Alpha 2.0

» Articles » PMID: 38898520

Association of Triglyceride-glucose Index and Its Related Parameters with Atherosclerotic Cardiovascular Disease: Evidence from a 15-year Follow-up of Kailuan Cohort

Overview

Overview

Journal Cardiovasc Diabetol

Publisher Biomed Central

Specialties Cardiology & Vascular Diseases
Endocrinology

Date 2024 Jun 19

PMID 38898520

Authors

Authors

Xue Xia

Shuohua Chen

Xue Tian

Qin Xu

Yijun Zhang

Xiaoli Zhang

Jing Li

Shouling Wu

Anxin Wang

Affiliations

Affiliations

Soon will be listed here.

Abstract

Background: Triglyceride glucose (TyG) index and its related parameters have been introduced as cost-effective surrogate indicators of insulin resistance, while prospective evidence of their effects on atherosclerotic cardiovascular disease (ASCVD) remained scattered and inconsistent. We aimed to evaluate the association of TyG and its related parameters with new-onset ASCVD, and the predictive capacity were further compared.

Method: A total of 95,342 ASCVD-free participants were enrolled from the Kailuan study. TyG and its related parameters were defined by fasting blood glucose, triglyceride, body mass index (BMI), waist circumstance (WC) and waist-to-height ratio (WHtR). The primary outcome was incident ASCVD, comprising myocardial infarction (MI) and ischemic stroke (IS). Cox proportional hazard models and restricted cubic spline (RCS) analyses were adopted to investigate the association between each index and ASCVD. The C-index, integrated discrimination improvement (IDI), and net reclassification improvement (NRI) were used for comparison of their predictive value for ASCVD.

Results: During a median follow-up of 15.0 years, 8,031 new cases of ASCVD were identified. The incidence rate of ASCVD increased along with elevated levels of each index, and the relationships were found to be nonlinear in the RCS analyses. The hazard ratio (HR) and 95% confidence interval (95% CI) for ASCVD was 1.39 (1.35, 1.43), 1.46 (1.41, 1.50), 1.50 (1.46, 1.55), and 1.52 (1.48, 1.57) per 1 IQR increase of baseline TyG, TyG-BMI, TyG-WC, and TyG-WHtR, respectively, and the association were more pronounced for females and younger individuals aged < 60 years (P<0.05). Using the updated mean or time-varying measurements instead of baseline indicators did not significantly alter the primary findings. Additionally, TyG-WC and TyG-WHtR showed better performance in predicting risk of ASCVD than TyG, with the IDI (95% CI) of 0.004 (0.001, 0.004) and 0.004 (0.001, 0.004) and the category-free NRI (95% CI) of 0.120 (0.025, 0.138) and 0.143 (0.032, 0.166), respectively. Similar findings were observed for MI and IS.

Conclusions: Both the TyG index and its related parameters were significantly and positively associated with ASCVD. TyG-WC and TyG-WHtR had better performance in predicting incident ASCVD than TyG, which might be more suitable indices for risk stratification and enhance the primary prevention of ASCVD.

Citing Articles

Can cardiovascular health and its modifiable healthy lifestyle offset the increased risk of all-cause and cardiovascular deaths associated with insulin resistance?.

Qiu J, Li J, Xu S, Zeng H, Zhang Y, Yang S Cardiovasc Diabetol. 2025; 24(1):114.

PMID: 40065337 PMC: 11895255. DOI: 10.1186/s12933-025-02674-z.

Associations of triglyceride glucose-body mass index and the combination of sedentary behavior and physical activity with risks of all-cause mortality and myocardial infarction: a cohort study from the UK biobank.

Zhu Y, Yao T, Tian L, Zhang Y, Ke Q Cardiovasc Diabetol. 2025; 24(1):102.

PMID: 40025584 PMC: 11871674. DOI: 10.1186/s12933-025-02652-5.

Comparison of triglyceride glucose index and modified triglyceride glucose indices in predicting cardiovascular diseases incidence among populations with cardiovascular-kidney-metabolic syndrome stages 0-3: a nationwide prospective cohort study.

