Predictive Effect of Triglyceride-Glucose Index on Adverse Prognostic Events in Patients with Type 2 Diabetes Mellitus and Ischemic Cardiomyopathy

Baiheremujiang Abuduaini; Long Yang; Nueraihemaiti Jiamali; Zulihuma Seyiti; Xue-Feng Shan; Xiao-Ming Gao

doi:10.2147/DMSO.S408766

Predictive Effect of Triglyceride-Glucose Index on Adverse Prognostic Events in Patients with Type 2 Diabetes Mellitus and Ischemic Cardiomyopathy

Diabetes Metab Syndr Obes. 2023 Apr 20:16:1093-1107. doi: 10.2147/DMSO.S408766. eCollection 2023.

Authors

Baiheremujiang Abuduaini^#¹, Long Yang^#², Nueraihemaiti Jiamali¹, Zulihuma Seyiti², Xue-Feng Shan^{3

4

5}, Xiao-Ming Gao^{4

5

6}

Affiliations

¹ First Clinical Medical College, Xinjiang Medical University, Urumqi, People's Republic of China.
² College of Pediatrics, Xinjiang Medical University, Urumqi, People's Republic of China.
³ Pediatric Cardiothoracic Surgery, First Affiliated Hospital of Xinjiang Medical University, Urumqi, People's Republic of China.
⁴ State Key Laboratory of Pathogenesis, Prevention, and Treatment of High Incidence Diseases in Central Asia, Department of Cardiology of the First Affiliated Hospital of Xinjiang Medical University, Urumqi, People's Republic of China.
⁵ Xinjiang Key Laboratory of Medical Animal Model Research, Urumqi, People's Republic of China.
⁶ Clinical Medical Research Institute of Xinjiang Medical University, Urumqi, People's Republic of China.

^# Contributed equally.

Abstract

Background: The triglyceride-glucose (TyG) index is regarded as an independent predictor of cardiovascular (CV) consequences and a reliable surrogate measure of insulin resistance (IR). However, the predictive significance of the TyG index in patients with type 2 diabetes mellitus (T2DM) and ischemic cardiomyopathy (ICM) remains unknown.

Methods: This study included 1514 consecutive subjects with ICM and T2DM. The tertile of the TyG index values was used to categorize these patients into three groups. Major adverse cardiac and cerebral events (MACCEs) were also noted. The TyG index was calculated using the [fasting triglycerides (mg/dL) × fasting plasma glucose (mg/dL)/2] equation.

Results: After adjusting for age, BMI, and other potential confounders, the scores of multivariate Cox proportional hazards regression models for chest pain [9.056 (4.370 to 18.767), p<0.001], acute myocardial infarction [4.437 (1.420 to 13.869), p=0.010], heart failure [7.334 (3.424 to 15.708), p<0.001], cardiogenic shock [3.707 (1.207 to 11.384), p=0.022], malignant arrhythmia [5.309 (2.367 to 11.908), p<0.001], cerebral infarction [3.127 (1.596 to 6.128), p<0.001], gastrointestinal bleeding [4.326 (1.612 to 11.613), p=0.004], all-cause death [4.502 (3.478 to 5.827), p<0.001] and cumulative incidence of MACCEs [4.856 (3.842 to 6.136), p<0.001] increased significantly with an increase in TyG index levels (all p<0.05). Time-dependent ROC analysis revealed that the area under the TyG index curve (AUC) reached 0.653 in the 3rd year, 0.688 in the 5th year, and 0.764 in the 10th year. The predictive efficiency of this model on MACCEs improved [net reclassification improvement (NRI): 0.361 (0.253 to 0.454); C-index: 0.678 (0.658 to 0.698); integrated discrimination improvement (IDI): 0.138 (0.098 to 0.175), all p<0.05] following the incorporation of the TyG index into the base risk model.

Conclusion: TyG index could be useful in predicting MACCEs and initiating preventive measures in subjects with ICM and T2DM.

Keywords: insulin resistance; ischemic cardiomyopathy; major adverse cardiac and cerebral events; triglyceride‑glucose index; type 2 diabetes mellitus.

Grants and funding

This work was supported by the National Natural Science Foundation of China (U1903212) and the key project of Xinjiang Natural Science Foundation.