Association between triglyceride glucose index and arterial stiffness in Korean adults

Lipid profile, lipid ratios, apolipoproteins, and risk of cardiometabolic multimorbidity in men: The Kuopio Ischaemic Heart Disease Risk Factor Study

The blood level of lipids, apolipoproteins, and lipid ratios are important predictors of some chronic diseases. However, their association with cardiometabolic multimorbidity (CMM) is less known. We evaluated a wide range of lipid profiles and lipid ratios, including low-density lipoprotein-cholesterol (LDL-C), very-low-density lipoprotein-cholesterol (VLDL-C), high-density lipoprotein-cholesterol (HDL-C), and apoA1 and B, as well triglyceride and total cholesterol with risk of incident CMM. In 1728 men aged 52.5 ± 5.2 years from the Kuopio Ischaemic Heart Disease were included in this study. We defined CMM as coexisting of two or more of stroke, type 2 diabetes mellitus (T2D), coronary heart disease (CHD). A Cox proportional hazard regression method was applied to evaluate the risk of CMM against the exposures. During the mean follow-up of 22.4 years, 335 men suffered from CMM conditions. Higher serum triglyceride and VLDL concentrations were associated with a higher risk of coexisting T2D-CHD (HRs 1.99 (95% CI, 1.12-3.53) and HRs 1.79 (95% CI, 1.04-3.11), respectively. Whereas higher HDL was associated with lower incident [HRs 0.49 (95% CI, 0.40-1.00)]. The HRs for coexisting T2D-CHD was 2.02 (95% CI, 1.01-3.07) for total cholesterol/HDL-C, 1.85 (95% CI, 1.04-3.29) for triglyceride/HDL-C, 1.69 (95% CI, 1.01-2.31) for Non-HDL-C/HDL-C, and 1.89 (95% CI, 1.03-2.46) for apoB/apoA1. In contrast, serum LDL-C/apoB ratios were inversely associated with the risk of coexisting T2D-CHD [HRs 0.50 (95% CI, 0.28-0.90)]. No associations were observed between our exposures and other CMM conditions. In conclusion, elevated triglyceride, VLDL-C, total cholesterol/HDL-C, TG/HDL-C, apoB/apoA1 as well as lower LDL-C/apoB were independently associated with the higher risk of T2D-CHD coexistence.

Triglyceride-glucose index trajectory and arterial stiffness: results from Hanzhong Adolescent Hypertension Cohort Study

Background

The triglyceride-glucose index (TyG index) has emerged as a reliable surrogate marker of insulin resistance associated with arterial stiffness. However, most studies were based on a cross-sectional design, and few studies have evaluated the longitudinal impact of the TyG index on arterial stiffness. This study aimed to investigate the associations of single time point measurement and the long-term trajectory of the TyG index with arterial stiffness in a Chinese cohort.

Methods

Data are derived from the Hanzhong Adolescent Hypertension Cohort study. A total of 2480 individuals who participated in the 2017 survey was included in the cross-sectional analysis. A sample of 180 individuals from the sub-cohort with follow-up data in 2005, 2013, and 2017 was enrolled in the longitudinal analysis. The TyG index was calculated as ln (fasting triglyceride [mg/dL] × fasting glucose [mg/dL]/2), and arterial stiffness was determined using brachial-ankle pulse wave velocity (baPWV). The latent class growth mixture modeling method was used to identify the TyG index trajectories from 2005 to 2017.

Results

In the cross-sectional analysis, the median age of the study population was 42.8 (39.8, 44.9) years, and 1351 (54.5%) were males. Each one-unit increment in TyG index was associated with a 37.1 cm/s increase (95% confidence interval [CI] 23.7–50.6 cm/s; P < 0.001) in baPWV, and similar results were observed when the TyG index was in the form of quartiles. In the longitudinal analysis, we identified three distinct TyG index trajectories and found that the highest TyG index trajectory carried the greatest odds of increased arterial stiffness, with a fully adjusted odds ratio (OR) of 2.76 (95% CI 1.40, 7.54).

Conclusions

Elevated levels of baseline TyG index and higher long-term trajectory of TyG index were independently associated with increased arterial stiffness. Monitoring immediate levels and longitudinal trends of the TyG index may help with the prevention of arterial stiffness in the long run.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12933-022-01453-4.

Association Between Triglyceride-Glucose Index and 2-Year Adverse Cardiovascular and Cerebrovascular Events in Patients with Type 2 Diabetes Mellitus Who Underwent Off-Pump Coronary Artery Bypass Grafting

BACKGROUND

Data on the relationship between the triglyceride glucose (TyG) index and prognosis after off-pump coronary artery bypass grafting (OPCABG) are limited. This retrospective observational cohort study evaluated the association of the TyG index with prognosis in patients with diabetes mellitus who underwent OPCABG.

METHODS

The TyG index was calculated using the following equation: TyG index = ln (fasting triglyceride level [mg/dL] × fasting glucose level [mg/dL]/2). The primary outcomes included the occurrence of major adverse cardiovascular and cerebrovascular events (MACCEs), which were defined as all-cause death, nonfatal myocardial infarction, nonfatal stroke and symptomatic graft failure. The association between the TyG index and MACCEs was assessed by Cox proportional hazards regression analysis.

RESULTS

A total of 1578 patients with diabetes who underwent OPCABG (mean age, 62.9 ± 8.0 years; men, 72.7%) were enrolled in this study. Over the follow-up of 2 years, 176 patients (11.2%) had at least 1 primary endpoint event. The follow-up incidence of the primary endpoint rose with increasing TyG index tertiles. The multivariate Cox proportional hazards regression analysis adjusted for multiple confounders revealed a hazard ratio for the primary endpoint of 2.133 (95% CI 1.347-3.377; P for trend = 0.001) when the highest and lowest TyG index tertiles were compared.

CONCLUSION

The TyG index was significantly and positively associated with MACCEs, suggesting that the TyG index may be a valuable predictor of adverse cardiovascular and cerebrovascular outcomes after OPCABG in patients with T2DM.

The Triglyceride Glucose Index Is a Risk Factor for Enlarged Perivascular Space

The triglyceride glucose (TyG) index is considered a simple surrogate marker for insulin resistance and has been associated with cerebrovascular diseases. However, limited information is available regarding its association with the subclinical cerebral small vessel disease (CSVD). Here, we investigated the association of TyG index with the burden and distribution of enlarged perivascular space (EPVS) in the non-diabetic population. The data of 531 non-diabetic patients from 2017 to 2020 were assessed. Participants were grouped according to the burden of EPVS. TyG index was calculated using the log scale of fasting triglycerides (mg/dl) × fasting glucose (mg/dl)/2. The association of TyG index with EPVS burden and distribution was evaluated. In the multivariable logistic regression analysis, the TyG index was associated with moderate to severe EPVS [odds ratio (OR): 2.077; 95% CI = 1.268–3.403]. The TyG index was significantly associated with an increased risk of moderate to severe EPVS in subgroups of age <65 years, male, diastolic blood pressure (DBP) <90 mmHg, low-density lipoprotein cholesterol (LDL-C) ≥2.85 mmol/L, serum homocysteine <10 μmol/L, and estimated glomerular filtration rate (eGFR) <90 ml/min/1.73 m², as well as those without smoking. Further analysis of EPVS distribution, the TyG index was found to be associated with moderate to severe EPVS in the centrum semiovale (CSO), not in the basal ganglia (BG). Conclusively, the TyG index was independently and positively associated with moderate to severe CSO EPVS. TyG index may serve as an independent risk factor for CSVD in clinical practice.

Triglyceride-glucose index associated with the risk of cardiovascular disease: the Kailuan study

PURPOSE

Previous studies suggest that triglyceride-glucose index (TyG) index, as a marker of insulin resistance, may have associations with the risk of cardiovascular diseases (CVD) in elderly population. Given the paucity of data, it remains controversial, especially in general Chinese population. We aimed to further assess whether TyG index is an independent risk factor for CVD.

METHODS

We conducted a prospective cohort study that enrolled a total of 96,541 participants from the Kailuan Study. TyG index was calculated as ln (fasting triglyceride [mg/dL] × fasting glucose [mg/dL]/2). Participants were divided into four groups (Q1, Q2, Q3, and Q4) by quartiles of the TyG index. Any CVD events occurred during 2006-2017 were recorded, including myocardial infarction (MI) and stroke. We assessed the association of TyG index with the risk of CVD and the subtypes of CVD by using Cox models estimated hazard ratios (HRs) and 95% confidence interval (CIs).

RESULTS

During a median follow-up of 10.33 years, totally 6421 CVD events, 1493 MIs, and 5083 stroke events occurred. Multivariate Cox regression analysis showed that compared with Q1, HR (95% CI) for CVD events was 1.12 (95%, 1.03-1.21) in Q2, 1.28 (95%, 1.18-1.38) in Q3, and 1.34 (95%, 1.23-1.45) in Q4. In a time-dependent Cox Model we also found that compared with Q1, HR (95% CI) for CVD events was 1.09 (95%, 1.02-1.18) in Q2, 1.18 (95%, 1.09-1.27) in Q3, and 1.20 (95%, 1.11-1.30) in Q4. Similar results were showed in MI and stroke.

CONCLUSIONS

TyG index as a marker of insulin resistance was an independent risk factor for CVD. This may help in the early identification of people at high risk of CVD and be applicable to the primordial and primary prevention.

The association of hypertriglyceridemic waist phenotype with hypertension: A cross-sectional study in a Chinese middle aged-old population

The present study aimed to evaluate the relationship between the hypertriglyceridemic waist (HTGW) phenotype and hypertension. We undertook a cross‐sectional study with a sample of 9015 adults from China. The HTGW phenotype was defined as elevated waist circumference (WC) and elevated triglyceride (TG) concentration. Logistic regression analysis was used to evaluate the association between the HTGW phenotype and hypertension. The prevalence of hypertension was significantly higher in individuals with the HTGW phenotype, than in those with the normal waist normal triglyceride (NWNT) phenotype (89.9% vs 75.3%, respectively, P < .001). After adjusting for age, sex, BMI, current smoker, and current alcohol consumption, the HTGW phenotype was associated with hypertension (Odds Ratio (OR)1.53; 95% CI 1.25–1.87). After further adjustment for potential confounders, the HTGW phenotype was still significantly associated with hypertension (adjusted OR1.28; 95% CI 1.04‐1.58) regardless of sex. The subgroup analyses generally revealed similar associations across all subgroups. This study indicated that the HTGW phenotype was strongly associated with hypertension, and blood pressure should be clinically monitored in individuals with the HTGW phenotype. We suggested a combined use of hypertriglyceridemia waist phenotype in identifying participants who are at high risk of hypertension.