Hong J, Zhang R, Tang H, Wu S, Chen Y, Tan X Cardiovasc Diabetol. 2025; 24(1):98.

PMID: 40022122 PMC: 11871812. DOI: 10.1186/s12933-025-02662-3.

The association between novel metabolic parameters and all-cause/cardiovascular mortality in patients with metabolic syndrome is modified by age.

Liu J, Fu Y, Liang P, Song Z, Li Y, Wu H Cardiovasc Diabetol. 2025; 24(1):96.

PMID: 40022121 PMC: 11871838. DOI: 10.1186/s12933-025-02587-x.

Insights into the complex relationship between triglyceride glucose-waist height ratio index, mean arterial pressure, and cardiovascular disease: a nationwide prospective cohort study.

Xu J, Cai D, Jiao Y, Liao Y, Shen Y, Shen Y Cardiovasc Diabetol. 2025; 24(1):93.

PMID: 40022080 PMC: 11871683. DOI: 10.1186/s12933-025-02657-0.

References

1.

Lopez-Jaramillo P, Gomez-Arbelaez D, Martinez-Bello D, Abat M, Alhabib K, Avezum A . Association of the triglyceride glucose index as a measure of insulin resistance with mortality and cardiovascular disease in populations from five continents (PURE study): a prospective cohort study. Lancet Healthy Longev. 2022; 4(1):e23-e33. DOI: 10.1016/S2666-7568(22)00247-1. View

2.

Qu H, Long L, Chen L, Wu H, Fu C, Zhang S . Triglyceride-glucose index and estimated 10-year risk of a first hard cardiovascular event. Front Cardiovasc Med. 2023; 9:994329. PMC: 9868293. DOI: 10.3389/fcvm.2022.994329. View

3.

Toro-Huamanchumo C, Urrunaga-Pastor D, Guarnizo-Poma M, Lazaro-Alcantara H, Paico-Palacios S, Pantoja-Torres B . Triglycerides and glucose index as an insulin resistance marker in a sample of healthy adults. Diabetes Metab Syndr. 2019; 13(1):272-277. DOI: 10.1016/j.dsx.2018.09.010. View

4.

Adeva-Andany M, Martinez-Rodriguez J, Gonzalez-Lucan M, Fernandez-Fernandez C, Castro-Quintela E . Insulin resistance is a cardiovascular risk factor in humans. Diabetes Metab Syndr. 2019; 13(2):1449-1455. DOI: 10.1016/j.dsx.2019.02.023. View

5.

Tunstall-Pedoe H, Kuulasmaa K, Amouyel P, Arveiler D, Rajakangas A, Pajak A . Myocardial infarction and coronary deaths in the World Health Organization MONICA Project. Registration procedures, event rates, and case-fatality rates in 38 populations from 21 countries in four continents. Circulation. 1994; 90(1):583-612. DOI: 10.1161/01.cir.90.1.583. View

6.

Zhang X, Zhang T, He S, Jia S, Zhang Z, Ye R . Association of metabolic syndrome with TyG index and TyG-related parameters in an urban Chinese population: a 15-year prospective study. Diabetol Metab Syndr. 2022; 14(1):84. PMC: 9202163. DOI: 10.1186/s13098-022-00855-4. View

7.

Li Y, Wu S, Gao J, Zhang Y, Zuo Y, Tian X . Association of Stroke With Metabolic Dysfunction-Associated Fatty Liver Disease With and Without CKD. Am J Kidney Dis. 2023; 83(4):477-488. DOI: 10.1053/j.ajkd.2023.08.016. View

8.

Liu Y, Wu M, Xu J, Sha D, Xu B, Kang L . Association between Triglyceride and glycose (TyG) index and subclinical myocardial injury. Nutr Metab Cardiovasc Dis. 2020; 30(11):2072-2076. DOI: 10.1016/j.numecd.2020.06.019. View

9.

