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Gao B, Yang C, Wu G, Zhao G, Huang J, Wang L. The triglyceride glucose index was nonlinearly associated with all-cause mortality in diabetic patients. Nutr Metab Cardiovasc Dis 2024; 34:2012-2015. [PMID: 38866610 DOI: 10.1016/j.numecd.2024.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 04/18/2024] [Accepted: 04/19/2024] [Indexed: 06/14/2024]
Abstract
BACKGROUND AND AIM The TyG index has been linked with cardiometabolic diseases. Our study aimed to investigate the specific relationship between the triglyceride and glucose index (TyG) and both all-cause and cardiovascular mortality in diabetic patients. METHODS AND RESULTS We enrolled 3120 participants with diabetes from the National Health and Nutrition Examination Survey. The TyG index was calculated using the formula ln [fasting triglycerides (mg/dL) × fasting glucose (mg/dL)/2]. Hazard ratios (HRs) of TyG associated with mortality risk were assessed using Cox proportional hazard regression models. Over a follow-up period of 10.8 thousand person-years, we observed 768 all-cause deaths and 155 cardiovascular deaths. Compared to the reference quartile, the multivariate-adjusted hazard ratios and 95% confidence intervals for all-cause mortality were 1.02 (1.01-1.05; p = 0.008) in the fourth quartile. Dose-response analysis revealed a non-linear association. However, no significant associations were found between the TyG index and cardiovascular mortality. CONCLUSIONS The TyG index exhibited a non-linear association with the risk of all-cause mortality in diabetic patients.
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Affiliation(s)
- Beibei Gao
- Department of Cardiology, Affiliated Hangzhou First People's Hospital, Westlake University School of Medicine, Hangzhou, 310000, China; The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, 310000, China
| | - Chao Yang
- The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, 310000, China
| | - Guomin Wu
- Department of Cardiology, Affiliated Hangzhou First People's Hospital, Westlake University School of Medicine, Hangzhou, 310000, China
| | - Guoying Zhao
- The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, 310000, China
| | - Jinyu Huang
- Department of Cardiology, Affiliated Hangzhou First People's Hospital, Westlake University School of Medicine, Hangzhou, 310000, China; The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, 310000, China; Department of Cardiology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, 310000, China.
| | - Long Wang
- Department of Cardiology, Affiliated Hangzhou First People's Hospital, Westlake University School of Medicine, Hangzhou, 310000, China; Department of Cardiology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, 310000, China.
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2
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Zhou H, Ding X, Lan Y, Fang W, Yuan X, Tian Y, Chen S, Wu S, Wu D. Dual-trajectory of TyG levels and lifestyle scores and their associations with ischemic stroke in a non-diabetic population: a cohort study. Cardiovasc Diabetol 2024; 23:225. [PMID: 38943172 PMCID: PMC11214241 DOI: 10.1186/s12933-024-02313-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Accepted: 06/16/2024] [Indexed: 07/01/2024] Open
Abstract
BACKGROUND The Triglyceride-glucose (TyG) index, a surrogate marker of insulin resistance, has been implicated in the risk of ischemic stroke. However, the interplay between TyG levels, lifestyle factors, and their collective impact on stroke risk in non-diabetic populations remains inadequately explored. This study aims to evaluate the association of ischemic stroke with the joint development of the TyG index and lifestyle in the non-diabetic population. METHODS In this prospective cohort study, data was collected across three consecutive biennial surveys of the Kailuan Study from 2006 to 2011. The dual-trajectory model was used to determine the temporal development of TyG levels and lifestyle scores. Statistical analysis involved Cox regression models to evaluate the association between TyG-lifestyle trajectories and ischemic stroke risk, adjusting for potential confounders. RESULTS A total of 44,403 participants were included, with five distinct TyG levels and lifestyle scores trajectory subtypes identified. In the multivariable-adjusted analyses, significant differences in ischemic stroke risk among the trajectory subtypes. Group 5, characterized by the highest TyG levels and moderate lifestyle scores, exhibited the greatest ischemic stroke risk (HR = 1.81, 95% CI: 1.51-2.18), while group 4, with moderate TyG levels and higher lifestyle scores, demonstrated the lowest risk (HR = 1.19, 95% CI: 1.04-1.37), compared with group 3. Participants with elevated TyG levels were at an increased risk of ischemic stroke in cases of pronounced insulin resistance, even with a healthy lifestyle. CONCLUSIONS This study reveals the significant associations between the identified TyG and lifestyle trajectories and the stratification of ischemic stroke risk among non-diabetics. The TyG index is a valuable indicator for assessing insulin resistance. However, the potential benefits of lifestyle changes for those with significantly high TyG levels need to be clarified by more research to develop more effective stroke prevention strategies.