Relationship of the Triglyceride-Glucose Index with Subclinical White Matter Hypersensitivities of Presumed Vascular Origin Among Community-Dwelling Koreans

Purpose

The triglyceride-glucose (TyG) index, a widely accessible measure, has been a surrogate indicator of peripheral insulin resistance, and its clinical importance continues to grow in East Asia. We hypothesized that the TyG index is relevant to subclinical white matter hypersensitivities (WMHs) of presumed vascular origin among community-dwelling Koreans.

Methods

We investigated the relationship between the TyG index and WMHs on brain magnetic resonance imaging scans in 2417 Koreans over 45 years of age without a history of cancer, stroke, or ischemic heart disease. The study population was divided into four groups according to the TyG index quartiles. Using multiple logistic regression analysis, we assessed the odds ratios (ORs) and 95% confidence intervals (95% CIs) for WMHs across the TyG index quartiles.

Results

The prevalence of WMHs was significantly higher in the fourth TyG index quartile, with an overall rate of 9.3%. After adjusting for potential confounding variables, the ORs of WMHs for the TyG index quartiles were 1.00, 1.47 (95% CI, 0.91–2.40), 1.76 (95% CI, 1.05–2.97), and 6.79 (95% CI, 3.85–1.54), respectively.

Conclusion

We found that higher TyG index values were associated with the brain’s WMHs of presumed vascular origin. Our findings suggest that the serum TyG index could be an additional valuable biomarker for assessing the risk of cerebral small vessel disease in the preclinical stage.

Glycated Hemoglobin and Risk of Arterial Stiffness in a Chinese Han Population: A Longitudinal Study

BACKGROUND AND AIMS

Glycated hemoglobin (HbA1c) associates with the risk of arterial stiffness, and such association can be found between fasting blood glucose (FBG), postprandial blood glucose (PBG), triglyceride-glucose index (TyG index), and arterial stiffness. However, the results were inconsistent, longitudinal studies were sparse, and comparison of these glycemic parameters was less conducted. We aimed to explore the longitudinal relationship between HbA1c and arterial stiffness and compare the effect of the parameters.

METHODS

Data were collected from 2011 to 2019 in Beijing Health Management Cohort (BHMC) study. Cox proportional hazard models were fitted to investigate the association between the parameters and arterial stiffness. A generalized estimation equation (GEE) analysis was conducted to investigate the effect of repeated measurements of glycemic parameters. A receiver operating characteristic (ROC) analysis was performed to compare the predictive value of glycemic parameters for arterial stiffness.

RESULTS

Among 3,048 subjects, 591 were diagnosed as arterial stiffness during the follow-up. The adjusted hazard ratio (HR) [95% confidence interval (CI)] for arterial stiffness of the highest quartile group of HbA1c was 1.63 (1.22-2.18), which was higher than those of FBG, PBG, and TyG index. The nonlinear association of arterial stiffness with HbA1c and PBG was proved. The robust results of the sensitivity analysis were obtained.

CONCLUSIONS

HbA1c is an important risk factor of arterial stiffness compared with PBG, FBG, and TyG index, and has a strong predictive ability for arterial stiffness among non-diabetics and the general population.

Association of obesity, triglyceride-glucose and its derivatives index with risk of hyperuricemia among college students in Qingdao, China

OBJECTIVE

To analyze and compare the associations of hyperuricemia (HUA) with obesity, triglyceride-glucose (TyG), and its derivatives in college students. To provide early guidance on risk predictors of HUA in college students.

METHODS

This study was a cross-sectional survey including 23,411 participants (age: 17-20 years). Investigators conducted face-to-face interview surveys and physical examinations. Automated biochemical methods were used to detect biochemical indicators such as serum uric acid (UA). Calculation of obesity, TyG, and their derivatives indices were performed. Logistic regression was used to analyze the relationship between different indexes and hyperuricemia. OR value and 95% CI were also calculated. ROC curve was used for assessing the predictive ability of different indices of hyperuricemia.

RESULTS

After adjusting for age, SBP, DBP, ALT, AST, TC, BUN, and CREA, multivariate logistic regression showed that the OR value of LAP in the obesity index was higher, especially in women (male OR: 4.347, 95%CI: 3.807, 4.964; female OR: 4.672, 95%CI: 3.800, 5.744). The other three quartiles of TyG derivatives were highly associated with hyperuricemia in men and women compared with the top quartile (all P< 0.05). The risk of hyperuricemia increased with an increase in quartiles. For college students, all indicators could distinguish the presence of hyperuricemia. For men, the area under the curve (AUC) of TyG-WC was the largest (AUC: 0.694; 95%CI: 0.684-0.704; P<0.05), according to the Maximum Youden index 0.290 with cut point value 477.853. In women, TyG-BMI showed a maximum AUC value of 0.702 (95%CI: 0.685-0.719; P<0.05), according to the maximum Youden index of 0.317 with cut point value 132.446. The TyG-WC, TyG-WHtR, TyG-LAP, and LAP indices also had relatively high AUC.

CONCLUSION

In clinical practice, LAP, TYG, and their related derivatives may be used as sensitive indicators for HUA prediction in college students.

The Triglyceride-Glucose Index Can Predict Long-Term Major Adverse Cardiovascular Events in Turkish Patients With High Cardiovascular Risk

Objective

There is an evidence gap regarding the predictive accuracy of the triglyceride-glucose (TyG) index for long-term major adverse cardiovascular events (MACEs) in individuals with high cardiovascular risk. The aim of this investigation was to evaluate the predictive value of the TyG index for long-term MACEs in patients at high cardiovascular risk.

Methods

In total, 483 patients with high cardiovascular risk were included in this analysis. The study population was separated into 2 groups depending on the occurrence of long-term MACEs. The independent predictors of long-term MACEs in patients with high cardiovascular risk were investigated. The long-term prognostic value of the TyG index in these patients was evaluated in terms of MACEs.

Results

Age, male sex, diabetes mellitus, and the TyG index were demonstrated to be independent predictors of long-term MACE occurrence in patients with high cardiovascular risk. The TyG index was independently related to long-term MACEs in patients with high cardiovascular risk (hazard ratio, 1.003; 95% confidence interval [CI], 1.001–1.006; p=0.011). The receiver operating characteristic curve revealed that the optimum value of the TyG index to predict long-term MACEs in the overall study cohort was >9.68, with 65% sensitivity and 63% specificity (area under the curve, 0.71; 95% CI, 0.65–0.77; p<0.001).

Conclusion

The TyG index was demonstrated to be an independent predictor of long-term MACE occurrence in patients with high cardiovascular risk who had not been previously diagnosed with cardiovascular disease.

Association of triglyceride-glucose with cardiac hemodynamics in type 2 diabetes

PURPOSE

Triglyceride-glucose (TyG) index is a reliable and inexpensive alternative indicator of insulin resistance. Previous studies have shown that elevated TyG index increases the risk of diabetes, coronary heart disease, and other diseases, but the relationship between TyG index and cardiac hemodynamics in patients with type 2 diabetes mellitus (T2DM) is not clear. This study was conducted in patients with T2DM to assess the relationship between TyG and cardiac hemodynamics and its predictive ability for T2DM.

METHODS

A total of 647 individuals (348 males and 299 females) were enrolled in this study, including 446 T2DM patients and 201 healthy controls. The clinical data and related laboratory variables were assessed and recorded, and TyG index was calculated. Cardiac hemodynamics was measured by echocardiography. Pearson or Spearman correlation analysis and linear regression analysis were conducted to explore the association between TyG and cardiac hemodynamics. The receiver operating characteristics (ROC) curve was used to evaluate the efficacy of TyG index in the diagnosis of T2DM.

RESULTS

Compared with healthy controls, the systolic blood pressure (SBP), body weight, body mass index (BMI), waist circumference (WC), hip circumference (HC), HOMA-IR, and TyG levels were higher in patients with T2DM. With the increase of TyG, the levels of left ventricular mass index (LVMI), left ventricular mass (LVM), left ventricular end diastolic diameter (LVDd), posterior wall thickness (PWT), and interventricular septum thickness (IVST) were also increased in T2DM individuals. Multivariate linear regression analysis showed that TyG was an independent determinant of LVEF, PWT, IVST, and ejection time (ET) after adjusting for confounding factors. In addition, individuals with visceral obesity had higher TyG and TyG can be used as a predictor of T2DM with an AUC of 0.903 (95% CI:0.879-0.927).

CONCLUSIONS

The increase of TyG index is closely related to cardiac hemodynamics of T2DM patients, which is expected to be a simple and practical biological index to predict the changes of cardiac function in patients with T2DM.

Triglyceride Glucose Index Is More Closely Related to Hyperuricemia Than Obesity Indices in the Medical Checkup Population in Xinjiang, China

BACKGROUND

Hyperuricemia (HUA) is a metabolic anomaly with an increased incidence rate, causing a global medical burden. Several studies have confirmed that obesity and insulin resistance (IR) are the risk factors for HUA. Reports on the predictive power of different obesity indices for HUA are limited. This study aimed to compare the association between different general, abdominal, and visceral obesity indices and markers of the IR-triglyceride glucose (TyG) index with serum uric acid (SUA) and to assess the ability of these indices to predict HUA.

METHODS

A total of 2243 participants were recruited from Barkol County Hospital and surrounding township hospitals in Xinjiang. Obesity indices, including the atherogenic index of plasma, cardiometabolic index, visceral adiposity index, lipid accumulation product index, a body shape index, body roundness index, waist circumference, waist-to-height ratio, body mass index, and TyG index, were divided into four quartiles. Moreover, partial correlations and logistic regression were used to analyze the association between these indices and SUA. The area under the curve (AUC) and receiver operating characteristic curves were used to analyze the predictive value of these indices for HUA.

