Triglyceride glucose index: A new biomarker in predicting cardiovascular risk

Susilane Pereira Araújo; Leidjaira Lopes Juvanhol; Josefina Bressan; Helen Hermana Miranda Hermsdorff

doi:10.1016/j.pmedr.2022.101941

Triglyceride glucose index: A new biomarker in predicting cardiovascular risk

Prev Med Rep. 2022 Aug 24:29:101941. doi: 10.1016/j.pmedr.2022.101941. eCollection 2022 Oct.

Authors

Susilane Pereira Araújo¹, Leidjaira Lopes Juvanhol¹, Josefina Bressan¹, Helen Hermana Miranda Hermsdorff¹

Affiliation

¹ Department of Nutrition and Health. Universidade Federal de Viçosa. Viçosa. Brazil.

Abstract

Introduction: Insulin resistance can be assessed by the Triglyceride-Glucose Index (TyG), a simple, low-cost, and easy-to-apply method.

Objective: To assess the predictive capacity of the TyG index about cardiovascular risk and identify its cutoff point in a population at cardiometabolic risk.

Methods: Cross-sectional study with 264 individuals at cardiometabolic risk (54.9% women, age: 43.1 ± 16.3 years). Demographic, anthropometric, clinical-laboratory, and lifestyle data were collected. The TyG index was determined using the formula Ln [fasting triglycerides (mg/dL) × fasting plasma glucose (mg (dL)/2]. The ten-year cardiovascular risk was assessed by the Framingham risk score (FRS). The receiver operating characteristic curve (ROC) was used to define the cutoff point for the TyG index, and the associations were tested by Poisson regression.

Results: ROC curve analysis indicated an area under the curve of 0.678 (95% CI = 0.618-0.734; p < 0.001), with a cutoff of 9.04 (sensitivity = 62.5%, specificity = 66.7%, positive predictive value = 29.4% and negative predictive value = 88.9%). Elevated TyG values (≥9.04) were positively associated with cardiometabolic risk factors (total cholesterol, LDL, VLDL, uric acid, alanine aminotransferase, aspartate aminotransferase, waist-hip ratio, systolic blood pressure, HOMA-IR, smoking, metabolic syndrome, diabetes, and hepatic steatosis). After adjustment for confounding factors, individuals with high TyG showed an increase of 69% (RP = 1.69; 95%CI = 1.03-2.78) in the prevalence of intermediate/high risk by FRS, compared to those with low TyG.

Conclusion: The TyG index showed a good predictive capacity for cardiovascular risk in ten years assessed by the FRS.

Keywords: ALT, Alanine aminotransferase; AST, Apartate aminotransferase; CVD, Cardiovascular diseases; Cardiovascular disease; Cardiovascular risk; FRS, Framingham risk score; Framingham score; HDL, High-density lipoprotein; IR, Insulin resistance; Insulin resistance; LDL, Low-density lipoprotein; ROC, Receiver operating characteristic; TC, Total cholesterol; TyG index; TyG, triglyceride-glucose index; VLDL, Very-low-density lipoprotein.