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Affiliation(s)
- Hui Zhou
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Xiong Ding
- School of Public Health, Wuhan University, Wuhan, China
- Global Health Research Center, Duke Kunshan University, Suzhou, China
| | - Yulong Lan
- The Second Affiliated Hospital of Shantou University Medical College, Shantou, China
- Centre for Precision Health, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - Wei Fang
- Department of Cardiology, Second Affiliated Hospital of Air Force Medical University, Xi'an, China
| | - Xiaojie Yuan
- Department of Epidemiology, Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, School of Public Health, Air Force Medical University, Xi'an, China
| | - Yan Tian
- School of Public Health, North China University of Science and Technology, Tangshan, China
| | - Shuohua Chen
- Department of Cardiology, Kailuan General Hospital, 57 Xinhua East Rd, Tangshan, China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, 57 Xinhua East Rd, Tangshan, China.
| | - Dan Wu
- The Second Affiliated Hospital of Shantou University Medical College, Shantou, China.
- Centre for Precision Health, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia.
- Department of Endocrinology, The First Affiliated Hospital of Shantou University Medical College, Shantou, China.
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Shi J, Zhang H, Wang X, Weng J, Ding Y, Wu J, Zheng X, Luo S, Hu H. Association of perioperative glucose profiles assessed by continuous glucose monitoring (CGM) with prognosis in Chinese patients with non-ST-elevation acute coronary syndrome: a cohort study protocol. BMJ Open 2024; 14:e079666. [PMID: 38866564 PMCID: PMC11177667 DOI: 10.1136/bmjopen-2023-079666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 01/18/2024] [Indexed: 06/14/2024] Open
Abstract
INTRODUCTION Non-ST-elevation acute coronary syndrome (NSTE-ACS) remains a significant clinical concern, accounting for over 70% of acute coronary syndrome cases. One well-established risk factor for NSTE-ACS is abnormal glucose metabolism, which is associated with a poor prognosis postpercutaneous coronary intervention. Effective monitoring of blood glucose is crucial in diabetes care, as it helps identify glucose metabolic imbalances, thereby guiding therapeutic strategies and assessing treatment efficacy. Continuous glucose monitoring (CGM) provides comprehensive glucose profiles. Therefore, the study aims to use CGM to track perioperative glucose variations in NSTE-ACS patients and to determine its prognostic implications. METHODS AND ANALYSIS This is a multicentre, prospective observational study in a sample of patients (aged >18 years) with NSTE-ACS. A total of 1200 eligible patients will be recruited within 1 year at 6 sites in China. The primary composite endpoint will be determined as major adverse cardiovascular events (MACE) at 3 years. MACE includes all-cause mortality, non-fatal myocardial infarction, non-fatal stroke and target vessel revascularisation. Employing the CGM system, glucose levels will be continuously monitored throughout the perioperative phase. Prespecified cardiovascular analyses included analyses of the components of this composite and outcomes according to CGM-derived glucometrics at baseline. ETHICS AND DISSEMINATION This study has received approval from the Medical Research Ethics Committee of The First Affiliated Hospital of the University of Science and Technology of China (No. 2022KY357) and will adhere to the moral, ethical and scientific principles outlined in the Declaration of Helsinki. All participants will provide written informed consent prior to any study-related procedures. Findings from the study will be shared at conferences and published in peer-reviewed scientific journals. TRIAL REGISTRATION NUMBER ChiCT2300069663.
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Affiliation(s)
- Jie Shi
- Department of Endocrinology, Centre for Leading Medicine and Advanced Technologies of IHM, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, 230001, China, University of Science and Technology of China, Hefei, Anhui, China
| | - Hongqiang Zhang
- Department of Endocrinology, Centre for Leading Medicine and Advanced Technologies of IHM, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, 230001, China, University of Science and Technology of China, Hefei, Anhui, China
| | - Xulin Wang
- Department of Endocrinology, Centre for Leading Medicine and Advanced Technologies of IHM, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, 230001, China, University of Science and Technology of China, Hefei, Anhui, China
| | - Jiahao Weng
- Department of Endocrinology, Centre for Leading Medicine and Advanced Technologies of IHM, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, 230001, China, University of Science and Technology of China, Hefei, Anhui, China
| | - Yu Ding
- Department of Endocrinology, Centre for Leading Medicine and Advanced Technologies of IHM, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, 230001, China, University of Science and Technology of China, Hefei, Anhui, China
| | - Jiawei Wu
- Department of Cardiology, The First Affiliated Hospital of USTC, Division of Life Science and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Xueying Zheng
- Department of Endocrinology, Centre for Leading Medicine and Advanced Technologies of IHM, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, 230001, China, University of Science and Technology of China, Hefei, Anhui, China
| | - Sihui Luo
- Department of Endocrinology, Centre for Leading Medicine and Advanced Technologies of IHM, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, 230001, China, University of Science and Technology of China, Hefei, Anhui, China
| | - Hao Hu
- Department of Cardiology, The First Affiliated Hospital of USTC, Division of Life Science and Medicine, University of Science and Technology of China, Hefei, Anhui, China
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Liu H, Wang L, Wang H, Hao X, Du Z, Li C, Hou X. The association of triglyceride-glucose index with major adverse cardiovascular and cerebrovascular events after acute myocardial infarction: a meta-analysis of cohort studies. Nutr Diabetes 2024; 14:39. [PMID: 38844442 PMCID: PMC11156940 DOI: 10.1038/s41387-024-00295-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 05/02/2024] [Accepted: 05/15/2024] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND Insulin resistance (IR) is indicated to be linked with adverse outcomes of acute myocardial infarction (AMI), for its pro-inflammatory and pro-thromboplastic function. The triglyceride-glucose (TyG) index is a newly developed substitute marker for IR. The aim of this pooled analysis was to provide a summary of the relationship of TyG index with occurrences of major adverse cardiovascular and cerebrovascular events (MACCEs) among populations suffering from AMI. METHODS Cohorts reporting multivariate-adjusted hazard ratios of TyG index with MACCEs or its independent events were identified through systematically searching PubMed, MEDLINE, Web of science, Embase and Cochrane databases. Results were combined using a random-effects model. RESULTS 21 cohorts comprising 20403 individuals were included. Compared to individuals in the lowest TyG category, patients in the highest TyG category exhibited elevated risks of both MACCEs (P < 0.00001) and all-cause death (P < 0.00001). These findings were in line with the results as TyG analyzed as continuous variables (MACCEs: P = 0.006; all-cause death: P < 0.00001). Subgroup analysis demonstrated that diabetic status, type of AMI, nor the reperfusion therapy did not destruct this correlation (for subgroups, all P < 0.05). CONCLUSION All these indicated that higher TyG index could potentially predict MACCEs and all-cause death in patients with AMI as an independent indicator.