RESULTS

After controlling for confounding variables, the association between the TyG index and HUA was stronger than that between the obesity indices in both males and females. The odds ratios (ORs) for HUA in the highest quartile of the TyG index were 2.098 (95% confidence interval, 1.555-2.831) in males and 7.788 (95% CI, 3.581-16.937) in females. For males, the AIP, CMI, VAI, LAP index, and TyG index were able to discriminate HUA, and the TyG index showed the highest AUC value of 0.586 (95% CI, 0.557-0.614; P < 0.001). For females, all indices, except BMI, can discriminate HUA. Moreover, the visceral obesity index CMI showed the highest AUC value of 0.737 (95% CI, 0.691-0.782; P < 0.001). Meanwhile, the TyG index had a relatively high AUC value of 0.728 (95% CI, 0.682-0.773; P < 0.001).

CONCLUSION

The TyG index was significantly related to HUA and was superior to obesity indices in identifying HUA in the medical checkup population in Xinjiang, China.

Triglyceride glucose index reflects the unfavorable changes of left ventricular diastolic functions and structure in uncomplicated newly diagnosed hypertensive patients

INTRODUCTION

Left ventricular (LV) diastolic dysfunction and structural abnormalities are common cardiac changes in hypertension (HTN), and several factors other than high blood pressure (BP) may play a role in these changes. The aim of this study was to reveal the relationship between triglyceride glucose (TyG) index, a novel parameter for insulin resistance (IR), with LV diastolic function and structure in hypertensive patients.

MATERIAL AND METHOD

A total of 119 newly diagnosed, untrated hypertensive patients free of diabetes and/or cardiovascular complications were included in this study. IR was estimated with the TyG index calculated from ln [fasting TG (mg/dL) × fasting blood glucose (mg/dL)/2]. Two-dimensional and Doppler echocardiographic examinations were performed to assess LV diastolic functions and structure.

RESULTS

Based on median TyG index, 51 patients was assigned as group I (<8.7) and 68 patients as group II (>8.7). In patients with high TyG index, left atrial volume index (LAVi) (p < .001) LV mass index (LVMI) (p = .016), E/e' ratio (p < .001) increased, and e' velocity (p < .001) and E/A ratio (p = .028) decreased. There was a statistically significant correlation between TyG index and these parameters (all p > .05). Stepwise multiple regression analysis demonstrated that the relationship of TyG index with LV diastolic function and structure was independent of potential confounders (all p < .001).

CONCLUSION

This study suggest that a high TyG index is related to LV diastolic functional impairment and structure abnormality in newly diagnosed hypertensive patients in the absence of diabetes or CVD.

Prognostic Significance of Triglyceride-Glucose Index for Adverse Cardiovascular Events in Patients With Coronary Artery Disease: A Systematic Review and Meta-Analysis

Background: Insulin resistance (IR) represents a critical regulator in the development and progress of coronary artery disease (CAD). Triglyceride-glucose (TyG) index, a novel surrogate biomarker of IR, has been implicated in several cardiovascular diseases. Accordingly, we conduct a meta-analysis to elucidate the relationship between TyG index and adverse cardiovascular events in patients with CAD.

Methods: To identify the studies examining the predictive capacity of the TyG index for adverse cardiovascular events in the setting of CAD, we performed a comprehensive literature retrieval of Scopus, PubMed, EMBASE, and Web of Science, from the inception of databases to October 5, 2021. We pooled the adjusted hazard ratio (HR) along with 95% CI using a random-effects model. The primary outcome was a composite of major adverse cardiovascular events (MACEs), including all-cause death, cardiovascular death (CV death), myocardial infarction (MI), stroke, hospitalization for unstable angina or heart failure, and revascularization. The secondary outcomes were all-cause death, CV death, MI, stroke, and revascularization. Additionally, we conducted subgroup analyses stratified by diabetes status, age, body mass index (BMI), low-density lipoprotein cholesterol (LDL-C), category of TyG index, sample size, follow-up duration, and study design.

Results: About 12 studies involving 28,795 patients with CAD were finally taken into the quantitative analysis. Our findings showed that there was a 2.14-fold higher risk of MACEs among CAD populations in the highest TyG group compared with those in the lowest TyG group (HR: 2.14, 95% CI: 1.69–2.71, P < 0.001). A greater risk of MACEs was observed in participants with higher BMI than those with lower BMI (P = 0.03 for interaction). In the analysis of secondary outcomes, we also observed a markedly increased risk of MI, stroke, and revascularization in the highest TyG group compared with the lowest TyG group. No evidence of a significant association between TyG index and CV mortality or all-cause mortality in patients with CAD was identified.

Conclusions: The elevated TyG index is a promising predictive factor of adverse cardiovascular events in patients with CAD.

Systematic Review Registration:https://www.crd.york.ac.uk/PROSPERO, identifier: CRD42021228521.

Association of Insulin Resistance with Vascular Ageing in a General Caucasian Population: An EVA Study

The data on the relationship between insulin resistance and vascular ageing are limited. The aim of this study was to explore the association of different indices of insulin resistance with vascular ageing in an adult Caucasian population without cardiovascular disease. We selected 501 individuals without cardiovascular disease (mean age: 55.9 years, 50.3% women) through random sampling stratified by sex and age. Arterial stiffness was evaluated by measuring the carotid-to-femoral pulse wave velocity (cfPWV) and brachial-to-ankle pulse wave velocity (baPWV). The participants were classified into three groups according to the degree of vascular ageing: early vascular ageing (EVA), normal vascular ageing (NVA) and healthy vascular ageing (HVA). Insulin resistance was evaluated with the homeostatic model assessment of insulin resistance (HOMA-IR) and another five indices. The prevalence of HVA and EVA was 8.4% and 21.4%, respectively, when using cfPWV, and 7.4% and 19.2%, respectively, when using baPWV. The deterioration of vascular ageing, with both measurements, presented as an increase in all the analysed indices of insulin resistance. In the multiple regression analysis and logistic regression analysis, the indices of insulin resistance showed a positive association with cfPWV and baPWV and with EVA.

The association between triglyceride-glucose index, cardio-cerebrovascular diseases, and death in Korean adults: A retrospective study based on the NHIS-HEALS cohort

BACKGROUND

The triglyceride-glucose (TyG) index is a reliable indicator of insulin resistance. We aimed to investigate the TyG index in relation to cardio-cerebrovascular diseases (CCVDs and mortality.

METHODS

This retrospective study included 114,603 subjects. The TyG index was categorized into four quartiles by sex: Q1, <8.249 and <8.063; Q2, 8.249‒<8.614 and 8.063‒<8.403; Q3, 8.614‒< 8.998 and 8.403‒<8.752; and Q4, ≥8.998 and ≥8.752, in men and women, respectively. To calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for the primary outcomes (CCVDs and all-cause mortality) and secondary outcomes (cardiovascular diseases [CVDs], cerebrovascular diseases [CbVDs], CCVD-related deaths, or all-cause deaths), Cox proportional hazards regression models were adopted.

RESULTS

Compared to Q1, the HRs (95% CIs) for the primary outcomes of Q2, Q3, and Q4 were 1.062 (0.981‒1.150), 1.110 (1.024-1.204), and 1.151 (1.058-1.252) in men and 1.099 (0.986-1.226), 1.046 (0.938-1.166), and 1.063 (0.954-1.184) in women, respectively, after adjusted for age, smoking status, drinking status, physical activity, body mass index, systolic blood pressure, low-density lipoprotein cholesterol, economic status, and anti-hypertensive medications. Fully adjusted HRs (95% CIs) for CVDs of Q2, Q3, and Q4 were 1.114 (0.969-1.282), 1.185 (1.031-1.363), and 1.232 (1.068-1.422) in men and 1.238 (1.017-1.508), 1.183 (0.971-1.440), and 1.238 (1.018-1.505) in women, respectively. The adjusted HRs (95% CIs) for ischemic CbVDs of Q2, Q3, and Q4 were 1.005 (0.850-1.187), 1.225 (1.041-1.441), and 1.232 (1.039-1.460) in men and 1.040 (0.821-1.316), 1.226 (0.981-1.532), and 1.312 (1.054-1.634) in women, respectively, while the TyG index was negatively associated with hemorrhagic CbVDs in women but not in men. The TyG index was not significantly associated with CCVD-related death or all-cause death in either sex.

CONCLUSIONS

Elevated TyG index was positively associated with the primary outcomes (CCVDs and all-cause mortality) in men and predicted higher risk of CVDs and ischemic CbVDs in both sexes.

Association of triglyceride-glucose index with intra- and extra-cranial arterial stenosis: a combined cross-sectional and longitudinal analysis

PURPOSE

This study aimed to assess the cross-sectional and longitudinal associations of the triglyceride glucose (TyG) index, a simple surrogate marker of insulin resistance, with intra-cranial and extra-cranial artery stenosis (ICAS and ECAS) in Chinese adults.

METHODS

Participants were recruited from the Asymptomatic Polyvascular Abnormalities Community study, 5381 participants were enrolled in the cross-sectional analysis, then 3447 and 1853 participants in the longitudinal analysis for incident ICAS and ECAS, respectively. The TyG index was calculated as ln [fasting triglyceride (mg/dL) × fasting glucose (mg/dL)/2]. Multivariable logistic analysis was used to calculate odds ratio (OR) and 95% confidence interval (CI).

RESULTS

The results of the cross-sectional and longitudinal analysis were basically the same, as the fully adjusted OR comparing participants in the highest tertile versus lowest tertile of the TyG index was 1.34 (95% CI, 1.13-1.59) for the prevalence of ECAS and 1.85 (95% CI, 1.26-2.71) for incident ECAS, respectively. The addition of TyG index to a conventional model had an incremental effect on the predictive value for ECAS. However, we did not observe any significant association between the TyG index and ICAS.

CONCLUSIONS

Elevated TyG index was significantly associated with a higher risk of ECAS, but not with ICAS in Chinese adults. This conclusion lends support to the clinical significance of the TyG index for the assessment of artery stenosis, especially for ECAS.

The association between triglyceride-glucose index and major adverse cardiovascular events in patients with acute coronary syndrome - dose-response meta-analysis

BACKGROUND AND AIMS

Triglyceride-Glucose (TyG) index is an accurate biomarker of insulin resistance, which is potentially associated with adverse cardiovascular events. We aimed to assess the dose-response relationship between Triglyceride-Glucose (TyG) Index and Major Adverse Cardiovascular Events (MACE) in patients with Acute Coronary Syndrome (ACS).

