Triglyceride-glucose index and uric acid associations with cardiovascular disease risk in middle-aged and elderly populations: findings from the China health and retirement longitudinal study.

BackgroundGlobally, cardiovascular disease (CVD) constitutes the primary cause of death, with insulin resistance (IR), measured by the triglyceride-glucose (TyG) index, and visceral obesity, reflected by the Chinese Visceral Adiposity Index (CVAI), as key contributors. However, the relationship between the TyG index and CVAI regarding CVD risk remains insufficiently understood. This research investigates the interactive impact of the TyG index and CVAI on the risk of cardiovascular disease.MethodsWe analyzed data from 8,358 participants from the China Health and Retirement Longitudinal Study (CHARLS) over a 9-year follow-up period. Participants were classified into four groups based on median TyG index (8.59) and CVAI values (101.26), and baseline characteristics were summarized. Missing data were addressed using multiple imputation by chained equations (MICE). Cox proportional hazards models assessed associations between TyG index, CVAI, CVD, coronary heart disease (CHD), and stroke risks, with Kaplan-Meier analysis used for cumulative hazard. Interaction effects were evaluated using both multiplicative and additive measures. Subgroup analyses by age, gender, and clinical conditions were conducted to explore interaction effects across different populations. Sensitivity analyses re-tested models, excluding the covariates BMI and diabetes, using tertiles for classification, and re-evaluating imputed data.ResultsOver the 9-year follow-up, 1,240 participants (14.8%) developed CVD, including 896 cases of CHD and 475 strokes. Kaplan-Meier curves indicated that participants with low TyG index but high CVAI had the highest cumulative hazard of CVD. Cox regression showed that this group had the highest CVD risk (HR = 1.87, 95% CI: 1.57–2.24), followed by those with both high TyG index and high CVAI (HR = 1.75, 95% CI: 1.49–2.06). Interaction analysis revealed a negative interaction effect between high TyG and high CVAI on CVD and CHD risks, with no significant effect on stroke. Subgroup and sensitivity analyses further confirmed these findings, showing consistent results across demographic groups and under various analytical conditions.ConclusionThis study suggests that the interaction between IR (TyG index) and visceral fat accumulation (CVAI) plays a complex role in CVD risk, with a potential antagonistic effect observed between high TyG and high CVAI on CVD events. These findings highlight the importance of considering both IR and visceral adiposity in CVD risk assessments to improve the identification of high-risk individuals.

BackgroundThe triglyceride-glucose (TyG) index and blood pressure (BP) are correlated and serve as risk factors for cardiovascular disease (CVD). The potential impact of BP status on the association between the TyG index and CVD risk remains uncertain. This study aims to investigate the relationships between the TyG index and incident CVD in Chinese middle-aged and elderly adults, considering variations in BP status among participants.Methods6558 participants (mean age: 58.3 (± 8.7) years; 46.0% were men) without prevalent CVD were recruited from the China Health and Retirement Longitudinal Study. Participants were divided into three groups according to their systolic blood pressure (SBP) levels (< 120mmHg, 120 ∼ 129mmHg, ≥ 130mmHg). The TyG index was computed as ln[triglyceride (mg/dl) * fasting blood glucose (mg/dl)/2]. The primary outcome was CVD (heart disease and stroke), and the secondary outcomes were individual CVD components. Cox regression models and restricted cubic splines were performed to investigate the associations between continuous and categorical TyG with CVD.Results1599 cases of CVD were captured during 58,333 person-years of follow-up. Per 1-SD higher TyG index was associated with a 19% (HR: 1.19; 95% CI: 1.12, 1.27) higher risk for incident CVD, and the participants with the highest quartile of TyG index had a 54% (HR: 1.54; 95% CI: 1.29, 1.84) higher risk of CVD compared to those in the lowest quartile. SBP significantly modifies the association between the TyG index and CVD, with higher HRs for CVD observed in those with optimal and normal SBP. SBP partially mediated the associations between the TyG index with CVD. The results were generally consistent among participants with varying pulse pressure statuses rather than diastolic BP statuses.ConclusionsThe associations between the TyG index and CVD were modified by BP status, with greater HRs for CVD observed among those who had SBP < 130mmHg. SBP can partially mediate the association between the TyG index with CVD, highlighting the importance of early screening for the TyG index to identify at risk of hypertension and CVD.

