Triglyceride-glucose index associated with the risk of cardiovascular disease: the Kailuan study

Abstract

Purpose: Previous studies suggest that triglyceride-glucose index (TyG) index, as a marker of insulin resistance, may have associations with the risk of cardiovascular diseases (CVD) in elderly population. Given the paucity of data, it remains controversial, especially in general Chinese population. We aimed to further assess whether TyG index is an independent risk factor for CVD.

Methods: We conducted a prospective cohort study that enrolled a total of 96,541 participants from the Kailuan Study. TyG index was calculated as ln (fasting triglyceride [mg/dL] × fasting glucose [mg/dL]/2). Participants were divided into four groups (Q1, Q2, Q3, and Q4) by quartiles of the TyG index. Any CVD events occurred during 2006-2017 were recorded, including myocardial infarction (MI) and stroke. We assessed the association of TyG index with the risk of CVD and the subtypes of CVD by using Cox models estimated hazard ratios (HRs) and 95% confidence interval (CIs).

Results: During a median follow-up of 10.33 years, totally 6421 CVD events, 1493 MIs, and 5083 stroke events occurred. Multivariate Cox regression analysis showed that compared with Q1, HR (95% CI) for CVD events was 1.12 (95%, 1.03-1.21) in Q2, 1.28 (95%, 1.18-1.38) in Q3, and 1.34 (95%, 1.23-1.45) in Q4. In a time-dependent Cox Model we also found that compared with Q1, HR (95% CI) for CVD events was 1.09 (95%, 1.02-1.18) in Q2, 1.18 (95%, 1.09-1.27) in Q3, and 1.20 (95%, 1.11-1.30) in Q4. Similar results were showed in MI and stroke.

Conclusions: TyG index as a marker of insulin resistance was an independent risk factor for CVD. This may help in the early identification of people at high risk of CVD and be applicable to the primordial and primary prevention.

Keywords: Cardiovascular disease; Prospective cohort study; Risk factors; Triglyceride-glucose index.