METHODS AND RESULTS

A systematic literature search was performed using PubMed, Scopus, and Embase for records published from the inception up until 7 February 2021. Studies that fulfilled all of these criteria were included: 1) prospective or retrospective observational studies reporting patients with ACS and 2) assessing the impact of TyG index on MACE with at least three quantitative classifications. The outcome of interest is MACE across the TyG index intervals. MACE was a composite of all-cause mortality, myocardial infarction, unstable angina pectoris, target vessel revascularization, cerebrovascular accidents, and heart failure. The effect estimates were reported as relative risks (RRs). There are 13,684 subjects from 4 studies included in this meta-analysis. This meta-analysis showed that the highest category of TyG index was associated with twofold MACE (RR 2.09 [1.59, 2.76], p < 0.001; I2: 68.4%, p = 0.02) compared to the lowest category in patients with ACS. Dose-response meta-analysis showed that the relationship between TyG index and MACE was non-linear (p < 0.001), with statistical significance reached around TyG index 8.9 and increased non-linearly. The dose-response curve became significantly steeper after TyG index of 9.1-9.2.

CONCLUSION

TyG index was associated with MACE in patients with ACS in a non-linear fashion.

PROSPERO

CRD42021235765.

Impact of triglyceride-glucose index on long-term cardiovascular outcomes in patients with myocardial infarction with nonobstructive coronary arteries

BACKGROUND AND AIMS

Triglyceride-glucose (TyG) index has been reported as a novel surrogate marker of insulin resistance and a risk factor in patients with coronary artery disease. We aimed to investigate the prognostic value of TyG index in a distinct entity with myocardial infarction with nonobstructive coronary arteries (MINOCA).

METHODS AND RESULTS

A total of 1179 MINOCA patients were recruited and divided according to tertile levels of TyG index. The primary endpoint was a composite of major adverse cardiovascular events (MACE), including all-cause death, reinfarction, stroke, revascularization and hospitalization for unstable angina or heart failure. Kaplan-Meier, Cox regression and receiver-operating characteristic analyses were performed. Patients with higher tertiles of TyG index had a significantly higher incidence of MACE (9.6%, 14.9%, 18.0%; p = 0.003) over the median follow-up of 41.7 months. After multivariate adjustment, elevated TyG index was significantly associated with an increased risk of MACE (HR 1.33, 95% CI: 1.04-1.69, p = 0.020). The adjusted risk of MACE also increased with rising tertiles of TyG index (tertile 1 as reference; tertile 2: HR 1.64, 95% CI: 1.06-2.53, p = 0.025; tertile 3: HR 1.85, 95% CI: 1.17-2.93, p = 0.008). The TyG index remained a robust risk factor in overall and subgroups of MINOCA patients (all p < 0.05). Moreover, the TyG index yielded a moderate predictive value of MACE (area under the curve 0.66, 95% CI:0.61-0.71, p < 0.001).

CONCLUSION

Elevated TyG index was independently associated with a poor prognosis after MINOCA. Routine assessment of TyG index may improve risk stratification and facilitate decision making in MINOCA patients.

Triglyceride glucose index influences platelet reactivity in acute ischemic stroke patients

Aim

Insulin resistance was reported to increase the risk of ischemic stroke, which can be assessed by the triglyceride glucose (TyG) index. However, it remains unclear whether the TyG index influences the platelet reactivity during the treatment of ischemic patients.

Methods

Ischemic stroke patients receiving dual antiplatelet therapy (DAPT) within 48 h onset were consecutively included. The TyG index was calculated as ln (fasting triglyceride [mg/dL] × fasting glucose [mg/dL]/2). The top quartile of TyG index was defined as insulin resistance. The platelet reactivity was assessed by thromboelastography. The platelet inhibition rate induced by arachidonic acid (AA) or adenosine diphosphate (ADP) was used to confirm the high residual on-treatment platelet reactivity (HRPR) to aspirin or clopidogrel, respectively. The association between TyG index and platelet reactivity was assessed by Kruskal–Wallis test. The independent risk factors of HRPR were determined by multivariate logistic regression analysis.

Results

A total of 1002 patients were included and divided into 4 groups by quartiles of the TyG index (< 2.02; 2.02–2.27; 2.27–2.52; ≥2.52). The findings demonstrated that the maximum intensity of the clot increased, but the AA-induced platelet inhibition rate decreased, depending on the TyG index quartiles. No significant difference was found in the ADP-induced platelet inhibition rate among groups. The prevalence of aspirin HRPR increased depending on the TyG index quartile. Unlike the non-insulin resistance group, the insulin resistance group was independently associated with aspirin HRPR (OR = 1.689, 95% CI 1.14 to 2.51, P = 0.009).

Conclusions

In acute ischemic stroke patients taking DAPT, the elevation of the TyG index is associated with enhanced platelet reactivity and higher prevalence of aspirin HRPR. Insulin resistance assessed by the TyG index could be an independent risk factor for aspirin HRPR.

Association between the triglyceride glucose index and coronary collateralization in coronary artery disease patients with chronic total occlusion lesions

Background

Recent studies have substantiated the role of the triglyceride glucose (TyG) index in predicting the prognosis of coronary artery disease (CAD) patients, while no relevant studies have revealed the association between the TyG index and coronary collateralization in the event of coronary chronic total occlusion (CTO). The current study intends to explore whether, or to what extent, the TyG index is associated with impaired collateralization in CAD patients with CTO lesions.

Methods

The study enrolled 1093 CAD patients undergoing cardiac catheterization for at least one CTO lesion. Data were collected from the Beijing Anzhen Hospital record system. The degree of collaterals was determined according to the Rentrop classification system. The correlation between the TyG index and coronary collateralization was assessed.

Results

Overall, 318 patients were included in a less developed collateralization (Rentrop classification 0-1) group. The TyG index was significantly higher in patients with impaired collateralization (9.3±0.65 vs. 8.8±0.53, P<0.001). After adjusting for various confounding factors, the TyG index remained correlated with the occurrence of impaired collateralization, with odds ratios (ORs) of 1.59 and 5.72 in the T2 and T3 group compared with the first tertile group (P<0.001). In addition, subgroup analysis showed that higher TyG index values remained strongly associated with increased risk of less developed collateralization. To compare the risk assessment efficacy for the formation of collateralization between the TyG index and other metabolic abnormality indicators, an area under the receiver-operating characteristic (ROC) curve (AUC) was obtained. A significant improvement in the risk assessment performance for impaired collateralization emerged when adding the TyG index into a baseline model.

Conclusions

The increased TyG index is strongly associated with less developed collateralization in CAD patients with CTO lesions and its risk assessment performance is better than single metabolic abnormality indicators.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12944-021-01574-x.

The Plasma Atherogenic Index is an Independent Predictor of Arterial Stiffness in Healthy Koreans

The plasma atherogenic index (AIP) has been suggested as a useful independent predictor of cardiovascular diseases (CVDs) in high CV risk patients. We investigated the association between AIP and arterial stiffness measured by brachial-ankle pulse wave velocity (baPWV) in healthy adults. A total of 3468 healthy subjects without any metabolic or CV diseases were enrolled. Anthropometric and CV risk factors were measured. The AIP was defined as the base 10 logarithm of the ratio of the concentration of triglycerides to high-density lipoprotein-cholesterol. Subjects were classified into AIP quartiles. There were gradual deteriorations in metabolic parameters and increase in baPWV across the increasing AIP quartiles. In a fully adjusted analysis, compared with Q1 (lowest quartile) group, the odds ratio (95% confidence interval) for increased baPWV was higher in Q2 1.51, Q3 1.64, and Q4 (highest quartile) 2.77 among men, and Q2 1.09, Q3 1.55, and Q4 1.83 among women (all P trend  <0 .05). There was a strong association between AIP and baPWV, and a higher AIP was an independent predictor of increased arterial stiffness in healthy Korean men and women. The AIP may be a simple screening tool for subclinical atherosclerosis.

Gender difference in the association between TyG index and subclinical atherosclerosis: results from the I-Lan Longitudinal Aging Study

Background

Insulin resistance (IR) is a known risk factor for cardiovascular disease (CVD) in non-diabetic patients through the association of hyperglycemia or associated metabolic factors. The triglyceride glucose (TyG) index, which was defined by incorporating serum glucose and insulin concentrations, was developed as a surrogate marker of insulin resistance. We aimed to investigate the association between the TyG index and the early phase of subclinical atherosclerosis (SA) between the sexes.

Methods

The I-Lan Longitudinal Aging Study (ILAS) enrolled 1457 subjects aged 50–80 years. For each subject, demographic data and the TyG index {ln[fasting triglyceride (mg/dL)  ×  fasting plasma glucose (mg/dL)]/²} were obtained. Patients were further stratified according to sex and the 50th percentile of the TyG index (≥  8.55 or  <  8.55). SA was defined as the mean carotid intima-media thickness (cIMT) at the 75th percentile of the entire cohort. Demographic characteristics and the presence of SA were compared between the groups. Logistic regression analysis was performed to assess the relationship between TyG index and SA.

Results

Patients with a higher TyG index (≥  8.55) had a higher body mass index (BMI), hypertension (HTN) and diabetes mellitus (DM). They had higher lipid profiles, including total cholesterol (T-Chol) and low-density lipoprotein (LDL), compared to those with a lower TyG index (<  8.55). Gender disparity was observed in non-diabetic women who had a significantly higher prevalence of SA in the high TyG index group than in the low TyG index group. In multivariate logistic regression analysis, a high TyG index was independently associated with SA in non-diabetic women after adjusting for traditional risk factors [adjusted odds ratio (OR): 1.510, 95% CI 1.010–2.257, p  =  0.045] but not in non-diabetic men. The TyG index was not associated with the presence of SA in diabetic patients, irrespective of sex.

Conclusion

A high TyG index was significantly associated with SA and gender disparity in non-diabetic patients. This result may highlight the need for a sex-specific risk management strategy to prevent atherosclerosis.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12933-021-01391-7.

Triglyceride Glucose Index Associated With Arterial Stiffness in Chinese Community-Dwelling Elderly

Background: The population of older adults is growing rapidly with the increasing pace of aging worldwide. The triglyceride glucose (TyG) index has been a convenient and reliable surrogate marker of insulin resistance (IR). This study aimed to determine the association between the TyG index and arterial stiffness assessed by brachial-ankle pulse wave velocity (baPWV) in Chinese older adults.

