Prognostic value of triglyceride glucose index in population at high cardiovascular disease risk
Xiao-Ling Cai1,2, Yi-Fei Xiang1,2, Xiao-Fang Chen1,2
1Cardiology, Department of Cardiology, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, Fujian Province, China.
Insights
The triglyceride glucose (TyG) index, a marker for insulin resistance, is linked to higher risks of all-cause and cardiovascular death in individuals at high cardiovascular disease risk. This highlights its prognostic value for primary CVD prevention.
Area of Science:
- Cardiovascular Disease Research
- Metabolic Syndrome Studies
- Biomarker Discovery
Background:
- Early identification of cardiovascular disease (CVD) risk is crucial for prevention and improved outcomes.
- Insulin resistance (IR) is a significant risk factor for CVD.
- The triglyceride glucose (TyG) index offers a simple yet reliable method for assessing IR.
Purpose of the Study:
- To investigate the prognostic value of the TyG index in a high-risk CVD population.
- To evaluate the association between the TyG index and adverse clinical outcomes, including all-cause and cardiovascular death.
Main Methods:
- A cohort of 35,455 high-risk individuals (aged 35-75) was analyzed.
- The TyG index was calculated using fasting triglyceride and glucose levels.
- Cox proportional hazard models and restricted cubic spline analysis assessed the relationship between TyG index and endpoints.
Main Results:
- A TyG index cutoff of 9.83 identified individuals with significantly higher risks.
- Participants with a TyG index ≥ 9.83 had increased hazard ratios for all-cause death (HR 1.86) and cardiovascular death (HR 2.41).
- Subgroup analyses confirmed the consistency of these findings across different demographic and clinical variables.
Conclusions:
- Elevated TyG index is significantly associated with increased mortality in high-risk CVD populations.
- The TyG index serves as a valuable tool for the primary prevention of cardiovascular disease.
- This study underscores the importance of the TyG index in risk stratification and management strategies for cardiovascular health.
Background:
Early identification of populations at high cardiovascular disease (CVD) risk and improvement of risk factors can significantly decrease the probability of CVD development and improve outcomes. Insulin resistance (IR) is a CVD risk factor. The triglyceride glucose (TyG) index is a simple and reliable index for evaluating IR. However, no clinical studies on the prognostic value of the TyG index in a high risk CVD population have been conducted. This study evaluated the relationship between the TyG index and prognosis in a high risk CVD population.
Methods:
This study enrolled 35,455 participants aged 35-75 years who were at high CVD risk and visited selected health centers and community service centers between 2017 and 2021. Their general clinical characteristics and baseline blood biochemical indicators were recorded. The TyG index was calculated as ln[fasting triglyceride (mg/dl)× fasting blood glucose (mg/dl)/2]. The endpoints were all-cause death and cardiovascular death during follow-up. Cox proportional hazard models and restricted cubic spline (RCS) analysis were used to evaluate the correlation between the TyG index and endpoints.
Results:
In the overall study population, the mean age of all participants was 57.9 ± 9.6 years, 40.7% were male, and the mean TyG index was 8.9 ± 0.6. All participants were divided into two groups based on the results of the RCS analysis, with a cut-off value of 9.83. There were 551 all-cause deaths and 180 cardiovascular deaths during a median follow-up time of 3.4 years. In the multivariate Cox proportional hazard model, participants with a TyG index ≥ 9.83 had a higher risk of all-cause death (Hazard ratio [HR] 1.86, 95% Confdence intervals [CI] 1.37-2.51, P<0.001) and cardiovascular death (HR 2.41, 95%CI 1.47-3.96, P = 0.001) than those with a TyG index < 9.83. Subgroup analysis revealed that there was no interaction between the TyG index and variables in all subgroup analyses.
Conclusions:
The high TyG index was associated with an increased risk of all-cause death and cardiovascular death in people at high risk of CVD. This finding demonstrates the value of the TyG index in the primary prevention of CVD.
Trial Registration:
retrospectively registered, the registration number is K2022-01-005 and the date is 2022.01.30.
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