Insulin resistance indicators in aortic disease: A large cohort study

Area of Science:

• Cardiovascular Medicine
• Metabolic Syndrome
• Epidemiology

Background:

• The triglyceride-glucose (TyG) index is an emerging marker for insulin resistance.
• Its association with aortic dissection and aneurysm (AD/AA) requires further clarification.
• Cardiovascular diseases are a leading cause of mortality worldwide.

Purpose of the Study:

• To investigate the relationship between the triglyceride-glucose (TyG) index and the risk of aortic dissection and aneurysm (AD/AA).
• To explore the potential causal link between TyG and AD/AA using genetic data.

Main Methods:

• Analysis of 386,063 participants from the UK Biobank prospective cohort.
• Multivariate Cox regression models to assess the association between TyG index and AD/AA incidence.
• Validation in a Chinese clinical cohort and two-sample Mendelian randomization analysis.

Main Results:

• A higher TyG index was significantly associated with an increased incidence of AD/AA (HR=1.14).
• TyG-related ratios (TyG-WHR, TyG-WHtR) also showed significant associations with AD/AA risk.
• Mendelian randomization indicated a causal relationship between genetically predicted TyG levels and aortic aneurysm (AA) (OR=1.97).

Conclusions:

• Elevated TyG index is a robust, potentially causal risk factor for aortic diseases, particularly aortic aneurysm (AA).
• Metabolic risk assessment, including TyG index, is crucial for aortic disease prevention.
• Further research is needed to elucidate the mechanisms linking TyG to specific aortic phenotypes.