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Affiliation(s)
- Huiruo Liu
- Centre for Cardiac Intensive Care, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Liangshan Wang
- Centre for Cardiac Intensive Care, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Hong Wang
- Centre for Cardiac Intensive Care, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Xing Hao
- Centre for Cardiac Intensive Care, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Zhongtao Du
- Centre for Cardiac Intensive Care, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Chenglong Li
- Centre for Cardiac Intensive Care, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Xiaotong Hou
- Centre for Cardiac Intensive Care, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
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Sun C, Hu L, Li X, Zhang X, Chen J, Li D, Zhang J, Liu L, Wu M. Triglyceride-glucose index's link to cardiovascular outcomes post-percutaneous coronary intervention in China: a meta-analysis. ESC Heart Fail 2024; 11:1317-1328. [PMID: 38246749 PMCID: PMC11098636 DOI: 10.1002/ehf2.14679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 12/05/2023] [Accepted: 12/27/2023] [Indexed: 01/23/2024] Open
Abstract
Percutaneous coronary intervention (PCI) addresses myocardial ischaemia, but a significant subset of patients encounter major adverse cardiovascular events (MACE) post-treatment. This meta-analysis investigated the relationship between the post-PCI triglyceride-glucose (TyG) index and MACE. Comprehensive searches of the Embase, PubMed, Cochrane Library, and Web of Science databases were conducted up to 3 March 2023, using relevant keywords. The effect size was determined based on I2 statistic using random-effects models. Cluster-robust standard errors crafted the dose-response curve, and the GRADE Evaluation Scale was employed to rate the quality of evidence. The group with the highest TyG index had significantly higher post-PCI MACE rates than the lowest index group, with hazard ratios (HRs) of 2.04 (95% CI 1.65-2.52; I2 = 77%). Each unit increase in TyG index corresponded to HRs of 1.82 for MACE (95% CI 1.34-2.46; I2 = 92%), 2.57 for non-fatal MI (95% CI 1.49-4.41; I2 = 63%), and 2.06 for revascularization (95% CI 1.23-3.50; I2 = 90%). A linear relationship between TyG index and MACE risk was established (R2 = 0.6114). For all-cause mortality, the HR was 1.93 (95% CI 1.35-2.75; I2 = 50%), indicating a higher mortality risk with elevated TyG index. The GRADE assessment yielded high certainty for non-fatal MI but low certainty for all-cause mortality, revascularization, and MACE. The TyG index may predict risks of post-PCI MACE, all-cause mortality, non-fatal MI, and revascularization, with varied levels of certainty. A potential linear association between the TyG index and MACE post-PCI was identified. Future research should validate these findings.