BackgroundThe impact of triglyceride-glucose (TyG) index, a surrogate marker for insulin resistance, on the risk of cardiovascular disease (CVD) in general populations remains controversial. We aimed to comprehensively study the relationship between TyG index with the risk of incident CVD events in the general population in Shanghai.MethodsA total of 42,651 participants without previous history of CVD events from Shanghai Suburban Adult Cohort and Biobank (SSACB) were included. SSACB was a community-based natural population cohort study using multistage cluster sampling method. TyG index was calculated as Ln [fasting serum triglyceride (mg/dL) * fasting blood glucose (mg/dL)/2]. Kaplan-Meier curves, log-rank test and cox proportional hazards model were used to calculate the association between TyG index and incident CVD, including stroke and coronary heart disease (CHD). Restricted cubic spline analyses were used to determine whether there was a non-linear relationship between TyG index and CVD events.ResultsDuring a median follow-up of 4.7 years, 1,422 (3.3%) individuals developed CVD, including 674 (1.6%) cases of stroke and 732 (1.7%) cases of CHD. A one unit increment higher TyG index was associated with [HR(95%CI)] 1.16(1.04–1.29) in CVD and with 1.39(1.19–1.61) in stroke. Only linear relationships between TyG and CVD/stroke were observed, while no relationship was observed with CHD after adjustments for confounders. In subgroup analyses, younger (< 50y) and diabetic participants had higher risk of CVD than their counterpart groups, while hypertensive and dyslipidemic participants depicted lower risks than their counterparts.ConclusionElevated TyG index was associated with a higher risk of incident CVD and stroke. TyG index may help in the early stage of identifying people at high risk of CVD.

The triglyceride-glucose (TyG) index was associated with an increased risk of cardiovascular disease (CVD) in patients with prediabetes. However, this association has not yet been evaluated in prospective studies. Hence, we aimed to investigate the association between the TyG index and the risk of incident CVD in patients with prediabetes. Participants with prediabetes were enrolled from the Kailuan study and were followed up for clinical events until 2022. The exposure variable was TyG index. The primary outcomes were the incidence of CVD events, including ischemic heart disease and stroke, while the secondary outcomes were each specific type of CVD events. Cox proportional hazards regression models and restricted cubic spline analysis were used to calculate multivariable-adjusted hazard ratios and investigate exposure-response association, respectively. Over a mean follow-up period of 14.19 years, 13.81% (n = 2,537) of the 18,364 participants with prediabetes developed CVD events. Compared with participants in the lowest TyG index quartile (Q1, TyG index < 8.45), those in Q2 (TyG index 8.45-8.81), Q3 (TyG index 8.81-9.23), and Q4 (TyG index ≥ 9.23) were associated with an increased risk of CVD, with hazard ratios (HRs) of 1.18 (95% confidence interval [CI] 1.05-1.34), 1.29 (95% CI 1.15-1.46), and 1.45 (95% CI 1.28-1.63), respectively. For each unit increase in TyG index, the risk of CVD events increased by 12% in prediabetes patients. We also found a linear association between baseline TyG index and CVD events in prediabetes patients (P-non-linear = 0.12). TyG index is an independent risk factor for incident CVD in the prediabetes patients.