Methods: A total of 2,035 participants aged 60 years or above were enrolled. Demographic, anthropometric, and cardiovascular risk factors were collected. TyG index was calculated using ln (fasting triglycerides [mg/dL] × fasting glucose [mg/dL]/2). Arterial stiffness was measured using baPWV.

Results: The participants, with the mean [standard deviation (SD)] age of 71.32 (6.75) years, the female proportion of 39.65%, the mean (SD) baPWV of 1,998 (437) cm/s, and the mean (SD) TyG index of 8.86 (0.54), were divided into four groups according to TyG index quartiles. Age-adjusted baPWV presented an increasing trend according to TyG index quartiles. In the fully adjusted linear regression model, the baPWV increased 49 cm/s, with the 95% confidence interval (CI) from 24 to 75 cm/s, per-SD increase in the TyG index. In the fully-adjusted logistic regression model, the odds ratio (95% CI) of high baPWV (>75th percentile) was 1.32 (1.09, 1.60) for each SD increase in the TyG index. The generalized additive model analysis also confirmed the significant association of the TyG index with baPWV and high baPWV.

Conclusion: The TyG index is significantly associated with arterial stiffness assessed by baPWV in Chinese older adults.

Association between triglyceride-glucose index and risk of arterial stiffness: a cohort study

BACKGROUND

Triglyceride-glucose (TyG) index, a simple surrogate marker of insulin resistance, has been reported to be associated with arterial stiffness. However, previous studies were limited by the cross-sectional design. The purpose of this study was to explore the longitudinal association between TyG index and progression of arterial stiffness.

METHODS

A total of 6028 participants were derived from the Kailuan study. TyG index was calculated as ln [fasting triglyceride (mg/dL) × fasting glucose (mg/dL)/2]. Arterial stiffness was measured using brachial-ankle pulse wave velocity (baPWV). Arterial stiffness progression was assessed by the annual growth rate of repeatedly measured baPWV. Multivariate linear regression models were used to estimate the cross-sectional association of TyG index with baPWV, and Cox proportional hazard models were used to investigate the longitudinal association between TyG index and the risk of arterial stiffness.

RESULTS

Multivariate linear regression analyses showed that each one unit increase in the TyG index was associated with a 39 cm/s increment (95%CI, 29-48 cm/s, P < 0.001) in baseline baPWV and a 0.29 percent/year increment (95%CI, 0.17-0.42 percent/year, P < 0.001) in the annual growth rate of baPWV. During 26,839 person-years of follow-up, there were 883 incident cases with arterial stiffness. Participants in the highest quartile of TyG index had a 58% higher risk of arterial stiffness (HR, 1.58; 95%CI, 1.25-2.01, P < 0.001), as compared with those in the lowest quartile of TyG index. Additionally, restricted cubic spline analysis showed a significant dose-response relationship between TyG index and the risk of arterial stiffness (P non-linearity = 0.005).

CONCLUSION

Participants with a higher TyG index were more likely to have a higher risk of arterial stiffness. Subjects with a higher TyG index should be aware of the following risk of arterial stiffness progression, so as to establish lifestyle changes at an early stage.

Association of TyG index and TG/HDL-C ratio with arterial stiffness progression in a non-normotensive population

Background

Cross-sectional studies have reported that insulin resistance (IR) is associated with arterial stiffness. However, the relationship between IR and arterial stiffness progression remains unclear. This study aims to evaluate the association of triglyceride glucose (TyG) index and triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio with arterial stiffness progression in a non-normotensive population.

Methods

A total of 1895 prehypertensive (systolic pressure 120–139 mmHg or diastolic pressure 80–90 mmHg) or hypertensive (systolic pressure ≥ 140 mmHg or diastolic pressure ≥ 90 mmHg or using antihypertensive medication) participants were enrolled in 2013 and 2014, and followed until December 31, 2019. Arterial stiffness progression was measured by brachial-ankle pulse wave velocity (baPWV) change (absolute difference between baseline and last follow-up), baPWV change rate (change divided by following years), and baPWV slope (regression slope between examination year and baPWV).

Results

During a median follow-up of 4.71 years, we observed an increasing trend of baPWV in the population. There were linear and positive associations of the TyG index and TG/HDL-C ratio with the three baPWV parameters. The difference (95% CI) in baPWV change (cm/s) comparing participants in the highest quartile versus the lowest of TyG index and TG/HDL-C ratio were 129.5 (58.7–200.0) and 133.4 (52.0–214.9), respectively. Similarly, the evaluated baPWV change rates (cm/s/year) were 37.6 (15.3–60.0) and 43.5 (17.8–69.2), while the slopes of baPWV were 30.6 (9.3–51.8) and 33.5 (9.0–58.0). The observed association was stronger in the hypertensive population.

Conclusion

Our study indicates that the TyG index and TG/HDL-C ratio are significantly associated with arterial stiffness progression in hypertensive population, not in prehypertensive population.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12933-021-01330-6.

Correlation Between the Triglyceride-Glucose Index and High Risk of Cardiovascular Disease: A Cohort Study of 102,061 Subjects from Tianjin, China

Objective

This study aims to investigate the correlation between triglyceride–glucose index (TyG) and the risk of cardiovascular disease (CVD).

Methods

A total of 102,061 permanent residents of Tianjin, China, aged 35–75 years were surveyed. A questionnaire, physical examination, and blood tests for biochemical markers were conducted for all subjects. The risk of CVD was judged based on the results, identifying the population with a high risk of CVD. TyG was calculated for all subjects who were then grouped into TyG quartiles. The correlation between TyG and the detection rate of subjects with a high risk of CVD was analyzed using the chi-square test and Pearson’s correlation analysis. The cut-off points and the magnitude of the predictive effect of TyG in determining a high risk of CVD were identified by calculating the TyG through analysis of the receiver operator characteristic (ROC) curve.

Results

The surveyed population consisted of 39,598 males (38.8%) and 62,463 females (61.2%). The average age was 55.84 ± 10.27 years. A statistically significant difference in the incidence of a high CVD risk between subjects in the four groups divided by the TyG levels was identified (p < 0.01). Pearson’s correlation analysis showed that TyG was correlated with all risk factors for CVD (p < 0.01). The maximum Youden’s J statistic for determining the high risk of CVD was found at a TyG of 9.04 (specificity 0.575, sensitivity 0.754). The area under the ROC curve was 0.780 (confidence interval [CI]: 0.777, 0.783, p < 0.01).

Conclusion

TyG index is closely related to the aggregation of cardiovascular risk factors and is correlated with the judgment results of the screening population’s high risk of CVD, suggesting that more attention should be paid to the identification and control of multiple risk factors in the population with significantly elevated TyG.

Triglyceride glucose index and carotid atherosclerosis incidence in the Chinese population: A prospective cohort study

BACKGROUND AND AIMS

The association of the triglyceride glucose (TyG) index with carotid atherosclerosis has not been reported in longitudinal studies. The present study aimed to investigate whether the TyG index increases the risk of carotid atherosclerosis incidence.

METHODS AND RESULTS

This study included data from the Beijing Health Management Cohort (BHMC; n = 6955) and the Beijing Physical Examination Cohort (BPEC; n = 8473). Participants without a history of carotid atherosclerosis who underwent health examination in 2011 or 2012 were annually followed until 2019. The TyG index was denoted as ln [triglycerides (mmol/L)∗fasting glucose (mmol/L)/2]. During a median follow-up of 5.02 years and 5.36 years, 1441 individuals in the BHMC group and 2181 individuals in the BPEC group developed carotid plaque, respectively. The adjusted hazard ratios (HRs) of the continuous TyG index were 1.253 (95% CI, 1.044 to 1.505) and 1.252 (95% CI, 1.091 to 1.437) for the BHMC and BPEC groups, respectively. Individuals in the highest quartile of the TyG index were associated with an increased risk of carotid plaque compared with those in the lowest quartile (BHMC: HR, 1.366; 95% CI, 1.101 to 1.695, P for trend = 0.010; BPEC: HR, 1.379; 95% CI, 1.196 to 1.591, P for trend = 0.013).

CONCLUSION

These findings suggested that a higher TyG index increases the risk of carotid atherosclerosis incidence in the general population.

Association between the triglyceride-glucose index and abdominal aortic calcification in adults: A cross-sectional study

BACKGROUND AND AIMS

The triglyceride-glucose (TyG) index is a reliable marker of insulin resistance, which is a substantial risk factor for cardiovascular diseases. Abdominal aortic calcification (AAC) is significantly associated with subclinical atherosclerotic diseases. The present study investigated the relationship between the TyG index and extensive AAC in middle-aged and elderly populations in the United States (US).

METHODS AND RESULTS

We performed cross-sectional analyses of data from 1419 participants from the National Health and Nutrition Examination Survey 2013-2014. AAC was detected using dual-energy X-ray absorptiometry on Hologic Discovery model A densitometer, and quantified using the Kauppila score system. Extensive AAC was defined as a Kauppila score ≥5. Multivariable logistic regression models were used to determine the association between AAC and the TyG index. The restricted cubic spline model was used for the dose-response analysis. Extensive AAC was detected in 196 (13.8%) participants. The odds of extensive AAC increased by 41% per unit increase in the TyG index (adjusted odds ratios [OR] = 1.41, 95% confidence interval [CI]: 1.04-1.91). The multivariable-adjusted OR and 95% CI of the highest TyG index tertile compared with the lowest tertile was 1.80 (95% CI: 1.11-2.94). Extensive AAC showed a more robust association with the TyG index than with triglycerides or glycemia. The subgroup analyses indicated that the association was consistent irrespective of age, sex, hypertension, diabetes, hypercholesteremia and smoking status.

CONCLUSION

The TyG index was independently associated with the presence of extensive AAC in the study population. Further studies are required to confirm this relationship.

Triglyceride-Glucose Index and Extracellular Volume Fraction in Patients With Heart Failure

Background: The triglyceride–glucose (TyG) index had been proposed as a reliable surrogate marker of insulin resistance. We aimed to evaluate the association between TyG index and myocardial fibrosis, which was quantified by extracellular volume (ECV) fraction using cardiovascular magnetic resonance (CMR) examination, and their prognostic value in patients with heart failure (HF).

Methods: In this retrospective cohort study, 103 hospitalized HF patients were included. ECV fraction was calculated using CMR measurements and T1 mapping. TyG index was calculated using fasting triglyceride and blood glucose. The primary outcome events were defined as all-cause mortality and HF hospitalization during follow-up.