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Affiliation(s)
- ChangXin Sun
- Beijing University of Chinese MedicineBeijingChina
- National Clinical Research Center for Chinese Medicine Cardiology, China Academy of Chinese Medical SciencesXiyuan HospitalBeijingChina
| | - LanQing Hu
- National Clinical Research Center for Chinese Medicine Cardiology, China Academy of Chinese Medical SciencesXiyuan HospitalBeijingChina
| | - XiaoYa Li
- National Clinical Research Center for Chinese Medicine Cardiology, China Academy of Chinese Medical SciencesXiyuan HospitalBeijingChina
| | - XiaoNan Zhang
- National Clinical Research Center for Chinese Medicine Cardiology, China Academy of Chinese Medical SciencesXiyuan HospitalBeijingChina
| | - JiYe Chen
- National Clinical Research Center for Chinese Medicine Cardiology, China Academy of Chinese Medical SciencesXiyuan HospitalBeijingChina
| | - DeXiu Li
- National Clinical Research Center for Chinese Medicine Cardiology, China Academy of Chinese Medical SciencesXiyuan HospitalBeijingChina
| | - JingYi Zhang
- Beijing University of Chinese MedicineBeijingChina
| | - LongTao Liu
- National Clinical Research Center for Chinese Medicine Cardiology, China Academy of Chinese Medical SciencesXiyuan HospitalBeijingChina
| | - Min Wu
- China Academy of Chinese Medical SciencesGuang'anmen HospitalBeijingChina
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Hao B, Lyu L, Xu J, Zhu X, Xu C, Gao W, Qin J, Huang T, Ding Y, Zhang Z, Yang Y, Liu H. The relationship between triglyceride-glucose index and prospective key clinical outcomes in patients hospitalised for coronary artery disease. Cardiovasc Diabetol 2024; 23:40. [PMID: 38254088 PMCID: PMC10804527 DOI: 10.1186/s12933-024-02132-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 01/10/2024] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND The triglyceride-glucose (TyG) index is regarded as a dependable alternative for assessing insulin resistance (IR), given its simplicity, cost-effectiveness, and strong correlation with IR. The relationship between the TyG index and adverse outcomes in patients with coronary heart disease (CHD) is not well established. This study examines the association of the TyG index with long-term adverse outcomes in hospitalized CHD patients. METHODS In this single-center prospective cohort study, 3321 patients hospitalized with CHD were included. Multivariate Cox regression models were employed to assess the associations between the TyG index and the incidence of all-cause mortality and major adverse cardiovascular events (MACEs). To examine potential nonlinear associations, restricted cubic splines and threshold analysis were utilized. RESULTS During a follow-up period of 9.4 years, 759 patients (22.9%) succumbed to mortality, while 1291 (38.9%) experienced MACEs. Threshold analysis demonstrated a significant "U"-shaped nonlinear relationship with MACEs, with different hazard ratios observed below and above a TyG index of 8.62 (below: HR 0.71, 95% CI 0.50-0.99; above: HR 1.28, 95% CI 1.10-1.48). Notably, an increased risk of all-cause mortality was observed only when the TyG index exceeded 8.77 (HR 1.53, 95% CI 1.19-1.96). CONCLUSIONS This study reveals a nonlinear association between the TyG index and both all-cause mortality and MACEs in hospitalized CHD patients with CHD. Assessing the TyG index, particularly focusing on individuals with extremely low or high TyG index values, may enhance risk stratification for adverse outcomes in this patient population.
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Affiliation(s)
- Benchuan Hao
- Department of Cardiology, The Second Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Lyu Lyu
- Department of Cardiology, The Second Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Juan Xu
- Department of General Surgery, Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hangzhou, China
| | | | - Cui Xu
- Department of Medical Administration, The 305 Hospital of PLA, Beijing, China
| | - Weiyang Gao
- Department of Cardiology, The Second Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Ji Qin
- Department of Cardiology, The Second Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Taoke Huang
- Department of Cardiology, The Second Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Yipu Ding
- Department of Cardiology, The Second Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Ziyue Zhang
- Outpatient Department, Hospital of PLA, Hanzhong, China
| | - Yanhui Yang
- Department of Cardiology, The Second Medical Center, Chinese PLA General Hospital, Beijing, China.
| | - Hongbin Liu
- Department of Cardiology, The Second Medical Center, Chinese PLA General Hospital, Beijing, China.
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Tao S, Yu L, Li J, Huang L, Huang X, Zhang W, Xie Z, Tan Y, Yang D. Association between the triglyceride-glucose index and 1-year major adverse cardiovascular events in patients with coronary heart disease and hypertension. Cardiovasc Diabetol 2023; 22:305. [PMID: 37940943 PMCID: PMC10633928 DOI: 10.1186/s12933-023-02018-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 10/09/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND The triglyceride-glucose (TyG) index has been proposed as a potential predictor of adverse prognosis of coronary heart disease (CHD). However, its prognostic value in patients with CHD and hypertension remains unclear. This study aimed to evaluate the association between the TyG index and the 1-year risk of major adverse cardiovascular events (MACEs) in patients with CHD and hypertension. METHODS The data for the study were taken from the Hospital Information System database in China-Japan Friendship Hospital which contained over 10,000 cardiovascular admissions from 2019 to 2022. The Boruta algorithm was performed for feature selection. The study used univariable analysis, multivariable logistic regression analysis, and restricted cubic spline (RCS) regression to evaluate the association between the TyG index and the 1-year risk of MACEs in patients with CHD and hypertension. RESULTS After applying inclusion and exclusion criteria, a total of 810 patients with CHD and hypertension were included in the study with a median TyG index of 8.85 (8.48, 9.18). Using the lowest TyG index quartile as the reference, the fully adjusted ORs (95% CIs) for 1-year MACEs for TyG index Q2, Q3, and Q4 were 1.001 (0.986 ~ 1.016), 1.047 (1.032 ~ 1.062), and 1.760 (1.268 ~ 2.444), respectively. After adjusting for all confounders, we found that those with the highest TyG index had a 47.0% increased risk of MACEs over the 1-year follow-up (OR 1.470, 95% CI 1.071 ~ 2.018). The results in the subgroup analysis were similar to the main analyses. RCS model suggested that the TyG index was nonlinearly associated with the 1-year risk of MACEs (P for nonlinear < 0.001). CONCLUSION This study shows that the elevated TyG index is a potential marker of adverse prognosis among patients with CHD and hypertension and informs the development of clinical decisions to improve outcomes.
