Association Between Triglyceride Glucose Index and Risk of New-Onset Diabetes Among Chinese Adults: Findings From the China Health and Retirement Longitudinal Study.

Chao-Lei Chen,Kenneth Lo,Yu-Ling Yu,Jia-Yi Huang,Yu-Qing Huang,Lin Liu,Ying-Qing Feng

doi:10.3389/fcvm.2020.610322

Abstract

The triglyceride glucose (TyG) index has been proposed to be a surrogate of insulin resistance. In the present study, we aimed to examine the relationship between TyG index and the risk of incident diabetes in middle-age and older adults in China using nationally representative data from the China Health and Retirement Longitudinal Study 2011–2015. Information on socio-demographics, medical background, anthropometric measurement, and laboratory information were collected. The association between TyG index and diabetes was examined by Cox proportional hazards models and restricted cubic spline regression, and the results were presented in hazard ratio (HR) with 95% confidence interval (CI). Subgroup analyses were also conducted to examine potential interactions between demographics and TyG index. Among 7,428 participants, 791 (10.6%) of them developed diabetes over 3.4 years of follow-up. The multivariate HR for every SD increment in TyG index was 1.22 (95% CI, 1.14–1.31). When comparing to the lowest quartile of TyG index, the multivariate HRs for new-onset diabetes were 1.22 (0.96–1.54) for Q2, 1.61 (1.28–2.01) for Q3, and 1.73 (1.38–2.16) for Q4 (P for trend <0.001). The restricted cubic spline regression also showed a linear association. No interaction was found between subgroup variables and the association between TyG index and the risk of diabetes. In conclusion, higher TyG index associated with the elevated risk of new-onset diabetes in middle-aged and older adults.

Highlights

Diabetes is associated with an increased risk of cardiovascular disease and all-cause mortality, imposing a huge burden to public health [1]
From the national data from the China Health and Retirement Longitudinal Study (CHARLS), we have found a positive relationship between the simple surrogate of Insulin resistance (IR) (TyG index) and the risk of new-onset diabetes in middle-aged and older Chinese adults
The effects of triglyceride glucose (TyG) index on diabetes did not interact with age, gender, body mass index (BMI), glycemic status, fasting blood glucose (FBG), or the level of TG

Summary

Introduction

Diabetes is associated with an increased risk of cardiovascular disease and all-cause mortality, imposing a huge burden to public health [1]. In the past few decades, the number of adults with diabetes has considerably increased, especially in low and middle-income countries [2]. Identifying individuals at high risk for developing diabetes is of major importance to reduce the incidence rate and related complications. A recent study indicated that IR was more closely associated with the risk of incident diabetes among Chinese adults than β-cell dysfunction, which is another pivotal pathological feature of diabetes [6]. In the past four decades, China has experienced disruptive transitions of dietary patterns and has witnessed a massive rise in with the rate of obesity, which is major factor for the progression of IR [7, 8]. The assessment of IR status is essential to identify individuals with high risk of diabetes. The traditional approach to measure IR, such as the homeostasis model assessment of IR (HOMA-IR), is time-consuming and costly for daily practice and in large epidemiological studies

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Conclusion