Results: During the median follow-up of 12.3 months, 39 patients (37.9%) experienced primary outcome events and had higher levels of TyG index, N-terminal pro–B-type natriuretic peptide (NT-proBNP), and ECV fraction compared with those without events. Multivariate linear regression analysis showed that the TyG index was the significant factor determined for ECV fraction (r_partial = 0.36, P = 0.01). In multivariate Cox regression analysis, presence of diabetes [hazard ratio (HR) = 1.28, 95% confidence interval (CI) = 1.01–1.62], higher TyG index (HR = 2.01, 95% CI = 1.03–4.01), ECV fraction (HR = 1.73, 95% CI = 1.04–2.88), and NT-proBNP (HR = 2.13, 95% CI = 1.08–4.20) were independent risk factors for the primary outcome events.

Conclusions: TyG index is a novel biomarker of myocardial fibrosis in HF patients and can be considered as a useful risk stratification metric in the management of HF.

Relationship of triglyceride-glucose index with chronic limb-threatening ischemia in lower extremity peripheral artery disease

OBJECTIVES

Triglyceride-glucose index (TyG index), which is defined as the simple and novel marker of insulin resistance, is becoming increasingly important as a promising predictive marker for atherosclerotic diseases. Chronic limb-threatening ischemia is defined as the most advanced stage of the lower extremity peripheral artery disease, whose main cause is atherosclerosis and is associated in this respect with amputation, impaired quality of life, and mortality. The main purpose of the present study was to investigate the relation between the calculated TyG index values and chronic limb-threatening ischemia development.

METHODS

A total of 296 patients who were diagnosed with lower extremity peripheral artery disease in our outpatient clinic between October 2018 and October 2020 were included in this study retrospectively. Two groups were formed by clinically staging the patients according to Rutherford Classification. Patients who did not develop chronic limb-threatening ischemia were classified as "Group 1" (n = 224) and those who developed were classified as "Group 2" (n = 72).

RESULTS

The mean TyG index values that were calculated in Group 2 were significantly higher than in Group 1 (9.27 ± 0.31 vs. 9.00 ± 0.34, p < 0.001). In the multivariate logistic regression analysis conducted to determine the predictors of chronic limb-threatening ischemia development, C-reactive protein (OR [Odds Ratio]: 1.220, 95% CI [confidence interval]: 1.092-1.363, p < 0.001), high-density lipoprotein cholesterol (OR: 0.775, 95% CI: 0.715-0.839, p < 0.001) and TyG index (OR: 5.796, 95% CI: 2.050-16.382, p = 0.001) were identified as independent predictors. Receiver operating characteristic analysis revealed that the cut-off value of TyG index was 9.13 (area under the curve: 0.721, p < 0.001) with 70.8% sensitivity and 65.2% specificity. The TyG index was significantly correlated with Rutherford category, high-density lipoprotein cholesterol and mean platelet volume.

CONCLUSIONS

Chronic limb-threatening ischemia development may be predicted with the TyG index value, which is calculated easily from routine biochemical parameters, in patients diagnosed with lower extremity peripheral artery disease.

The association between triglyceride glucose index and depression: data from NHANES 2005-2018

BACKGROUND

The association between triglyceride glucose (TyG) index and depression is unclear. We conducted this analysis to explore whether higher TyG index is associated with a higher odd of depression.

METHODS

This was an observational study using data from the National Health and Nutrition Examination Survey (2005-2018), a cross-sectional and nationally representative database. Depression was assessed using the Patient Health Questionnaire-9 (PHQ-9). TyG index was calculated based on the equation as follows: ln [triglyceride (mg/dL) × fasting blood glucose (mg/dL)/2], and participants were divided into quartiles based on TyG index. Weighted multivariable logistic regression models were used to explore the relationship between the TyG index and depression.

RESULTS

A total of 13,350 patients were included, involving 1001 (7.50%) individuals with depression. Higher TyG index is significantly associated with elevated depressive symptoms in U.S. adults. Multivariate-adjusted HRs for patients in the TyG index 4th quartile were higher for depression (OR = 1.46; 95% confidence interval (CI) 1.30, 1.64) compared with the 1st quartile of TyG index. Similar results were seen in men and women, across age groups, and baseline comorbidities.

CONCLUSION

In this large cross-sectional study, our result suggests that population with higher TyG index are significantly more likely to have depressive symptoms in U.S. adults.

Stronger association of triglyceride glucose index than the HOMA-IR with arterial stiffness in patients with type 2 diabetes: a real-world single-centre study

Background

The triglyceride-glucose index (TyG index) has been proposed as a simple and reliable alternative insulin resistance (IR) marker, while the homeostasis model assessment for IR (HOMA-IR) is the most frequently used index. Few studies have evaluated the role of IR assessed by the TyG index and HOMA-IR on arterial stiffness in a type 2 diabetes (T2D) population with a high risk of increased arterial stiffness. We aimed to investigate the association of the TyG index and HOMA-IR with arterial stiffness in patients with T2D.

Methods

We recruited 3185 patients with T2D, who underwent brachial-ankle pulse wave velocity (baPWV), an indicator of arterial stiffness, but without previous cardiovascular disease. Increased arterial stiffness was defined as a baPWV value greater than the 75th percentile (18.15 m/s) in the present study. The TyG index was determined as ln(fasting triglycerides [mg/dL] × fasting glucose [mg/dL]/2), and the HOMA-IR was calculated as (fasting insulin [μIU/mL] × fasting glucose [mmol/L])/22.5.

Results

The mean age of the study participants was 54.6 ± 12.0 years, and 1954 (61.4%) were men. Seemingly unrelated regression estimation analysis demonstrated that the TyG index had stronger associations with baPWV than the HOMA-IR (all P < 0.001). In the multivariable logistic analyses, each one-unit increase in the TyG index was associated with a 1.40-fold (95% CI 1.16–1.70, P < 0.001) higher prevalence of increased arterial stiffness, but the prominent association of the HOMA-IR with the prevalence of increased arterial stiffness was not observed. Subgroup analyses showed that a more significant association between the TyG index and the prevalence of increased arterial stiffness was detected in older patients with a longer duration of diabetes and poor glycaemic control (all P < 0.05).

Conclusions

Compared with the HOMA-IR, the TyG index is independently and more strongly associated with arterial stiffness in patients with T2D.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12933-021-01274-x.

Triglyceride Glucose Index Is Associated With Arterial Stiffness and 10-Year Cardiovascular Disease Risk in a Chinese Population

Background: Insulin resistance (IR) is a significant risk factor for cardiovascular disease (CVD). In this study, the association of the triglyceride glucose (TyG) index, a simple surrogate marker of IR, with arterial stiffness and 10-year CVD risk was evaluated.

Methods: A total of 13,706 participants were enrolled. Anthropometric and cardiovascular risk factors were determined in all participants, while serum insulin levels were only measured in 955 participants. Arterial stiffness was measured through brachial-ankle pulse wave velocity (baPWV), and 10-year CVD risk was evaluated using the Framingham risk score.

Results: All participants were classified into four groups according to the quartile of the TyG index. BaPWV and the percentage of participants in the 10-year CVD risk categories significantly increased with increasing quartiles of the TyG index. Logistic regression analysis showed that the TyG index was independently associated with a high baPWV and 10-year CVD risk after adjusting for traditional CVD risk factors. The area under the receiver operating characteristics curve (AUROC) of the TyG index for predicting a high baPWV was 0.708 (95%CI 0.693–0.722, P < 0.001) in women, higher than that in men. However, the association of the homeostatic model assessment of IR (HOMA-IR) with a high baPWV and the 10-year CVD risk was absent when adjusting for multiple risk factors in 955 participants.

Conclusions: The TyG index is independently associated with arterial stiffness and 10-year CVD risk.

Association Between Triglyceride Glucose Index and Non-Small Cell Lung Cancer Risk in Chinese Population

Background

Numerous studies showed that insulin resistance (IR) was associated with cancer risk. However, few studies investigated the relationship between IR and non-small cell lung cancer (NSCLC). The aim of this study is to explore the association of triglyceride glucose (TyG) index, a simple surrogate marker of IR, with NSCLC risk.

Methods

791 histologically confirmed NSCLC cases and 787 controls were enrolled in the present study. Fasting blood glucose and triglyceride were measured. The TyG index was calculated as ln [fasting triglycerides (mg/dl) ×fasting glucose (mg/dl)/2]. Logistic regression analysis was performed to estimate the relationship between NSCLC risk and the TyG index.

Results

The TyG index was significantly higher in patients with NSCLC than that in controls (8.42 ± 0.55 vs 8.00 ± 0.45, P < 0.01). Logistic regression analysis showed that the TyG index (OR = 3.651, 95%CI 2.461–5.417, P < 0.001) was independently associated with NSCLC risk after adjusting for conventional risk factors. In addition, a continuous rise in the incidence of NSCLC was observed along the tertiles of the TyG index (29.4 vs 53.8 vs 67.2%, P < 0.001). However, there were no differences of the TyG index in different pathological or TNM stages. In receiver operating characteristic (ROC) curve analysis, the optimal cut-off level for the TyG index to predict incident NSCLC was 8.18, and the area under the ROC curve (AUROC) was 0.713(95% CI 0.688–0.738).

Conclusions

The TyG index is significantly correlated with NSCLC risk, and it may be suitable as a predictor for NSCLC.

Association between triglyceride glucose index and coronary artery disease with type 2 diabetes mellitus in middle-aged and elderly people

This study aimed to investigate the correlation between triglyceride glucose (TyG) index and coronary artery disease (CAD) with type 2 diabetes mellitus (T2DM) and identify the risk associated TyG index in different subgroups.A total of 1665 eligible inpatients (CAD with T2DM group [n = 680], non-coronary artery disease without T2DM [n = 985]) were consecutively enrolled in this study. They were assigned into 4 subgroups: middle-aged, elderly, male, and female subgroups. Receiver operating characteristic curve diagnostic test and a logistic regression model was established to analyze the risk factors for CAD with T2DM.TyG index is an independent risk factor for patients with CAD with T2DM. The risk of increased TyG index is greater in the middle-aged and male subgroups than in the elderly and female subgroups, respectively (all P < .05). The specificity and the positive predictive value of the TyG index is greater than the sensitivity and the negative predictive value, respectively (all P < .05).Increased TyG index is a new independent risk factor for CAD with T2DM, and its risk is higher in the middle-aged and male subgroups than in the elderly and female subgroups, respectively. TyG index may be used as a clinical predictor of CAD with T2DM.