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Affiliation(s)
- Shiyi Tao
- Department of Cardiology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Lintong Yu
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Jun Li
- Department of Cardiology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
| | - Li Huang
- Department of Integrative Cardiology, China-Japan Friendship Hospital, Beijing, China
| | - Xuanchun Huang
- Department of Cardiology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Wenjie Zhang
- Department of Cardiology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Zicong Xie
- Department of Cardiology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yuqing Tan
- Department of Cardiology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Deshuang Yang
- Department of Integrative Cardiology, China-Japan Friendship Hospital, Beijing, China
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Yang Y, Ma M, Zhang J, Jin S, Zhang D, Lin X. Triglyceride-glucose index in the prediction of clinical outcomes after successful recanalization for coronary chronic total occlusions. Cardiovasc Diabetol 2023; 22:304. [PMID: 37940976 PMCID: PMC10634094 DOI: 10.1186/s12933-023-02037-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 10/17/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND Triglyceride-glucose index (TyG) has been widely used to predict cardiovascular outcomes. However, it remains unclear whether TyG holds prognostic significance for patients with coronary chronic total occlusions (CTO). Thus, our study aimed to evaluate the predictive accuracy and prognostic value of TyG in individuals who underwent successful percutaneous coronary intervention (PCI) for CTO. METHODS A total of 331 consecutive patients with ≥ 1 successful CTO-PCI were included. The baseline and angiographic data were acquired. The duration of follow-up ranged from 32 to 79 months, with a median of 44 months and an interquartile range of 39 to 67 months. The primary outcome measured was the occurrence of major adverse cardiac and cerebrovascular events (MACCE), including mortality, target vessel revascularization, recurrent myocardial infarction, and stroke. RESULTS After controlling for confounders, multivariate Cox regression analysis revealed that TyG remained statistically significant, regardless of being a continuous or categorical variable. In the partially adjusted regression model, the Hazard ratio (95%CI) for MACCE was 2.54 (1.12-5.79) in tertile 3 and 1.61 (1.22-2.12) per SD increase in the TyG.Kaplan-Meier survival analysis demonstrated significant differences in MACCE-free survival rates across tertiles of the TyG, as indicated by the log-rank test (p = 0.001). ROC analysis was conducted to evaluate the predictive ability of TyG for MACCE, resulting in an AUC of 0.677. CONCLUSION The TyG index demonstrates independent predictive capabilities for MACCE in patients who have undergone successful CTO-PCI. These findings suggest that TyG holds the potential as a valuable tool in risk stratification and the identification of patients who may benefit from early intervention in the management of CTO.
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Affiliation(s)
- Yu Yang
- Department of cardiology, The First Affiliated Hospital of Anhui Medical University, Hefei city, 230022, Anhui province, China
| | - Mengqing Ma
- Department of cardiology, The First Affiliated Hospital of Anhui Medical University, Hefei city, 230022, Anhui province, China
| | - Jian Zhang
- Department of cardiology, The First Affiliated Hospital of Anhui Medical University, Hefei city, 230022, Anhui province, China
| | - Shiyu Jin
- Department of cardiology, The First Affiliated Hospital of Anhui Medical University, Hefei city, 230022, Anhui province, China
| | - Dingxin Zhang
- Department of cardiology, The First Affiliated Hospital of Anhui Medical University, Hefei city, 230022, Anhui province, China
| | - Xianhe Lin
- Department of cardiology, The First Affiliated Hospital of Anhui Medical University, Hefei city, 230022, Anhui province, China.