BackgroundBody mass index (BMI) consistently correlates with the triglyceride-glucose (TyG) index, a marker of insulin resistance, which in turn is linked to heightened cardiovascular disease (CVD) risk. Thus, insulin resistance could potentially mediate the association between BMI and CVD risk. However, few studies have explored this mechanism in the general population.MethodsWe used data from the China Health and Retirement Longitudinal Study, which is an ongoing prospective cohort study. It initially enrolled 7233 middle-aged and older Chinese adults who were free of heart disease and stroke at baseline. The exposure variable was BMI. Incident CVD, defined as self-reported physician-diagnosed heart disease and stroke combined, served as the main outcome.ResultsOf the 7 233 participants (mean [SD] age, 58.93 [9.33] years), 3 415 (47.2%) were men. During the 7 years of follow-up, 1 411 incident CVD cases were identified. Both BMI and TyG index were associated with CVD risk (HR per 1-SD increase: BMI, 1.23; 95% CI, 1.17–1.29; TyG, 1.13; 95% CI, 1.07–1.19). The 4-way decomposition analysis show that, overweight increased CVD risk by 28% (HR [total association], 1.28; 95% CI, 1.14–1.45), with 18.1% (95% CI, 2.2%–34.0%) mediated by TyG index (HR [pure indirect association], 1.05; 95% CI, 1.02–1.09); while obesity increased CVD risk by 91% (HR [total association], 1.91; 95% CI, 1.63–2.23), with 9.5% (95% CI, 2.2%–16.7%) mediated by TyG index (HR [pure indirect association], 1.09; 95% CI, 1.03–1.15). No evidence suggested TyG index modified BMI’s association with incident CVD.ConclusionsThe study revealed that the TyG index was associated to CVD risk and acted as a small partial mediator in the relationship between BMI and CVD among middle-aged and older Chinese adults. Consequently, solely addressing insulin resistance might not significantly mitigate the impact of body weight on CVD. Thus, exploring alternative pathways and potential mediators of CVD risk becomes imperative.

The triglyceride-glucose (TyG) index has been recognized as a surrogate marker for insulin resistance (IR) and an independent risk factor for cardiovascular disease (CVD). However, the combined effect of the TyG index and visceral obesity on CVD incidence remains unclear. We aimed to investigate the interaction, joint association, and potential mediators between the TyG index and comprehensive anthropometric indices with CVD risk in middle-aged and older adults. We analyzed 7046 participants aged ≥ 45years without baseline CVD from the China Health and Retirement Longitudinal Study (CHARLS) over a 9-year follow-up period. Retrospective collection included sociodemographic details, health status, physical examination results, and blood biomarkers. Adjusted Cox proportional hazards models were used to examine the interaction between TyG levels and anthropometric indices and their joint associations with CVD incidence. Subgroup analyses were conducted to evaluate the associations across different populations, and mediation analysis was performed to identify potential mediating pathways. The predictive value was determined using the area under the curve (AUC) of receiver operating characteristic curves. In addition, we validated the findings in the Multi-Ethnic Study of Atherosclerosis (MESA) cohort. In the CHARLS study, 1768 (25.1%) participants developed CVD. All TyG-anthropometric indices exhibited significant positive associations with the incidence of CVD. TyG-waist-to-height ratio (WHtR) showed the strongest association, with each 1-SD increase correlating with a 25% increase in CVD risk. Elevated systolic and diastolic blood pressure (BP) levels partially mediated these associations. TyG-weight-adjusted waist index (WWI) indicated the highest predictive performance in CHARLS, while TyG-conicity index (ConI) was the most predictive in the MESA cohort. Across both cohorts, TyG-WHtR provided the most substantial incremental improvement to the baseline model. Models combining TyG-anthropometric indices showed higher prediction accuracy and goodness of fit than the basic model combining TyG or anthropometric indices alone. Decision curve analysis showed that TyG-WC and TyG-ConI yielded the superior net clinical benefits for CVD prediction. Subgroup analyses demonstrated consistent associations between TyG-anthropometric indices and CVD incidence across different clinical characteristics and sociodemographic groups. The integration of TyG with anthropometric indices strengthened its association with CVD incidence. While TyG-WWI and TyG-ConI exhibited the highest predictive ability in the CHARLS and MESA cohorts, respectively, TyG-WHtR consistently yielded the greatest improvement to traditional risk models. Elevated BP levels partially mediated this association. Early intervention targeting visceral adiposity and impaired insulin sensitivity is crucial for mitigating CVD incidence in middle-aged and older adults.