Triglyceride-glucose index and the risk of stroke and its subtypes in the general population: an 11-year follow-up

Background

Triglyceride-glucose (TyG) index was recently suggested to be a reliable surrogate marker of insulin resistance. We aim to investigate the associations between baseline and long-term TyG index with subsequent stroke and its subtypes in a community-based cohort.

Methods

A total of 97,653 participants free of history of stroke in the Kailuan Study were included. TyG index was calculated as ln (fasting triglyceride [mg/dL] × fasting glucose [mg/dL]/2). Baseline TyG index was measured during 2006–2007. Updated cumulative average TyG index used all available TyG index from baseline to the outcome events of interest or the end of follow up. The outcome was the first occurrence of stroke, including ischemic stroke, intracerebral hemorrhage and subarachnoid hemorrhage. The associations of TyG index with outcomes were explored with Cox regression.

Results

During a median of 11.02 years of follow-up, 5122 participants developed stroke of whom 4277 were ischemic stroke, 880 intracerebral hemorrhage, and 144 subarachnoid hemorrhage. After adjusting for confounding variables, compared with participants in the lowest quartile of baseline TyG index, those in the third and fourth quartile were associated with an increased risk of stroke (adjusted hazard ratio [HR] 1.22, 95% confidence interval [CI] 1.12–1.33, and adjusted HR 1.32, 95% CI 1.21–1.44, respectively, P for trend < 0.001). We also found a linear association between baseline TyG index with stroke. Similar results were found for ischemic stroke. However, no significant associations were observed between baseline TyG index and risk of intracranial hemorrhage. Parallel results were observed for the associations of updated cumulative average TyG index with outcomes.

Conclusions

Elevated levels of both baseline and long-term updated cumulative average TyG index can independently predict stroke and ischemic stroke but not intracerebral hemorrhage in the general population during an 11-year follow-up.

Predictive effect of triglyceride‑glucose index on clinical events in patients with type 2 diabetes mellitus and acute myocardial infarction: results from an observational cohort study in China

Background

Triglyceride glucose (TyG) index is considered a reliable alternative marker of insulin resistance and an independent predictor of cardiovascular (CV) outcomes. However, the prognostic value of TyG index in patients with type 2 diabetes mellitus (T₂DM) and acute myocardial infarction (AMI) remains unclear.

Methods

A total of 1932 consecutive patients with T₂DM and AMI were enrolled in this study. Patients were divided into tertiles according to their TyG index levels. The incidence of major adverse cardiac and cerebral events (MACCEs) was recorded. The TyG index was calculated as the ln [fasting triglycerides (mg/dL) × fasting plasma glucose (mg/dL)/2].

Results

Competing risk regression revealed that the TyG index was positively associated with CV death [2.71(1.92 to 3.83), p < 0.001], non-fatal MI [2.02(1.32 to 3.11), p = 0.001], cardiac rehospitalization [2.42(1.81 to 3.24), p < 0.001], revascularization [2.41(1.63 to 3.55), p < 0.001] and composite MACCEs [2.32(1.92 to 2.80), p < 0.001]. The area under ROC curve of the TyG index for predicting the occurrence of MACCEs was 0.604 [(0.578 to 0.630), p < 0.001], with the cut-off value of 9.30. The addition of TyG index to a baseline risk model had an incremental effect on the predictive value for MACCEs [net reclassification improvement (NRI): 0.190 (0.094 to 0.337); integrated discrimination improvement (IDI): 0.027 (0.013 to 0.041); C-index: 0.685 (0.663 to 0.707), all p < 0.001].

Conclusions

The TyG index was significantly associated with MACCEs, suggesting that the TyG index may be a valid marker for risk stratification and prognosis in patients with T₂DM and AMI.

Trial registration Retrospectively registered.

Relationship between Muscle Mass and Non-Alcoholic Fatty Liver Disease

Simple Summary

Sarcopenia and non-alcoholic fatty liver disease share common pathological and physiological mechanisms that can co-occur with aging. Low skeletal muscle mass index and non-alcoholic fatty liver disease were related, regardless of abdominal obesity. Maintenance of muscle mass should be emphasized for prevention of non-alcoholic fatty liver disease. Management of fatty liver also could be an important strategy to preserve muscle mass.

Abstract

Although sarcopenia is known to be a risk factor for non-alcoholic fatty liver disease (NAFLD), whether NAFLD is a risk factor for the development of sarcopenia is not clear. We investigated relationships between NAFLD and low skeletal muscle mass index (LSMI) using three different datasets. Participants were classified into LSMI and normal groups. LSMI was defined as a body mass index (BMI)-adjusted appendicular skeletal muscle mass <0.789 in men and <0.512 in women or as the sex-specific lowest quintile of BMI-adjusted total skeletal muscle mass. NAFLD was determined according to NAFLD liver fat score or abdominal ultrasonography. The NAFLD groups showed a higher hazard ratios (HRs) with 95% confidence intervals (CIs) for LSMI than the normal groups (HRs = 1.21, 95% CIs = 1.05–1.40). The LSMI groups also showed a higher HRs with 95% CIs for NAFLD than normal groups (HRs = 1.56, 95% CIs = 1.38–1.78). Participants with NAFLD had consistently less skeletal muscle mass over 12 years of follow-up. In conclusion, LSMI and NAFLD showed a relationship. Maintaining muscle mass should be emphasized in the management of NAFLD.

High Triglyceride-Glucose Index is Associated with Poor Cardiovascular Outcomes in Nondiabetic Patients with ACS with LDL-C below 1.8 mmol/L

Aim: To evaluate the prognostic value of triglyceride-glucose (TyG) index in nondiabetic patients with acute coronary syndrome (ACS) with low-density lipoprotein cholesterol (LDL-C) below 1.8 mmol/L.

Methods: A total of 1655 nondiabetic patients with ACS with LDL-C below 1.8 mmol/L were included in the analysis. Patients were stratified into two groups. The incidence of acute myocardial infarction (AMI), infarct size in patients with AMI, and major adverse cardiac and cerebral event during a median of 35.6-month follow-up were determined and compared between the two groups. The TyG index was calculated using the following formula: ln [fasting triglycerides (mg/dL)×fasting plasma glucose (mg/dL)/2].

Results: Compared with the TyG index ＜8.33 group, the TyG index ≥ 8.33 group had a significantly higher incidence of AMI (21.2% vs. 15.2%, p =0.014) and larger infarct size in patients with AMI [the peak value of troponin I: 10.4 vs. 4.8 ng/ml, p =0.003; the peak value of Creatine kinase MB: 52.8 vs. 22.0 ng/ml, p =0.006; the peak value of myoglobin: 73.7 vs. 46.0 ng/ml, p =0.038]. Although there was no significant difference in mortality between the two groups, the incidence of revascularization of the TyG index ≥ 8.33 group was significantly higher than that of the TyG index ＜8.33 group (8.9% vs. 5.0%, p =0.035). A multivariable Cox regression revealed that the TyG index was positively associated with revascularization [hazard ratio, 1.67; 95% confidence interval, 1.02–2.75; p =0.043].

Conclusions: In nondiabetic patients with ACS with LDL-C below 1.8 mmol/L, a high TyG index level was associated with higher incidence of AMI, larger infarct size, and higher incidence of revascularization. A high TyG index level might be a valid predictor of subsequent revascularization.

A High Triglyceride-Glucose Index Is Associated With Contrast-Induced Acute Kidney Injury in Chinese Patients With Type 2 Diabetes Mellitus

Background and Objectives

Triglyceride-glucose (TyG) is an emerging vital indicator of insulin resistance and is associated with increased risk of T2DM and cardiovascular events. We aimed to explore the TyG index and contrast-induced acute kidney injury (CI-AKI) in patients with type 2 diabetes who underwent coronary angiology.

Methods

This study enrolled 928 patients with suspected coronary artery disease who underwent coronary angiology or percutaneous coronary intervention in Zhongda hospital. Patient data were divided into quartiles according to the TyG index: group 1: TyG ≤ 8.62; group 2: 8.629.45. CI-AKI was diagnosed according to the KIDIGO criteria. Demographic data, hematological parameters, coronary angiology data, and medications were all recorded. We calculated the TyG index using the following formula: ln [fasting TG (mg/dL)×FPG (mg/dL)/2].

Results

Patients who developed CI-AKI exhibited significantly higher TyG index levels compared to patients who did not develop CI-AKI. The incidence of CI-AKI sharply increased with increasing TyG. Univariate and multivariate analysis identified TyG as an independent risk factor for CI-AKI. The AUC of the ROC curve was as high as 0.728 when the value of TyG was 8.88. The corresponding sensitivity was as high as 94.9%. Adding the variable TyG to the model for predicting CI-AKI risk further increased the predictive value of the model from 80.4% to 82%.

Conclusions

High TyG is closely associated with increased incidence of CI-AKI, demonstrating that TyG is an independent risk factor for CI-AKI. TyG has potentially predictive value for CI-AKI and may play a crucial role in risk stratification in clinical practice.

The Triglyceride-Glucose Index, an Insulin Resistance Marker, Was Non-linear Associated With All-Cause and Cardiovascular Mortality in the General Population

Background: The triglyceride-glucose (TyG) index could serve as a convenient substitute of insulin resistance (IR), but epidemiological evidence on its relationship with the long-term risk of mortality is limited.

Methods: Participants from the National Health and Nutrition Examination Survey during 1999–2014 were grouped according to TyG index (<8, 8–9, 9–10, >10). Cox regression was conducted to compute the hazard ratios (HRs) and 95% confidence interval (CI). Restricted cubic spline and piecewise linear regression were performed to detect the shape of the relationship between TyG index and mortality.

Results: A total of 19,420 participants (48.9% men) were included. On average, participants were followed-up for 98.2 months, and 2,238 (11.5%) and 445 (2.3%) cases of mortality due to all-cause or cardiovascular disease were observed. After adjusting for confounders, TyG index was independently associated with an elevated risk of all-cause (HR, 1.10; 95% CI, 1.00–1.20) and cardiovascular death (HR, 1.29; 95% CI, 1.05–1.57). Spline analyses showed that the relationship of TyG index with mortality was non-linear (All non-linear P < 0.001), and the threshold value were 9.36 for all-cause and 9.52 for cardiovascular death, respectively. The HRs above the threshold point were 1.50 (95% CI, 1.29–1.75) and 2.35 (95% CI, 1.73–3.19) for all-cause and cardiovascular death. No significant difference was found below the threshold points (All P > 0.05).