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Zhang Z, Zhao L, Lu Y, Meng X, Zhou X. Relationship of triglyceride-glucose index with cardiometabolic multi-morbidity in China: evidence from a national survey. Diabetol Metab Syndr 2023; 15:226. [PMID: 37926824 PMCID: PMC10626797 DOI: 10.1186/s13098-023-01205-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 11/01/2023] [Indexed: 11/07/2023] Open
Abstract
BACKGROUND Cardiometabolic multi-morbidity (CMM) is emerging as a global healthcare challenge and a pressing public health concern worldwide. Previous studies have principally focused on identifying risk factors for individual cardiometabolic diseases, but reliable predictors of CMM have not been identified. In the present study, we aimed to characterize the relationship of triglyceride-glucose (TyG) index with the incidence of CMM. METHODS We enrolled 7,970 participants from the China Health and Retirement Longitudinal Study (CHARLS) and placed them into groups according to quartile of TyG index. The endpoint of interest was CMM, defined as the presence of at least two of the following: stroke, heart disease, and diabetes mellitus. Cox regression models and multivariable-adjusted restricted cubic spline (RCS) curves were used to evaluate the relationship between TyG index and CMM. RESULTS In total, 638 (8.01%) incident cases of CMM were recorded among the participants who did not have CMM at baseline (2011) during a median follow-up of 84 months (interquartile range, 20‒87 months). The incidences of CMM for the participants in quartiles (Q) 1-4 of TyG index were 4.22%, 6.12%, 8.78%, and 12.60%, respectively. A fully adjusted Cox model showed that TyG index was closely associated with the incidence of CMM: the hazard ratio (HR) [95% confidence interval (CI)] for each 1.0-unit increment in TyG index for CMM was 1.54 (1.29-1.84); and the HRs (95% CIs) for Q3 and Q4 (Q1 as reference) of the TyG index for CMM were 1.41 (1.05-1.90) and 1.61 (1.18-2.20), respectively. The association of TyG index with the incidence of CMM was present in almost all the subgroups, and persisted in the sensitivity analyses and additional analyses. Multivariable-adjusted RCS analysis revealed a significant dose-response relationship of TyG index with the risk of CMM (overall P < 0.001; non-linear P = 0.129). CONCLUSIONS We found that a high TyG index is associated with a higher risk of incident CMM. This finding may have significance for clinical practice and facilitate the creation of a personalized prevention strategy that involves monitoring the TyG index.
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Affiliation(s)
- Zenglei Zhang
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No.167, Beilishi Road, Xicheng District, Beijing, China
| | - Lin Zhao
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No.167, Beilishi Road, Xicheng District, Beijing, China
| | - Yiting Lu
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No.167, Beilishi Road, Xicheng District, Beijing, China
| | - Xu Meng
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No.167, Beilishi Road, Xicheng District, Beijing, China.
| | - Xianliang Zhou
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No.167, Beilishi Road, Xicheng District, Beijing, China.
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Dong S, Zhao Z, Huang X, Ma M, Yang Z, Fan C, Han H, Wang Z, Shi D, Zhou Y. Triglyceride-glucose index is associated with poor prognosis in acute coronary syndrome patients with prior coronary artery bypass grafting undergoing percutaneous coronary intervention. Cardiovasc Diabetol 2023; 22:286. [PMID: 37891647 PMCID: PMC10612342 DOI: 10.1186/s12933-023-02029-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 10/12/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND The triglyceride-glucose (TyG) index, which is a reliable substitute indicator for insulin resistance, has been considered an independent risk factor for long-term outcomes in patients with cardiovascular disease. However, it remains unknown whether the TyG index is associated with poor prognosis in acute coronary syndrome (ACS) patients with prior coronary artery bypass grafting (CABG) undergoing percutaneous coronary intervention (PCI). METHODS A total of 1158 ACS patients with prior CABG undergoing PCI were retrospectively studied. The TyG index was calculated by ln[fasting triglyceride (mg/dL) × fasting blood glucose (mg/dL)/2]. The primary endpoint was major adverse cardiovascular and cerebrovascular events (MACCE), a composite of all-cause death, nonfatal myocardial infarction, nonfatal stroke, and unplanned repeat revascularization. RESULTS During a median of 42-month follow-up, 350 patients (30.2%) experienced at least one endpoint event. Based on the optimal cut-off value of the TyG index, patients were divided into the high TyG index group and the low TyG index group. Patients in the high TyG index group had higher risks of MACCE (35.3% vs. 25.3%, p < 0.001), major adverse cardiovascular events (MACE) (31.1% vs. 23.4%, p = 0.003), nonfatal stroke (4.2% vs. 1.9%, p = 0.022) and unplanned repeat revascularization (19.4% vs. 11.3%, p < 0.001) than those in the low TyG index group. Cox regression analysis demonstrated that there was an independent association between the TyG index and MACCE regardless of whether the TyG index was a continuous or categorical variable (HR 1.42, 95% CI 1.09-1.86, p = 0.009; HR 1.53, 95% CI 1.16-2.01, p = 0.003, respectively). Restricted cubic spline curve exhibited that the relationship between the TyG index and MACCE was linear (p for non-linear = 0.595, p for overall = 0.005). By incorporating the TyG index groups into baseline risk model, the accuracy of predicting MACCE was improved [AUC: baseline risk model, 0.618 vs. baseline risk model + TyG index groups, 0.636, p for comparison = 0.042]. CONCLUSIONS The TyG index is independently associated with MACCE, suggesting that the TyG index may serve as a valid indicator for predicting poor prognosis in ACS patients with prior CABG undergoing PCI.
