutaneous coronary intervention (PCI). MethodsA total of 857 CHD patients with blood stasis syndrome after PCI were enrolled and divided into four groups according to the baseline TyG index quartiles, Q1 (TyG < 8.51), Q2 (8.51 ≤ TyG < 8.88), Q3 (8.88 ≤ TyG < 9.22), and Q4 (TyG ≥ 9.22). The clinical outcome was defined as a compound endpoint of cardiovascular events including cardiac death, non-fatal myocardial infarction, unplanned revascularization, in-stent restenosis and stroke. The machine learning Boruta algorithm was used for feature selection related to MACEs risk. Kaplan-Meier survival analysis and Cox proportional hazards regression model were used to compare the differences in MACEs risk among the four groups. Restricted cubic spline (RCS) and subgroup analysis were performed to determine the relationship between the TyG index and MACEs risk. The area under the receiver operating characteristic (ROC) curve (AUC), calibration curve and Hosmer-Lemeshow test, and decision curve analysis (DCA) were plotted to evaluate the predictive value of the TyG index for MACEs risk. ResultsThe median follow-up time of the included patients was 2.45 years. During the follow-up period, 313 cases (36.52%) of new MACEs occurred. The incidence of MACEs in Q1, Q2, Q3, Q4 group was 28.17% (60/213), 29.05% (61/210), 39.45% (86/218) and 49.07% (106/216), respectively. Kaplan-Meier survival analysis suggested statistically significant differences in MACEs risk among the four groups (P<0.001). Cox proportional hazards regression model analysis found that the risk of MACEs in patients with high TyG index increased by 60.1% (P<0.01). Using Q1 as the reference, the MACEs risk in Q2, Q3 and Q4 groups gradually increased, and the trend was statistically significant (P<0.05). RCS model suggested that the TyG index was nonlinearly associated with the MACEs risk (P<0.001). The TyG index had a good predictive performance for MACEs risk according to ROC analysis (AUC=0.758, 0.724-0.792) and Hosmer-Lemeshow test (χ2 = 4.319, P = 0.827). Additionally, DCA analysis also suggested a good clinical efficacy of the TyG index for predicting MACEs. Subgroup analysis showed that different baseline TyG index was positively correlated with the MACEs risk in the stratification of age, male, BMI, history of diabetes and hypertension, and low-density lipoprotein cholesterol (LDL-C)≥1.8 mmol

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