Triglyceride-glucose index associated with the risk of cardiovascular disease: the Kailuan study.

Qian Liu,Zhiwei Cao,Yihan Ma,Haozhe Cui,Xu Han,Yuntao Wu

doi:10.1007/s12020-021-02862-3

Abstract

Previous studies suggest that triglyceride-glucose index (TyG) index, as a marker of insulin resistance, may have associations with the risk of cardiovascular diseases (CVD) in elderly population. Given the paucity of data, it remains controversial, especially in general Chinese population. We aimed to further assess whether TyG index is an independent risk factor for CVD. We conducted a prospective cohort study that enrolled a total of 96,541 participants from the Kailuan Study. TyG index was calculated as ln (fasting triglyceride [mg/dL] × fasting glucose [mg/dL]/2). Participants were divided into four groups (Q1, Q2, Q3, and Q4) by quartiles of the TyG index. Any CVD events occurred during 2006-2017 were recorded, including myocardial infarction (MI) and stroke. We assessed the association of TyG index with the risk of CVD and the subtypes of CVD by using Cox models estimated hazard ratios (HRs) and 95% confidence interval (CIs). During a median follow-up of 10.33 years, totally 6421 CVD events, 1493 MIs, and 5083 stroke events occurred. Multivariate Cox regression analysis showed that compared with Q1, HR (95% CI) for CVD events was 1.12 (95%, 1.03-1.21) in Q2, 1.28 (95%, 1.18-1.38) in Q3, and 1.34 (95%, 1.23-1.45) in Q4. In a time-dependent Cox Model we also found that compared with Q1, HR (95% CI) for CVD events was 1.09 (95%, 1.02-1.18) in Q2, 1.18 (95%, 1.09-1.27) in Q3, and 1.20 (95%, 1.11-1.30) in Q4. Similar results were showed in MI and stroke. TyG index as a marker of insulin resistance was an independent risk factor for CVD. This may help in the early identification of people at high risk of CVD and be applicable to the primordial and primary prevention.

Highlights

Cardiovascular disease (CVD) is a leading cause of population death worldwide from the Global Burden of Disease Study of 2017, with 17.70 million people died from CVD, accounting for 40% of all deaths worldwide [1]
We found similar results in myocardial infarction (MI), stroke and ischemic stroke incidence and a non-significantly increased risk of hemorrhagic stroke (Table 2). 7414 competing events occurred among the study participants during the follow-up
Multivariable adjusted spline regression model showed a nonlinear relationship between TyG index and the risk of CVD (Figure 1)

Summary

Introduction

Cardiovascular disease (CVD) is a leading cause of population death worldwide from the Global Burden of Disease Study of 2017, with 17.70 million people died from CVD, accounting for 40% of all deaths worldwide [1]. The China Cardiovascular Diseases Report 2018 shows that about 290 million patients suffer from CVD and the prevalence of CVD in China is continuously rising. The prevalence of CVD will continuously rise due to the emerging epidemic of obesity and diabetes and some uncovered factors. Insulin resistance (IR) has been extensively demonstrated to be a significant risk factor for emergence and development of CVD because it leads to vascular damage [3].

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