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Affiliation(s)
- Shutong Dong
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical center for coronary heart disease, Capital Medical University, Beijing, 100029, China
| | - Zehao Zhao
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical center for coronary heart disease, Capital Medical University, Beijing, 100029, China
| | - Xin Huang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical center for coronary heart disease, Capital Medical University, Beijing, 100029, China
| | - Meishi Ma
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical center for coronary heart disease, Capital Medical University, Beijing, 100029, China
| | - Zhiqiang Yang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical center for coronary heart disease, Capital Medical University, Beijing, 100029, China
| | - Chu Fan
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical center for coronary heart disease, Capital Medical University, Beijing, 100029, China
| | - Hongya Han
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical center for coronary heart disease, Capital Medical University, Beijing, 100029, China
| | - Zhijian Wang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical center for coronary heart disease, Capital Medical University, Beijing, 100029, China
| | - Dongmei Shi
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical center for coronary heart disease, Capital Medical University, Beijing, 100029, China
| | - Yujie Zhou
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical center for coronary heart disease, Capital Medical University, Beijing, 100029, China.
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Ozyildirim S, Barman HA, Dogan O, Ersanli MK, Dogan SM. The Relationship between Coronary Flow Reserve and the TyG Index in Patients with Gestational Diabetes Mellitus. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1811. [PMID: 37893529 PMCID: PMC10608421 DOI: 10.3390/medicina59101811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 09/15/2023] [Accepted: 09/25/2023] [Indexed: 10/29/2023]
Abstract
Background and Objectives: Gestational diabetes mellitus (GDM) is a prevalent metabolic disorder characterized by glucose intolerance during pregnancy. The triglyceride glucose (TyG) index, a marker of insulin resistance, and coronary flow reserve (CFR), a measure of coronary microvascular function, are emerging as potential indicators of cardiovascular risk. This study aims to investigate the association between CFR and the TyG index in GDM patients. Materials and Methods: This cross-sectional study of 87 GDM patients and 36 healthy controls was conducted. The participants underwent clinical assessments, blood tests, and echocardiographic evaluations. The TyG index was calculated as ln(triglycerides × fasting glucose/2). CFR was measured using Doppler echocardiography during rest and hyperemia induced by dipyridamole. Results: The study included 87 individuals in the GDM group and 36 individuals in the control group. There was no significant difference in age between the two groups (34.1 ± 5.3 years for GDM vs. 33.1 ± 4.9 years for the control, p = 0.364). The TyG index was significantly higher in the GDM group compared to the controls (p < 0.001). CFR was lower in the GDM group (p < 0.001). A negative correlation between the TyG index and CFR was observed (r = -0.624, p < 0.001). Linear regression revealed the TyG index as an independent predictor of reduced CFR. Conclusions: The study findings reveal a significant association between the TyG index and CFR in GDM patients, suggesting their potential role in assessing cardiovascular risk.
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Affiliation(s)
| | - Hasan Ali Barman
- Institute of Cardiology, Department of Cardiology, Istanbul University-Cerrahpasa, Istanbul 34320, Turkey; (S.O.); (O.D.); (M.K.E.); (S.M.D.)
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12
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Chen W, Wang X, Jiang Q, Wu J, Shi W, Wang X, Yin Y, Zheng J, Hu X, Lin C, Zhang X. Association between triglyceride glucose index and severity of diabetic foot ulcers in type 2 diabetes mellitus. J Foot Ankle Res 2023; 16:68. [PMID: 37794445 PMCID: PMC10552301 DOI: 10.1186/s13047-023-00663-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 09/04/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Triglyceride glucose (TyG) index is a good surrogate biomarker to evaluate insulin resistance (IR). The study aimed to investigate whether the TyG index is related to the severity of diabetic foot ulcers (DFUs) in patients with type 2 diabetes mellitus (T2DM). METHODS A total of 1059 T2DM patients were enrolled in this observational, retrospective, single-center study. TyG index was calculated as ln[fasting triglycerides (mg/dl) × fasting glucose (mg/ dl)/2]. The severity of DFUs was classified into mild-to-moderate DFUs (Wagner grade score < 3) and severe DFUs (Wagner grade score ≥ 3) based on Wagner classification. Patients were stratified according to the tertiles of TyG index. Logistic regression models were implemented to explore the association between TyG index and the severity of DFUs. Subgroup analyses were used to verify the reliability of results. RESULTS Compared with the reference lowest TyG tertile (T1), the highest tertile (T3) was associated with 0.377-fold increased risk of prevalence of severe DFUs (odds ratio [OR] 1.377, 95% confidence interval [CI] 1.017-1.865) (P = 0.039). After adjusting for potential confounders, the multivariable-adjusted OR and 95% CI were 1.506 (1.079-2.103) (P = 0.016) in patients with highest tertile. Moreover, subgroup analyses indicated that the association was stronger among men, patients with age ≥ 65 years, duration of diabetes more than 10 years, or without PAD. CONCLUSIONS Elevated TyG index is independently associated with severity of DFUs even after adjusting conventional confounders.
