Abstract

Triglycerides and glucose (TyG) index is a useful marker of insulin resistance and a predictor of nonalcoholic fatty liver disease (NAFLD), incident hypertension, cardiovascular events, and subclinical atherosclerosis. The aim of this study was to evaluate the association between TyG index and mortalities in a Korean population using a large health study database. A total of 318,224 subjects (165,131 men and 153,093 women) in the Kangbuk Samsung Health Study cohort were enrolled. A comprehensive annual or biennial health examination was performed to all subjects from 2002 through 2012. Normal glucose tolerance (NGT) was defined as fasting plasma glucose < 100 mg/dL and HbA1c < 5.7%, and having no history of diabetes. The presence of NAFLD was ascertained by ultrasonography in the absence of other known liver diseases. Mortality data (from 2002 through 2012) were derived from the Korea National Statistical Office.The cumulative overall mortality was 0.51% (1,613 deaths) during a median 5.66-year follow-up. In subject with NGT, higher TyG index was associated with an increased risk of death from all causes (HR 1.12; 95% CI 1.03-1.22), cardiovascular disease (HR 1.26; 95% CI 1.02-1.55), and liver disease (HR 1.26; 95% CI 1.02-1.55) but not from cancer, after adjusting for age, sex, and body mass index. In addition, when we have analyzed according to the presence of NAFLD in this group, higher TyG index was only associated with an increased risk of death from all causes in subject without NAFLD (HR 1.16; 95% CI 1.05-1.29). However, there was no significant association between TyG index and mortalities in subject with prediabetes and diabetes. Interestingly, TyG index was associated with overall mortality in subjects with metabolic syndrome (HR 1.31; 95% CI 1.17-1.47) although it was not associated with specific mortalities. In subjects without metabolic syndrome, TyG index was not associated with death from all and specific causes. The TyG index might predict mortalities in subjects with NGT and metabolic syndrome. Disclosure K. Kim: None. Y. Hwang: None. H. Ahn: None. S. Park: None. C. Park: None.

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