Is Triglyceride-Glucose Index a Valuable Parameter in Peripheral Artery Disease?

Predictive value of the triglyceride-glucose index for coronary artery bypass grafting-acute kidney injury patients

BACKGROUND

Acute kidney injury (AKI) is a common and serious complication after coronary artery bypass grafting (CABG), significantly affecting patient outcomes. The triglyceride-glucose (TyG) index, a marker of insulin resistance, has shown potential in predicting various metabolic and cardiovascular conditions. This study aimed to evaluate the predictive value of the TyG index for AKI occurrence following CABG.

METHODS

This retrospective, single-center study included 3,260 patients who underwent CABG. Patients were categorized into AKI and non-AKI groups based on postoperative renal function. The preoperative TyG index was calculated from fasting blood glucose and triglyceride levels. Patients were further divided into quartiles based on the TyG index. Logistic regression analysis was used to assess the relationship between TyG index and AKI risk. Subgroup analyses and spline regression were employed to explore potential interactions and non-linear relationships.

RESULTS

Of the 3,260 patients, 514 (15.8%) developed AKI. Baseline characteristics showed that AKI patients had significantly higher levels of hemoglobin (Hb), alanine aminotransferase (ALT), aspartate aminotransferase (AST), triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and glucose, while brain natriuretic peptide (BNP) levels were lower compared to non-AKI patients. Logistic regression analysis confirmed that the TyG index was an independent risk factor for AKI following CABG, both as a continuous variable (OR 1.034 [95% CI 1.017-1.050], p < 0.001) and when grouped by quartiles. A non-linear relationship between TyG index and AKI risk was observed, with a significant increase in AKI risk when the TyG index exceeded 5.4. Subgroup analyses revealed that this association was consistent across multiple patient groups, including those stratified by age, sex, BMI, extracorporeal circulation use, and comorbidities such as hypertension, diabetes, and hyperlipidemia.

CONCLUSIONS

The preoperative TyG index is a significant independent predictor of AKI after CABG, with a dose-response relationship observed across various subgroups. Monitoring the TyG index can help identify high-risk patients, potentially guiding early intervention and improving postoperative outcomes. These findings underscore the potential of the TyG index as a valuable tool for predicting AKI in clinical practice, warranting further validation in prospective studies.

Triglyceride glucose (TyG) index: A promising biomarker for diagnosis and treatment of different diseases

The Triglyceride-glucose index (TyG index) is a comprehensive statistical measure that incorporates fasting triglyceride and fasting glucose levels. Research has demonstrated that it can serve as an effective alternative biomarker for insulin resistance (IR) due to its high sensitivity and specificity. The TyG index is straightforward to compute and imposes fewer time and cost constraints, rendering it suitable for large populations and advantageous for use in various applications, clinical settings, and epidemiological investigations. Numerous high-quality clinical studies have underscored the significance of the TyG index in diverse medical conditions. This review provides a synthesis of the association between the TyG index and diseases such as diabetes, cardiovascular diseases, cerebrovascular diseases, fatty liver, kidney diseases, and reproductive system diseases. Furthermore, the TyG index has exhibited predictive capabilities for identifying IR in children and adolescents. Through a systematic review of pertinent clinical trials, this paper elucidates the correlation between the TyG index and various diseases. The findings presented herein suggest that the TyG index holds promise as a valuable and practical indicator for different medical conditions, prompting a reevaluation of conventional disease risk assessment paradigms and highlighting the intricate interplay of metabolic parameters with diverse diseases. By leveraging insights from the TyG index, tailored disease risk management strategies can be developed to offer a fresh perspective and guidance for clinical interventions.

Investigating the association between the triglyceride-glucose index and peripheral artery disease: a systematic review and meta-analysis

BACKGROUND

Peripheral artery disease (PAD) is a common disease associated with atherosclerosis, leading to significant mortality and morbidity worldwide. Our study focuses on the association between insulin resistance (IR) and PAD, specifically investigating the triglyceride-glucose index (TyG) as a potential surrogate marker of IR in the context of PAD by pooling the existing studies on this topic.

METHODS

Online databases, including PubMed, Embase, Scopus, and the Web of Science, were searched to find the studies comparing the TyG index in PAD vs. control, reporting the TyG index among PAD severities, and assessing the association of increase in TyG with PAD prevalence. Random-effect meta-analysis was performed to calculate the standardized mean difference (SMD) and 95% confidence interval (CI) for TyG level comparison and to calculate pooled odds ratio (ORs) for a 1-unit increase in TyG and higher vs. lower quartile/tertile of TyG association with PAD.

RESULTS

In the final review, 22 studies comprising 73,168 cases were included. Random-effect meta-analysis showed that patients with PAD had significantly higher levels of the TyG index compared with controls (SMD 0.76, 95%CI 0.65-0.88, P < 0.001). Also, higher severities of PAD were associated with higher TyG levels (SMD 0.48, 95%CI 0.22-0.74, P = 0.0003). Additionally, a 1-unit increase in TyG was associated with a 60% increase in odds of PAD (OR 1.60, 95%CI 1.41-1.80, P < 0.001). Finally, the highest quartile (Q4) of TyG had significantly higher odds of PAD compared to Q1 (OR 1.94, 95%CI 1.49-2.54, P < 0.001).

CONCLUSION

Our meta-analysis has identified a significant association between TyG levels and PAD and its severity. These findings not only contribute to our understanding of the role of IR in PAD pathology but also offer clinicians an exact index for evaluating PAD risk and its complications. This could potentially lead to more effective prevention and management strategies in the future.

Association of the triglyceride glucose index with all-cause and cardiovascular mortality in a general population of Iranian adults

BACKGROUND

The triglyceride glucose (TyG) index is a new and low-cost marker to determine insulin resistant which may be a predictor of cardiovascular disease (CVD). Although available evidence showed that its association with CVD mortality (CVM) and all-cause mortality (ACM) may differ in different populations, scarce data are available in this regard specially in low and middle-income countries.

PURPOSE

To examine the association between TyG index and risk of CVM and ACM in Iranians.

METHODS

This prospective cohort study included 5432 adults (age ≥ 35 years) with no history of CVD events. Fasting glucose and triglyceride were measured at baseline in all participants and TyG index was calculated. Cox frailty model was used to calculate hazard ratios (HRs) for CVM and ACM across the tertiles of TyG index.

RESULTS

After a median follow-up of 11.25 years, a total number of 191 cardiovascular deaths, and 487 all-cause mortality was recorded. The risk of both CVM and ACM increased across the tertiles of TyG index. In the adjusted model for lifestyle and metabolic variables, the risks of ACM and CVM increased by 41% (95% CI 1.11, 1.81; P for trend = 0.005) and 64% (95% CI 1.07, 2.50; P for trend = 0.024), respectively. However, adjustment for diabetes mellitus disappeared the significance for both ACM and CVM. These associations may vary by sex. TyG was not related to the risk of non-CVD mortality.

CONCLUSION

The predicting value of TyG index for ACM and CVM might be mediated by diabetes status. Further studies are required to confirm these findings.