Triglyceride Glucose Index for Predicting Cardiovascular Outcomes in Patients with Coronary Artery Disease

Overview

Journal J Thorac Dis

Publisher AME Publishing Company

Specialty Pulmonary Medicine

Date 2019 Jan 10

PMID 30622785

Citations 111

Authors

Jing-Lu Jin

Ye-Xuan Cao

Li-Guo Wu

Xiang-Dong You

Yuan-Lin Guo

Na-Qiong Wu

Cheng-Gang Zhu

Ying Gao

Qiu-Ting Dong

Hui-Wen Zhang

Di Sun

Geng Liu

Qian Dong

Jian-Jun Li

Affiliations

Soon will be listed here.

Abstract

Background: Triglyceride glucose (TyG) index is a novel marker for metabolic disorders and recently it has been reported to be associated with cardiovascular disease (CVD) risk in apparently healthy individuals. However, the prognostic value of TyG index in patients with stable coronary artery disease (CAD) is not determined.

Methods: We conducted a nested case-control study among 3,745 patients with stable CAD. Patients were followed up for 11,235 person-years. The cardiovascular events (CVEs) were defined as all-cause death, non-fatal myocardial infarction (MI), stroke and post-discharge revascularization [percutaneous coronary intervention (PCI) coronary artery bypass grafting (CABG)]. In total, 290 (7.7%) patients with CVEs and 1,450 controls were matched according to age, gender, previous history of PCI or CABG and the duration of follow-up. TyG index was calculated as formula: ln[fasting triglycerides (mg/dL) × fasting plasma glucose (mg/dL)/2].

Results: Multivariable Cox proportional hazards models revealed that TyG index was positively associated with CVEs risk (hazard ratio: 1.364, 95% confidence interval: 1.100-1.691, P=0.005). The Kaplan-Meier analysis indicated that patients within the highest quartile of TyG index presented the lowest event-free survival (P=0.029). Moreover, a 1-standard deviation (SD) increment in TyG index was associated with 23.2% [hazard ratio (HR): 1.232, 95% confidence interval (95% CI): 1.084-1.401] higher risk of CVEs, which was superior to other triglyceride or glycemic related markers.

Conclusions: The present study, firstly, showed that TyG index was positively associated with future CVEs, suggesting that TyG may be a useful marker for predicting clinical outcomes in patients with CAD.

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References

Freeman D, Norrie J, Sattar N, Neely R, Cobbe S, Ford I . Pravastatin and the development of diabetes mellitus: evidence for a protective treatment effect in the West of Scotland Coronary Prevention Study. Circulation. 2001; 103(3):357-62. DOI: 10.1161/01.cir.103.3.357. View

Libby P, Ridker P, Maseri A . Inflammation and atherosclerosis. Circulation. 2002; 105(9):1135-43. DOI: 10.1161/hc0902.104353. View

Dotevall A, Johansson S, Wilhelmsen L, Rosengren A . Increased levels of triglycerides, BMI and blood pressure and low physical activity increase the risk of diabetes in Swedish women. A prospective 18-year follow-up of the BEDA study. Diabet Med. 2004; 21(6):615-22. DOI: 10.1111/j.1464-5491.2004.01189.x. View

Schmidt M, Duncan B, Bang H, Pankow J, Ballantyne C, Golden S . Identifying individuals at high risk for diabetes: The Atherosclerosis Risk in Communities study. Diabetes Care. 2005; 28(8):2013-8. DOI: 10.2337/diacare.28.8.2013. View

Wilson P, Meigs J, Sullivan L, Fox C, Nathan D, DAgostino Sr R . Prediction of incident diabetes mellitus in middle-aged adults: the Framingham Offspring Study. Arch Intern Med. 2007; 167(10):1068-74. DOI: 10.1001/archinte.167.10.1068. View

Simental-Mendia L, Rodriguez-Moran M, Guerrero-Romero F . The product of fasting glucose and triglycerides as surrogate for identifying insulin resistance in apparently healthy subjects. Metab Syndr Relat Disord. 2008; 6(4):299-304. DOI: 10.1089/met.2008.0034. View

Tam C, Ma R, So W, Wang Y, Lam V, Germer S . Interaction effect of genetic polymorphisms in glucokinase (GCK) and glucokinase regulatory protein (GCKR) on metabolic traits in healthy Chinese adults and adolescents. Diabetes. 2008; 58(3):765-9. PMC: 2646078. DOI: 10.2337/db08-1277. View

Trauner M, Arrese M, Wagner M . Fatty liver and lipotoxicity. Biochim Biophys Acta. 2009; 1801(3):299-310. DOI: 10.1016/j.bbalip.2009.10.007. View

Di Angelantonio E, Sarwar N, Perry P, Kaptoge S, Ray K, Thompson A . Major lipids, apolipoproteins, and risk of vascular disease. JAMA. 2009; 302(18):1993-2000. PMC: 3284229. DOI: 10.1001/jama.2009.1619. View

10.

