Triglyceride-Glucose Index Predicts Future Atherosclerotic Cardiovascular Diseases: A 16-Year Follow-up in a Prospective, Community-Dwelling Cohort Study

• Published in: Endocrinology and metabolism (Seoul) Vol. 38; no. 4; pp. 406 - 417
• Main Authors: Moon, Joon Ho, Kim, Yongkang, Oh, Tae Jung, Moon, Jae Hoon, Kwak, Soo Heon, Park, Kyong Soo, Jang, Hak Chul, Choi, Sung Hee, Cho, Nam H.
• Format: Journal Article
• Language: English
• Published: Korea (South) Korean Endocrine Society 01.08.2023; 대한내분비학회
• Subjects: atherosclerosis; cardiovascular diseases; glucose; insulin resistance; mortality; Original; risk factors; triglycerides; 내과학; Mortality; Atherosclerosis; Insulin resistance; Triglycerides; Glucose; Cardiovascular diseases; Risk factors
• ISSN: 2093-596X; 2093-5978; 2093-5978
• DOI: 10.3803/EnM.2023.1703

Background: While the triglyceride-glucose (TyG) index is a measure of insulin resistance, its association with cardiovascular disease (CVD) has not been well elucidated. We evaluated the TyG index for prediction of CVDs in a prospective large communitybased cohort.Methods: Individuals 40 to 70 years old were prospectively followed for a median 15.6 years. The TyG index was calculated as the Ln [fasting triglycerides (mg/dL)×fasting glucose (mg/dL)/2]. CVDs included any acute myocardial infarction, coronary artery disease or cerebrovascular disease. We used a Cox proportional hazards model to estimate CVD risks according to quartiles of the TyG index and plotted the receiver operating characteristics curve for the incident CVD.Results: Among 8,511 subjects (age 51.9±8.8 years; 47.5% males), 931 (10.9%) had incident CVDs during the follow-up. After adjustment for age, sex, body mass index, diabetes mellitus, hypertension, total cholesterol, smoking, alcohol, exercise, and C-reactive protein, subjects in the highest TyG quartile had 36% increased risk of incident CVD compared with the lowest TyG quartile (hazard ratio, 1.36; 95% confidence interval, 1.10 to 1.68). Carotid plaque, assessed by ultrasonography was more frequent in subjects in the higher quartile of TyG index (P for trend=0.049 in men and P for trend <0.001 in women). The TyG index had a higher predictive power for CVDs than the homeostasis model assessment of insulin resistance (HOMA-IR) (area under the curve, 0.578 for TyG and 0.543 for HOMA-IR). Adding TyG index on diabetes or hypertension alone gave sounder predictability for CVDs.Conclusion: The TyG index is independently associated with future CVDs in 16 years of follow-up in large, prospective Korean cohort.