Conclusion: Elevated TyG index reflected a more severe IR and was associated with mortality due to all-cause and cardiovascular disease in a non-linear manner.

Triglyceride-glucose index is associated with the risk of myocardial infarction: an 11-year prospective study in the Kailuan cohort

Background

The triglyceride–glucose (TyG) index, which is a simple surrogate marker of insulin resistance, has been suggested as a contributor of cardiovascular disease. However, evidence on the effect of long-term elevation of the TyG index exposure on myocardial infarction (MI) is limited. The current study aimed to evaluate the association of baseline and long-term elevation of the TyG index exposure with the risk of MI.

Methods

A total of 98,849 participants without MI at baseline (2006) were enrolled from the Kailuan study. The baseline TyG index was calculated as ln [fasting triglyceride (mg/dL) × fasting glucose (mg/dL)/2]. The long-term TyG index was characterized in two ways as follows. The updated mean TyG index was calculated as the mean of TyG index at all previous visits before MI occurred or the end of follow-up; alternatively, the TyG index was calculated as the number of visits with a high TyG index in 2006, 2008, and 2010, ranging from 0 (no exposure) to 3 (had high TyG index at all three study visits). Hazard ratio (HR) and 95% confidence interval (CI) was estimated using multivariable Cox proportion hazard models.

Results

During a median follow-up of 11.03 years, 1555 incident MI occurred. In the multivariable-adjusted model, the risk of MI increased with quartiles of the baseline and updated mean TyG index, the HR in quartile 4 versus quartile 1 was 2.08 (95% CI,1.77–2.45) and 1.58 (1.18–2.12), respectively. Individuals with a high TyG index at all three visits had a 2.04-fold higher risk (95% CI, 1.63–2.56) of MI compared with no exposure. Subgroup analyses showed that the associations were more pronounced in women than in men (P_interaction = 0.0411).

Conclusions

Elevated levels of the baseline and long-term TyG index are associated with an increased risk of MI. This finding indicates that the TyG index might be useful in identifying people at high risk of developing MI.

A high triglyceride-glucose index is associated with left ventricular dysfunction and atherosclerosis

Background: The triglyceride-glucose (TyG) index has been reported to be a simple and reliable surrogate marker of insulin resistance. The aim of this study was to investigate associations between the TyG index and echocardiographic parameters including left ventricular mass (LVM), left atrial diameter (LAD) and left ventricular ejection fraction (LVEF), and markers of peripheral artery disease, ankle-brachial index (ABI) and brachial-ankle pulse wave velocity (baPWV). Methods: A total of 823 (483 males and 340 females) patients were enrolled from 2007 to 2011 at a regional hospital in southern Taiwan. Multivariable stepwise linear regression analysis was performed to identify the factors related to echocardiographic parameters and peripheral artery disease. Results: The patients were stratified into four groups according to TyG index quartile. Multivariable stepwise linear regression analysis showed that a higher TyG index was associated with elevated observed/predicted LVM (p = 0.081), increased LAD (p = 0.004), decreased LVEF (p = 0.003) and lower ABI (p = 0.030), but not observed/predicted LVM and baPWV. Conclusions: A high TyG index was significantly associated with high LAD, low LVEF and low ABI. However, the TyG index was not significantly associated with inappropriate LVM or baPWV. The results suggest that the TyG index, as a simple indicator of insulin resistance, may reflect cardiac remodeling and dysfunction and atherosclerosis.

Higher Triglyceride-Glucose Index Is Associated With Increased Likelihood of Kidney Stones

AIMS

We aimed to assess the association between triglyceride-glucose (TyG) index and kidney stones in US adults.

METHODS

Data were obtained from the 2007-2014 National Health and Nutrition Examination Survey (NHANES). Participants aged ≥18 years who were not pregnant and provided complete data about TyG index and kidney stones were included in the analysis. Weighted multivariable regression analysis and subgroup analysis were preformed to estimate the independent relationship between TyG index and nephrolithiasis and recurrence.

RESULTS

A total of 20,972 participants were included with the mean TyG index of 8.71 ± 0.72. The prevalence rates of nephrolithiasis and recurrence were 9.30% and 3.17% overall and increased with the higher TyG index tertiles (Nephrolithiasis: Tertile 1, 6.98%; Tertile 2, 9.15%; Tertile 3, 11.98%, p < 0.01; Recurrence: Tertile 1, 1.84%; Tertile 2, 3.27%; Tertile 3, 4.50%, p < 0.01). Each unit increase in TyG index was associated with 12% and 26% higher odds of nephrolithiasis [odds ratio (OR) = 1.12; 95% CI: 1.02-1.22; p = 0.02] and recurrence (OR = 1.26; 95% CI: 1.08-1.46; p < 0.01). Interaction tests indicated no significant effect of gender, age, body mass index, hypertension, and diabetes on this association between TyG index and kidney stones.

CONCLUSIONS

Higher TyG index was associated with an increased likelihood of nephrolithiasis and recurrence. Considering TyG index is a reliable indicator of insulin resistance (IR). Treatment and management of IR at a younger age may improve or alleviate the occurrence and recurrence of kidney stones.

Relationship between triglyceride glucose index, retinopathy and nephropathy in Type 2 diabetes

Aims

To explore the relationship between TyG index, diabetic retinopathy (DR) and nephropathy.

Methods

This was a cross-sectional observational study that examined 1413 subjects with type 2 diabetes (both known and newly diagnosed). Subjects underwent a detailed standard evaluation to detect diabetic retinopathy (fundus photography) and nephropathy (defined as urinary albumin excretion ≥ 30 mg/24 h). The TyG index was calculated as ln (fasting triglycerides (mg/dL) × fasting glucose (mg/dL)/2) and stratified into 4 quartiles (TyG-Q). The baseline characteristics of the study population in the four TyG-Q (Q1 (≤7.3) n = 349, Q2 (>7.3 to ≤ 7.5) n = 358, Q3 (>7.5 to ≤ 8.0) n = 354, and Q4 (>8.0) n = 352) were analysed. Variables associated with the presence of DR and nephropathy were assessed using a stepwise binary logistic regression analysis.

Results

The presence of DR was associated with higher TyG index (OR = 1.453, P =.001) and longer duration of diabetes (OR = 1.085, P < .001). The presence of nephropathy was associated with a higher TyG index (OR = 1.703, P < .001), greater age (OR = 1.031, P < .001), use of insulin (OR = 1.842, P = .033), higher systolic BP (OR = 1.015, P < .001), and the presence of DR (OR = 3.052, P < .001). Higher TyG-Q correlated with the severity of DR (P = .024), presence of nephropathy (P = .001), age (P < .001) and diastolic blood pressure (P = .006).

Conclusions

A higher TyG index is associated with the presence of retinopathy and nephropathy in individuals with diabetes and could be used for monitoring metabolic status in clinical settings.

The triglyceride-glucose index predicts ischemic heart disease risk in Koreans: a prospective study using National Health Insurance Service data

Background

Ischemic heart disease (IHD) without diabetes is considered an important challenge to human health and is associated with a poor prognosis, as well as a lack of health awareness. We prospectively investigated the relationship between the triglyceride-glucose (TyG) index, a surrogate marker of early insulin resistance, and incident IHD risk in a large cohort of nondiabetic Korean adults using National Health Insurance Service data.

Methods

We assessed 16,455 participants (8426 men and 8029 women) without diabetes using data from a health risk assessment study (HERAS) and Korea Health Insurance Review and Assessment (HIRA) data. The participants were divided into four groups according to TyG index quartiles, calculated as ln [fasting triglycerides (mg/dL) × fasting plasma glucose (mg/dL)/2]. We prospectively assessed hazard ratios (HRs) with 95% confidence intervals (CIs) for IHD using multivariate Cox proportional-hazards regression models over a 50-month period that followed the baseline survey.

Results

During the follow-up period, 322 (2.0%) participants developed IHD. HRs of IHD for TyG index quartiles 2–4 were 1.61 (95% CI 1.05–2.48), 1.85 (95% CI 1.21–2.81), and 2.29 (95% CI 1.50–3.51), respectively, after adjusting for age, sex, body mass index, smoking status, alcohol intake, and physical activity.

Conclusions

A higher TyG index precedes and significantly predicts future IHD among nondiabetic Koreans. Accordingly, the TyG index may be a useful measure in assessing cardiovascular risk for nondiabetic adults in the preclinical stage.

High triglyceride-glucose index is associated with adverse cardiovascular outcomes in patients with acute myocardial infarction

BACKGROUND AND AIMS

Triglyceride glucose (TyG) index is considered a new surrogate marker of insulin resistance that associated with the development of vascular disease. The aim of this study was to evaluate the prognostic value of TyG index in patients with acute myocardial infarction (AMI).

METHODS AND RESULTS

A total of 3181 patients with AMI were included in the analysis. Patients were stratified into 2 groups according to their TyG index levels: the TyG index <8.88 group and the TyG index ≥8.88 group. The incidence of major adverse cardiovascular events (MACEs) during a median of 33.3-month follow-up were recorded. Multivariable Cox regression models revealed that the TyG index was positively associated with all-cause death [HR (95% CI): 1.51 (1.10,2.06), p = 0.010], cardiac death [HR (95% CI): 1.68 (1.19,2.38), p = 0.004], revascularization [HR (95% CI): 1.50 (1.16,1.94), p = 0.002], cardiac rehospitalization [HR (95% CI): 1.25 (1.05,1.49), p = 0.012], and composite MACEs [HR (95% CI): 1.19 (1.01,1.41), p = 0.046] in patients with AMI. The independent predictive effect of TyG index on composite MACEs was mainly reflected in the subgroups of male gender and smoker. The area under the curve (AUC) of the TyG index predicting the occurrence of MACEs in AMI patients was 0.602 [95% CI 0.580,0.623; p < 0.001].

CONCLUSION

High TyG index levels appeared to be associated with an increased risk of MACEs in patients with AMI. The TyG index might be a valid predictor of cardiovascular outcomes of patients with AMI.

TRIAL REGISTRATION

Retrospectively registered.