Combined effects of high sensitivity C-reactive protein and triglyceride–glucose index on risk of cardiovascular disease among middle-aged and older Chinese: Evidence from the China Health and Retirement Longitudinal Study

Objective: To evaluate the association between triglyceride glucose (TyG) index and its novel composite metabolic indexes combined with obesity-related indexes and cardiovascular disease (CVD) risk in middle-aged and old adults in China. Methods: Based on data from the China Health and Retirement Longitudinal Study from 2011 to 2020, a study was conducted in 6 158 middle-aged and old adults without CVD at baseline survey. Cox proportional hazard regression model was used to assess the association of each indicator with the risk for CVD. Kaplan-Meier curve and restricted cubic spline (RCS) were also used to explore the dose-response relationship and nonlinear trends. Subgroup analyses were used to test the stability of the association in people with different demographic characteristics. Results: A total of 1 639 CVD events occurred during the 9-year follow-up period. After adjusting for confounding factors, high levels of TyG index and its combined obesity index were significantly associated with an increased risk for CVD. Compared with the Q1 group, the HRs (95%CIs) of TyG, TyG-BMI, TyG-waist-to-height ratio (WHtR), and TyG-weight-adjusted-waist index (WWI) were 1.36 (95%CI: 1.19-1.57), 1.74 (95%CI: 1.51-2.01), 1.55 (95%CI: 1.34-1.79), and 1.38 (95%CI: 1.20-1.60) in the Q4 group, respectively. RCS analysis showed that TyG and TyG-BMI had linear association with the risk for CVD, whereas TyG-WHtR and TyG-WWI had non-linear association with the risk for CVD. Subgroup analyses suggested that the associations were in good agreement in people in different age, sex, education level and hypertension status group (all P for interaction >0.05). Conclusions: The TyG index combined with obesity index is significantly associated with the risk for CVD in middle-aged and old adults in China. Paying attention to the TyG index and obesity index in the middle-aged and old adults can benefit the prevention and treatment of CVD and other chronic diseases in the elderly in China.

BackgroundElevated urinary albumin-to-creatinine ratio (UACR) within the normal range (< 30 mg/g) and the triglyceride-glucose (TyG) index are associated with cardiovascular disease (CVD) incidence, yet their joint effect remains underexplored.MethodsThis prospective cohort study used data from the 2016 Shandong-MOH Salt and Hypertension (SMASH) project, linked to CVD records until September 30, 2023, including 14,481 adults with normal UACR. Participants were stratified by TyG index and UACR quantiles. Multivariable Cox proportional hazards models and restricted cubic splines (RCS) were employed to evaluate individual and joint effects on overall CVD, coronary heart disease (CHD), and stroke. The incremental predictive value was assessed using the C-index, Net Reclassification Improvement (NRI), and Integrated Discrimination Improvement (IDI). Additionally, an exploratory mediation analysis was performed to examine the potential bidirectional effects between the TyG index and UACR.ResultsMean age was 41.75 ± 13.06 years, with median follow-up of 7.2 years. Among 420 incident overall CVD cases (309 stroke, 111 CHD), Compared to the Low TyG & Low UACR group, the High TyG & High UACR group demonstrated the highest risks for overall CVD (HR = 2.632, 95% CI: 1.695–4.085, P < 0.001), CHD (HR = 2.680, 95% CI: 1.144–6.282, P = 0.023), and stroke (HR = 2.628, 95% CI: 1.573–4.392, P < 0.001). The TyG index showed nonlinear associations with overall CVD and stroke risk but a linear association with CHD, while UACR exhibited linear positive correlations with all outcomes. The model combining the TyG index and UACR significantly enhanced the predictive ability for CVD events. Mediation analysis revealed that elevated UACR significantly mediated 4.9% of the association between TyG index and CVD, while elevated TyG index mediated 11.2% of the association between UACR and CVD.ConclusionThe study demonstrates that both elevated UACR (within normal range) and higher TyG index are jointly associated with increased CVD risk, with evidence suggesting potential bidirectional mediation. Their combined assessment provides significant incremental predictive value, supporting its integration into high-risk population screening for precise CVD prevention and management.Graphical abstractSupplementary InformationThe online version contains supplementary material available at 10.1186/s12933-025-03009-8.

