Triglyceride-Glucose Index and Risks of All-Cause and Cause-Specific Mortality in Young Adults

Abstract

Context: The triglyceride-glucose (TyG) index is a reliable marker of insulin resistance. Although the TyG index is useful for identifying individuals at a high risk of future cardiovascular events and mortality in the general population, its clinical impact on young adults remains unclear.

Objective: This study aimed to investigate the association between the TyG index and mortality in young individuals.

Methods: We enrolled 6 667 138 individuals aged 20-39 years who underwent Korean national health screening between 2009 and 2012. Participants were categorized into quartiles based on their TyG indices. The study outcomes included all-cause and cause-specific mortality associated with cardiovascular events, cancer, and respiratory diseases.

Results: During a median follow-up duration of 10.7 years, 41 004 (0.6%) deaths occurred. The cumulative event rates for all-cause and cause-specific mortality were highest among participants in the TyG index quartile 4. In the multivariable Cox analysis, participants in the TyG index quartile 4 had significantly increased risks of all-cause, cardiovascular, and respiratory mortality compared with those in the quartile 1 (adjusted hazard ratio [HR] 1.21 (95% CI 1.17-1.24), 1.42 (1.29-1.56), and 1.68 (1.21-2.34), respectively). In contrast, the risk of cancer-related mortality was not increased in participants in the TyG index quartile 4. The risks of all-cause, cardiovascular, and respiratory mortality increased as the TyG index increased. However, there was no significant relationship between the TyG index and the risk of cancer-related mortality.

Conclusion: The TyG index can be a useful marker to identify young individuals at an increased risk of all-cause, cardiovascular, and respiratory mortality.

Keywords: cardiovascular disease; mortality; triglyceride-glucose index; young adult.