Association of triglyceride-glucose index with cardiovascular disease among a general population: a prospective cohort study

Yiming Wan; Ziliang Zhang; Yong Ling; Hui Cui; Zihan Tao; Jianfeng Pei; Aikedan Maimaiti; Haifan Bai; Yiling Wu; Jing Li; Genming Zhao; Maryam Zaid

doi:10.1186/s13098-023-01181-z

Association of triglyceride-glucose index with cardiovascular disease among a general population: a prospective cohort study

Diabetol Metab Syndr. 2023 Oct 16;15(1):204. doi: 10.1186/s13098-023-01181-z.

Authors

Yiming Wan¹, Ziliang Zhang², Yong Ling¹, Hui Cui¹, Zihan Tao³, Jianfeng Pei¹, Aikedan Maimaiti¹, Haifan Bai¹, Yiling Wu⁴, Jing Li⁵, Genming Zhao¹, Maryam Zaid⁶

Affiliations

¹ Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China.
² Shanghai Depeac Biotechnology Co., Ltd, Shanghai, China.
³ Department of Plastic Surgery, Changhai Hospital, Naval Medical University, Shanghai, China.
⁴ Songjiang Center for Disease Control and Prevention, Shanghai, China.
⁵ Songjiang District Zhongshan Street Community Healthcare Center, Shanghai, China.
⁶ Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China. maryzaid@fudan.edu.cn.

Abstract

Background: The impact of triglyceride-glucose (TyG) index, a surrogate marker for insulin resistance, on the risk of cardiovascular disease (CVD) in general populations remains controversial. We aimed to comprehensively study the relationship between TyG index with the risk of incident CVD events in the general population in Shanghai.

Methods: A total of 42,651 participants without previous history of CVD events from Shanghai Suburban Adult Cohort and Biobank (SSACB) were included. SSACB was a community-based natural population cohort study using multistage cluster sampling method. TyG index was calculated as Ln [fasting serum triglyceride (mg/dL) * fasting blood glucose (mg/dL)/2]. Kaplan-Meier curves, log-rank test and cox proportional hazards model were used to calculate the association between TyG index and incident CVD, including stroke and coronary heart disease (CHD). Restricted cubic spline analyses were used to determine whether there was a non-linear relationship between TyG index and CVD events.

Results: During a median follow-up of 4.7 years, 1,422 (3.3%) individuals developed CVD, including 674 (1.6%) cases of stroke and 732 (1.7%) cases of CHD. A one unit increment higher TyG index was associated with [HR(95%CI)] 1.16(1.04-1.29) in CVD and with 1.39(1.19-1.61) in stroke. Only linear relationships between TyG and CVD/stroke were observed, while no relationship was observed with CHD after adjustments for confounders. In subgroup analyses, younger (< 50y) and diabetic participants had higher risk of CVD than their counterpart groups, while hypertensive and dyslipidemic participants depicted lower risks than their counterparts.

Conclusion: Elevated TyG index was associated with a higher risk of incident CVD and stroke. TyG index may help in the early stage of identifying people at high risk of CVD.

Keywords: Cardiovascular disease; Cohort studies; Triglyceride-glucose index.