BackgroundThis study aimed to assess the association of baseline insulin resistance (IR) surrogates and their longitudinal trajectories with cardiovascular diseases (CVD) to provide a useful reference for preventing CVD.MethodsThis study was a prospective cohort study conducted in the 51st Regiment of the Third Division of Xinjiang Corps. A total of 6362 participants were recruited in 2016 to conduct the baseline survey, and the follow-up surveys in 2019, 2020, 2021, and 2022. The Kaplan–Meier method was used to estimate the cumulative incidence of CVD according to the baseline IR surrogates of metabolic insulin resistance score (METS-IR) and triglyceride-glucose (TyG) index. Cox regression models were used to assess the association between the baseline IR surrogates and CVD. The impact of the longitudinal trajectories of the IR surrogates on CVD was analyzed after excluding those with IR surrogate data measured ≤2 times. Based on the group-based trajectory model (GBTM), the trajectory patterns of IR surrogates were determined. The Kaplan-Meier method was used to estimate the cumulative incidence of CVD in each trajectory group of METS-IR and TyG index. Cox regression models were used to analyze the association between different trajectory groups of each index and CVD. In addition, the Framingham model was utilized to evaluate whether the addition of the baseline IR surrogates increased the predictive potential of the model.ResultsBaseline data analysis included 4712 participants. During a median follow-up of 5.66 years, 572 CVD events were recorded (mean age, 39.42 ± 13.67 years; males, 42.9%). The cumulative CVD incidence increased with the ascending baseline METS-IR and TyG index quartiles (Q1–Q4). The hazard ratio and 95% confidence interval for CVD risk in Q4 of the METS-IR and TyG index were 1.79 (1.25, 2.58) and 1.66 (1.28, 2.17), respectively, when compared with Q1. 4343 participants were included in the trajectory analysis, based on the longitudinal change patterns of the METS-IR and TyG index, the following three trajectory groups were identified: low-increasing, moderate-stable, and elevated-increasing groups. Multivariate Cox regression revealed that the hazard ratio (95% confidence interval) for CVD risk in the elevated-increasing trajectory group of the METS-IR and TyG index was 2.13 (1.48, 3.06) and 2.63 (1.68, 4.13), respectively, when compared with the low-rising group. The C-index, integrated discrimination improvement value, and net reclassification improvement value were enhanced after adding the baseline METS-IR and TyG index values to the Framingham model (P<0.05).ConclusionsElevated baseline IR surrogates and their higher long-term trajectories were strongly associated with a high risk of CVD incidence in Xinjiang’s rural areas. Regular METS-IR and TyG index monitoring can aid in the early detection of CVD-risk groups.

Hypertension significantly contributes to cardiovascular events and global all-cause mortality. The triglyceride-glucose (TyG) index, amarker of insulin resistance (IR), is an established risk factor for cardiovascular disease (CVD) events. This study examined the relationship between the TyG index and cardiovascular events in patients with controlled hypertension (SBP <140 mmHg). We performed a post-hoc analysis of data from the Systolic Blood Pressure Intervention Trial (SPRINT), involving 9,323 participants with controlled hypertension. The triglyceride-glucose (TyG) index served as a surrogate marker for IR. Cox restricted cubic regression analysis and multivariate Cox regression models were employed to investigate the association between the TyG index and CVD outcomes, adjusting for established cardiovascular risk factors. The impact of intensive versus standard BP control on CVD risk associated with high IR levels were also analyzed. Over a median follow-up of 3.33 years, 725 CVD events were recorded. The TyG index was independently linked to a heightened risk of CVD events,with the highest quartile (Q4:8.93≤TyG<12.47) exhibiting a significantly greater risk (HR = 1.57, 95% CI: 1.18-2.08) compared to the lowest quartile (Q1: 6.74 ≤ TyG < 8.21). The significantly trend was seen only in the standard treatment group (p for trend = 0.001). The TyG index is a robust predictor of CVD events in patients with controlled hypertension, and a stronger association between the TyG index and CVD risk was seen in the standard treatment group, but not in the intensive 1treatment group. http://www.clinicaltrials.gov, identifier NCT01206062.

