Triglyceride-Glucose Index and Homeostasis Model Assessment-Insulin Resistance in Young Adulthood and Risk of Incident Congestive Heart Failure in Midlife: The Coronary Artery Risk Development in Young Adults Study

Xianghui Zeng; Dunzheng Han; Haobin Zhou; Yuting Xue; Xiao Wang; Qiong Zhan; Yujia Bai; Xingfu Huang; Qingchun Zeng; Hao Zhang; Zhuang Ma; Hao Ren; Dingli Xu

doi:10.3389/fcvm.2022.944258

Triglyceride-Glucose Index and Homeostasis Model Assessment-Insulin Resistance in Young Adulthood and Risk of Incident Congestive Heart Failure in Midlife: The Coronary Artery Risk Development in Young Adults Study

Front Cardiovasc Med. 2022 Jun 30:9:944258. doi: 10.3389/fcvm.2022.944258. eCollection 2022.

Authors

Xianghui Zeng¹, Dunzheng Han¹, Haobin Zhou¹, Yuting Xue¹, Xiao Wang¹, Qiong Zhan¹, Yujia Bai¹, Xingfu Huang¹, Qingchun Zeng¹, Hao Zhang¹, Zhuang Ma¹, Hao Ren², Dingli Xu¹

Affiliations

¹ Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
² Department of Rheumatology, Nanfang Hospital, Southern Medical University, Guangzhou, China.

Abstract

Objective: This study aimed to assess the association between triglyceride-glucose (TyG) index/homeostasis model assessment-insulin resistance (HOMA-IR) within young adults and congestive heart failure (CHF), and to explore whether TyG index can replace HOMA-IR as a surrogate marker for IR in predicting the risk of CHF.

Methods: A total of 4,992 participants between the ages of 18 and 30 years were enrolled from the Coronary Artery Risk Development in Young Adults (CARDIA) investigation [from 1985 to 1986 (year 0)]. A Cox proportional hazard regression analysis was conducted for assessing correlations between baseline TyG index/HOMA-IR and CHF events, together with the receiver operating characteristic (ROC) curve employed for scrutinizing TyG index/HOMA-IR and the risk of CHF.

Results: During the 31-year follow-up period, 64 (1.3%) of the 4,992 participants developed CHF. In multivariable Cox proportional hazards models, adjusted for confounding factors for CHF, an increased risk of CHF was associated with a per-unit increase in the TyG index [hazard ratio (HR) 2.8; 95% confidence interval (CI), 1.7-4.7] and HOMA-IR (HR 1.2; 95% CI, 1.1-1.3). A Kaplan-Meier curve analysis showed that participants in the TyG index and HOMA-IR index Q4 group had a higher risk of CHF than those in the Q1 group. The area under curve (AUC) for the TyG index and HOMA-IR consisted of 0.67 (95% CI, 0.6-0.742) and 0.675 (95% CI, 0.604-0.746), respectively. There were no significant differences between the TyG index and HOMA-IR for AUC (p = 0.986).

Conclusion: The higher TyG index and HOMA-IR are independent risk factors for CHF. The TyG index can replace HOMA-IR in young adulthood as a surrogate marker for IR to predict the risk of CHF.

Keywords: HOMA-IR; congestive heart failure; insulin resistance; the CARDIA study; triglyceride-glucose index.