[Assessment of the risk of retinal arteriosclerosis by the triglyceride glucose-WHR index]

Objective: To investigate the relationship between Triglyceride Glucose-WHR index and retinal arteriosclerosis. Methods: Retrospective longitudinal cohort research method. Using data from the Tongren Health Care Study of Beijing Tongren Hospital from March 2014 to June 2020. The TyG-WHR index was calculated, the restricted cubic spine regression model was used to explore the dose-response relationship between TyG-WHR index and the risk of retinal arteriosclerosis. Cox proportional regression model was implemented to estimate the impact on the risk of retinal arteriosclerosis associated with the different TyG-WHR groups. Receiver operating characteristic were used to explore the value of triglyceride glucose-WHR index for the risk of retinal arteriosclerosis. Results: A total of 8 215 subjects were included, including 3 334 (40.58%) males, 4 881 (59.42%) females;7 689 cases had normal fundus, 296 cases had newly developed retinal arteriosclerosis, and 230 cases had retinal arteriosclerosis. The median age is 45 years old, and the average age is (47.63±13.89) years old. The cumulative incidence rate of new retinal arteriosclerosis was 3.71%(296/7 985), and the cumulative incidence rate of women (3.31%,158/4 767) was lower than that of men (4.29%, 138/3 218) (χ²=5.105, P<0.001); The cumulative incidence rate of new retinal arteriosclerosis increased with age (χ²=365.133,P<0.001); The TyG-WHR index was divided into four groups according to the interquartile range, and the Q₂-Q₄ group had an increased risk of developing new retinal arteriosclerosis compared to Q₁ (χ²=132.887,P<0.001).In the restricted cubic spine regression model, the results showed a non-linear dose-response relationship (χ²=54.27,P<0.001) between baseline TyG-WHR index and the new-onset of retinal arteriosclerosis. By the multivariate Cox Regression models, three models were constructed in this study. TyG-WHR index was positively correlated with the risk of retinal arteriosclerosis: the HR (95%CI) of model 1-3 was 1.534,1.517 and 1.502.The AUC curve analysis verified that the prediction AUC of the TyG-WHR index for new-onset retinal arteriosclerosis was 0.755, the best prediction value was 7.343, the sensitivity was 90.2%, and the specificity was 75.60%. Conclusion: TyG-WHR index may be an independent risk factor for new-onset retinal arteriosclerosis.