BackgroundBoth the triglyceride-glucose (TyG) index, as a surrogate marker of insulin resistance, and systemic inflammation are predictors of cardiovascular diseases; however, little is known about the coexposures and relative contributions of TyG index and inflammation to cardiovascular diseases. Using the nationally representative data from the China Health and Retirement Longitudinal Study (CHARLS), we conducted longitudinal analyses to evaluate the joint and mutual associations of the TyG index and high-sensitivity C-reactive protein (hsCRP) with cardiovascular events in middle-aged and older Chinese population.MethodsThis study comprised 8 658 participants aged at least 45 years from the CHARLS 2011 who are free of cardiovascular diseases at baseline. The TyG index was calculated as Ln [fasting triglyceride (mg/dL) × fasting glucose (mg/dL)/2]. Cardiovascular events were defined as the presence of physician-diagnosed heart disease and/or stroke followed until 2018.We performed adjusted Cox proportional hazards regression and mediation analyses.ResultsThe mean age of the participants was 58.6 ± 9.0 years, and 3988 (46.1%) were females. During a maximum follow-up of 7.0 years, 2606 (30.1%) people developed cardiovascular diseases, including 2012 (23.2%) cases of heart diseases and 848 (9.8%) cases of stroke. Compared with people with a lower TyG index (< 8.6 [median level]) and hsCRP < 1 mg/L, those concurrently with a higher TyG and hsCRP had the highest risk of overall cardiovascular disease (adjusted hazard ratio [aHR], 1.300; 95% CI 1.155–1.462), coronary heart disease (aHR, 1.294; 95% CI 1.130–1.481) and stroke (aHR, 1.333; 95% CI 1.093–1.628), which were predominant among those aged 70 years or below. High hsCRP significantly mediated 13.4% of the association between the TyG index and cardiovascular disease, while TyG simultaneously mediated 7.9% of the association between hsCRP and cardiovascular risk.ConclusionsThe findings highlight the coexposure effects and mutual mediation between the TyG index and hsCRP on cardiovascular diseases. Joint assessments of the TyG index and hsCRP should be underlined for the residual risk stratification and primary prevention of cardiovascular diseases, especially for middle-aged adults.

BackgroundInsulin resistance and visceral adiposity are established pathophysiological drivers of cardiovascular disease (CVD). The triglyceride‒glucose (TyG) index and the Chinese visceral adiposity index (CVAI) are respective indicators of these conditions. However, the association of their combination, the TyG-CVAI, with the risk of new-onset CVD in the general population remains unclear. This study aimed to investigate this relationship using data from a large national cohort.MethodsThis prospective study included participants in the China Health and Retirement Longitudinal Study (CHARLS) who lacked CVD at baseline. The TyG-CVAI was calculated and used to categorize participants into quartiles. The primary endpoint was the incidence of new-onset CVD. Kaplan‒Meier analysis was performed to assess the cumulative incidence, while multivariable Cox proportional hazards models were used to estimate risk ratios (HRs) and 95% confidence intervals (CIs). The nonlinearity of the relationship was examined using restricted cubic splines (RCSs), and the predictive performance of the TyG-CVAI was evaluated and compared to that of its components using receiver operating characteristic (ROC) curve analysis.ResultsAmong the 7977 participants, 1221 ultimately developed a CVD. Kaplan‒Meier analysis showed a significantly higher cumulative incidence of CVD with increasing TyG-CVAI quartiles (log-rank P < 0.001). After full adjustment for demographic, lifestyle, and cardiometabolic risk factors, participants in the highest quartile (Q4) had a significantly higher CVD risk (HR = 1.64, 95% CI 1.35–2.00) than those in the lowest quartile (Q1). RCS analysis revealed a significant nonlinear association between the TyG-CVAI and CVD risk, with a threshold at 778.62; below this point, no significant association was observed, whereas above it, each unit increase in the index conferred a 47% higher CVD risk (HR 1.47, 95% CI 1.31–1.64; P < 0.001). Furthermore, the TyG-CVAI (AUC = 0.6315) outperformed the TyG index (AUC = 0.5938) and the CVAI (AUC = 0.5851) alone in predicting the risk of CVD.ConclusionsIn this national cohort of middle-aged and older Chinese adults, a higher TyG-CVAI was independently and nonlinearly associated with an increased risk of new-onset CVD, demonstrating superior predictive value over its individual components. The TyG-CVAI may serve as a simple and effective integrated tool for the early identification of high-risk individuals for primary CVD prevention.Graphical abstractSupplementary InformationThe online version contains supplementary material available at 10.1186/s12933-025-03063-2.