Guerrero-Romero F, Simental-Mendia L, Gonzalez-Ortiz M, Martinez-Abundis E, Ramos-Zavala M, Hernandez-Gonzalez S . The product of triglycerides and glucose, a simple measure of insulin sensitivity. Comparison with the euglycemic-hyperinsulinemic clamp. J Clin Endocrinol Metab. 2010; 95(7):3347-51. DOI: 10.1210/jc.2010-0288. View

11.

Shaye K, Amir T, Shlomo S, Yechezkel S . Fasting glucose levels within the high normal range predict cardiovascular outcome. Am Heart J. 2012; 164(1):111-6. PMC: 4934381. DOI: 10.1016/j.ahj.2012.03.023. View

12.

Gonzalez M, Bibiloni M, Pons A, Llompart I, Tur J . Inflammatory markers and metabolic syndrome among adolescents. Eur J Clin Nutr. 2012; 66(10):1141-5. DOI: 10.1038/ejcn.2012.112. View

13.

Bays H . Adiposopathy, diabetes mellitus, and primary prevention of atherosclerotic coronary artery disease: treating "sick fat" through improving fat function with antidiabetes therapies. Am J Cardiol. 2012; 110(9 Suppl):4B-12B. DOI: 10.1016/j.amjcard.2012.08.029. View

14.

Irace C, Carallo C, Scavelli F, De Franceschi M, Esposito T, Tripolino C . Markers of insulin resistance and carotid atherosclerosis. A comparison of the homeostasis model assessment and triglyceride glucose index. Int J Clin Pract. 2013; 67(7):665-72. DOI: 10.1111/ijcp.12124. View

15.

Vega G, Barlow C, Grundy S, Leonard D, DeFina L . Triglyceride-to-high-density-lipoprotein-cholesterol ratio is an index of heart disease mortality and of incidence of type 2 diabetes mellitus in men. J Investig Med. 2014; 62(2):345-9. DOI: 10.2310/JIM.0000000000000044. View

16.

Miselli M, Dalla Nora E, Passaro A, Tomasi F, Zuliani G . Plasma triglycerides predict ten-years all-cause mortality in outpatients with type 2 diabetes mellitus: a longitudinal observational study. Cardiovasc Diabetol. 2014; 13:135. PMC: 4198794. DOI: 10.1186/s12933-014-0135-6. View

17.

Du T, Yuan G, Zhang M, Zhou X, Sun X, Yu X . Clinical usefulness of lipid ratios, visceral adiposity indicators, and the triglycerides and glucose index as risk markers of insulin resistance. Cardiovasc Diabetol. 2014; 13:146. PMC: 4209231. DOI: 10.1186/s12933-014-0146-3. View

18.

Tenenbaum A, Klempfner R, Fisman E . Hypertriglyceridemia: a too long unfairly neglected major cardiovascular risk factor. Cardiovasc Diabetol. 2014; 13:159. PMC: 4264548. DOI: 10.1186/s12933-014-0159-y. View

19.

Li X, Guo Y, Zhu C, Xu R, Qing P, Wu N . Relationship of high-density lipoprotein cholesterol with periprocedural myocardial injury following elective percutaneous coronary intervention in patients with low-density lipoprotein cholesterol below 70 mg/dL. J Am Heart Assoc. 2015; 4(1):e001412. PMC: 4330066. DOI: 10.1161/JAHA.114.001412. View

20.

Lee S, Yang H, Ha H, Lee J, Kwon H, Park Y . Changes in Metabolic Health Status Over Time and Risk of Developing Type 2 Diabetes: A Prospective Cohort Study. Medicine (Baltimore). 2015; 94(40):e1705. PMC: 4616763. DOI: 10.1097/MD.0000000000001705. View