Muniyappa R, Lee S, Chen H, Quon M . Current approaches for assessing insulin sensitivity and resistance in vivo: advantages, limitations, and appropriate usage. Am J Physiol Endocrinol Metab. 2007; 294(1):E15-26. DOI: 10.1152/ajpendo.00645.2007. View

10.

Wu S, An S, Li W, Lichtenstein A, Gao J, Kris-Etherton P . Association of Trajectory of Cardiovascular Health Score and Incident Cardiovascular Disease. JAMA Netw Open. 2019; 2(5):e194758. PMC: 6547110. DOI: 10.1001/jamanetworkopen.2019.4758. View

11.

Zhou Y, Chen S, Wang G, Chen S, Zhang Y, Chen J . Effectiveness of a Workplace-Based, Multicomponent Hypertension Management Program in Real-World Practice: A Propensity-Matched Analysis. Hypertension. 2021; 79(1):230-240. DOI: 10.1161/HYPERTENSIONAHA.121.18305. View

12.

Wang A, Wang G, Liu Q, Zuo Y, Chen S, Tao B . Triglyceride-glucose index and the risk of stroke and its subtypes in the general population: an 11-year follow-up. Cardiovasc Diabetol. 2021; 20(1):46. PMC: 7893902. DOI: 10.1186/s12933-021-01238-1. View

13.

Cho Y, Lee J, Kim H, Kim E, Lee M, Yang D . Triglyceride Glucose-Waist Circumference Better Predicts Coronary Calcium Progression Compared with Other Indices of Insulin Resistance: A Longitudinal Observational Study. J Clin Med. 2021; 10(1). PMC: 7795085. DOI: 10.3390/jcm10010092. View

14.

Schmiegelow M, Hedlin H, Stefanick M, Mackey R, Allison M, Martin L . Insulin Resistance and Risk of Cardiovascular Disease in Postmenopausal Women: A Cohort Study From the Women's Health Initiative. Circ Cardiovasc Qual Outcomes. 2015; 8(3):309-16. DOI: 10.1161/CIRCOUTCOMES.114.001563. View

15.

Wang Y, Wang J, Chen S, Li J, Lu Q, Vitiello M . Association of Longitudinal Patterns of Habitual Sleep Duration With Risk of Cardiovascular Events and All-Cause Mortality. JAMA Netw Open. 2020; 3(5):e205246. PMC: 7244989. DOI: 10.1001/jamanetworkopen.2020.5246. View

16.

Lee E, Yang H, Lee J, Kang B, Yang Y, Lee S . Triglyceride glucose index, a marker of insulin resistance, is associated with coronary artery stenosis in asymptomatic subjects with type 2 diabetes. Lipids Health Dis. 2016; 15(1):155. PMC: 5024477. DOI: 10.1186/s12944-016-0324-2. View

17.

Cheng W, Kong F, Chen S . Comparison of the predictive value of four insulin resistance surrogates for the prevalence of hypertension: a population-based study. Diabetol Metab Syndr. 2022; 14(1):137. PMC: 9511744. DOI: 10.1186/s13098-022-00907-9. View

18.

Van Gaal L, Mertens I, De Block C . Mechanisms linking obesity with cardiovascular disease. Nature. 2006; 444(7121):875-80. DOI: 10.1038/nature05487. View

19.

Huang Q, Yin L, Liu Z, Wei M, Feng J, Huang Q . Association of novel lipid indicators with the risk of stroke among participants in Central China: a population-based prospective study. Front Endocrinol (Lausanne). 2023; 14:1266552. PMC: 10577285. DOI: 10.3389/fendo.2023.1266552. View

20.

Huang Y, Huang J, Lin C, Chien H, Lin Y, Wang C . Comparison of Innovative and Traditional Cardiometabolic Indices in Estimating Atherosclerotic Cardiovascular Disease Risk in Adults. Diagnostics (Basel). 2021; 11(4). PMC: 8067018. DOI: 10.3390/diagnostics11040603. View