BackgroundThere is limited evidence regarding the evaluation of the association between the triglyceride glucose (TyG) index, an indicator of insulin resistance, and the incident risk of cardiovascular disease (CVD). Therefore, we aimed to examine the relationship between the TyG index and CVD incidence in a cohort of Iranian adults.MethodsThis study was performed in the framework of the Isfahan Cohort Study (ICS). The study population included 5,432 individuals aged ≥ 35 years. CVD events, including acute myocardial infarction (MI), stroke, and unstable angina (UA), were diagnosed by physicians. The TyG index was calculated as Ln [fasting triglycerides (mg/dL) × fasting plasma glucose (mg/dL)/2]. The relationship between the TyG index and CVD events was investigated using Cox regression models. Receiver operating characteristics (ROC) curve analysis was used to determine the best cut-off for the TyG index for predicting CVD outcomes.ResultsDuring a median follow-up period of 11.2 years, a total number of 819 CVD, 164 MI, 172 stroke, and 384 UA were recorded. Following adjustment for multiple confounders, elevated TyG levels were associated with a higher risk of CVD (HR = 1.48; 95% CI 1.22–1.79; p < 0.001), MI (HR = 2.24; 95% CI 1.42–3.52; p < 0.001), stroke (HR = 1.45; 95% CI 0.96–2.19; p = 0.042), but not UA (HR = 1.28; 95% CI 0.96–1.69). The optimal TyG index cut-off was 8.91 for predicting CVD (sensitivity 58%; specificity 58%), 9.04 for predicting MI (sensitivity 57%; specificity 65%), 8.92 for predicting stroke (sensitivity 57%; specificity 57%), and 8.98 for predicting UA (sensitivity 53%; specificity 61%).ConclusionWe found a robust, direct association between the TyG index and the incidence of CVD events. This emphasizes the significance of observing the TyG index as an indicator of the occurrence of CVD events.

Background: Cardiovascular disease (CVD) is projected to be responsible for millions of deaths worldwide annually, including Saudi Arabia. CVD risk factors are highly prevalent, particularly among women in Saudi Arabia. Early awareness and treatment of cardiovascular signs before a CVD event occurs are therefore critical. Increased triglycerides and fasting glucose levels are two important risks for CVD, and the triglyceride glucose (TyG) index has been proved to predict CVD in many studies. Aim of Study: This study aims to examine the association of TyG-index and risk of cardiovascular disease in female health colleges to identify individuals at risk of developing CVD events. Methods: A total of 128 females from female health colleges in Riyadh participated in this cross-sectional study. Glucose and lipid profile parameters along with anthropometric and central obesity parameters were measured. The TyG index and the association between the TyG index and anthropometric and lipid profile parameters using the Spearman correlation coefficient were calculated. ROC analysis was used to detect long-term cardiovascular risk among women by using the TyG index against standard Framingham and ASVCVD risk scores. Results: This study identified that TyG-index was associ-ated with BMI and waist circumference, which are well-established anthropometric risk factors for CVD progression, along with total-cholesterol. A significant positive but weak association between TyG index and Framingham risk scores and lifetime ASCVD score was found. However, the TyG index may not be independently used to identify the people at risk of developing CVD as observed by the low area under the curves (AUC) scores using standard Framingham risk scores and ASCVD risk scores as gold standards. Conclusion: In conclusion, the positive correlation between TyG index and anthropometric indices and total cholesterol, which are known cardiovascular risks, suggests that the TyG index might be a useful indicator for early identification of CVD in conjunction with other established instruments, such as Farmington and lifetime ASCVD risk scores.