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Affiliation(s)
- Weihao Chen
- Department of Burn and Wound Center, The First Affiliated Hospital of Wenzhou Medical University, Shangcai Village, Wenzhou, 325000, Zhejiang, China
| | - Xuedong Wang
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Wenzhou Medical University, Shangcai Village, Wenzhou, 325000, Zhejiang, China
| | - Qilin Jiang
- Department of Burn and Wound Center, The First Affiliated Hospital of Wenzhou Medical University, Shangcai Village, Wenzhou, 325000, Zhejiang, China
| | - Jiyan Wu
- Department of Burn and Wound Center, The First Affiliated Hospital of Wenzhou Medical University, Shangcai Village, Wenzhou, 325000, Zhejiang, China
| | - Wanyan Shi
- Department of Internal Medicine, Taishun County Hospital of Traditional Chinese Medicine, Wenzhou, Zhejiang, China
| | - Xiaoxiao Wang
- Department of Endocrine, Wencheng People's Hospital, Wenzhou, Zhejiang, China
| | - Yihu Yin
- Department of Burn and Wound Center, The First Affiliated Hospital of Wenzhou Medical University, Shangcai Village, Wenzhou, 325000, Zhejiang, China
| | - Jiayin Zheng
- Department of Clinical Laboratory, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xiang Hu
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Wenzhou Medical University, Shangcai Village, Wenzhou, 325000, Zhejiang, China.
| | - Cai Lin
- Department of Burn and Wound Center, The First Affiliated Hospital of Wenzhou Medical University, Shangcai Village, Wenzhou, 325000, Zhejiang, China.
| | - Xingxing Zhang
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Wenzhou Medical University, Shangcai Village, Wenzhou, 325000, Zhejiang, China.
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Li H, Jiang Y, Su X, Meng Z. The triglyceride glucose index was U-shape associated with all-cause mortality in population with cardiovascular diseases. Diabetol Metab Syndr 2023; 15:181. [PMID: 37679825 PMCID: PMC10483863 DOI: 10.1186/s13098-023-01153-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 08/20/2023] [Indexed: 09/09/2023] Open
Abstract
BACKGROUND The triglyceride and glucose (TyG) index has been considered a simple surrogate marker of insulin resistance, related to a high risk of mortality. However, few studies have investigated the specific relationship between the TyG index and all-cause mortality among population with cardiovascular diseases. METHODS 2,072 participants with cardiovascular diseases were enrolled from the National Health and Nutrition Examination Survey (NHANES) 1999-2014. The TyG index was calculated as log [fasting triglycerides (mg/dL) x fasting glucose (mg/dL)/2]. Outcomes were all-cause mortality and cardiovascular mortality. The baseline levels of TyG associated with the risk of mortality were evaluated on a continuous scale (restricted cubic splines) and by a priori defined quantile categories with Cox regression models. RESULTS After a follow-up of 16.8 years, 791 all-cause deaths and 184 cardiovascular deaths occurred. Restricted cubic splines showed that the association between levels of TyG index and the risk of all-cause mortality was non-linear (p < 0.001) and the TyG index associated with the lowest risk of all-cause mortality ranges 8.83 to 9.06 in individuals with cardiovascular diseases. Compared with the reference quartile of 8.84 ~ 9.29, the multivariate-adjusted hazards ratios and 95% confidence intervals were 1.40 (1.13-1.74; p = 0.002) in the lowest quartile and 1.08 (0.88, 1.32; p = 0.475) in the highest quartile for all-cause mortality. However, TyG was not associated with cardiovascular mortality. CONCLUSIONS TyG index was U-shape associated with the risk of all-cause mortality in participants with cardiovascular diseases and the level associated with the lowest risk ranged 8.83 to 9.06.
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Affiliation(s)
- Haiyu Li
- Department Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yaohui Jiang
- Department Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xin Su
- Department Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zhe Meng
- Department Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
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Liang S, Wang C, Zhang J, Liu Z, Bai Y, Chen Z, Huang H, He Y. Triglyceride-glucose index and coronary artery disease: a systematic review and meta-analysis of risk, severity, and prognosis. Cardiovasc Diabetol 2023; 22:170. [PMID: 37415168 PMCID: PMC10327356 DOI: 10.1186/s12933-023-01906-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 06/28/2023] [Indexed: 07/08/2023] Open
Abstract
BACKGROUND The TyG index is an indicator of insulin resistance (IR), which is associated with the development and prognosis of cardiovascular disease. This study aimed to summarize the relationship between the TyG index and the risk, severity, and prognosis of coronary artery disease (CAD) by performing a systematic review and meta-analysis. METHODS The PubMed, EMBASE, The Cochrane Library, and Web of Science databases were searched for articles published from inception until May 1, 2023. Cross-sectional studies, retrospective or prospective cohort studies recruiting patients with CAD were included. For the analysis of CAD severity, the outcomes were coronary artery calcification, coronary artery stenosis, coronary plaque progression, multi-vessel CAD, and in-stent re-stenosis. For the analysis of CAD prognosis, the primary outcome was major adverse cardiovascular events (MACE). RESULTS Forty-one studies were included in this study. Compared to patients with the lowest TyG index, those with the highest TyG index had a higher CAD risk [odds ratio (OR): 1.94, 95% confidence interval (CI) 1.20-3.14, I2 = 91%, P = 0.007]. Additionally, these patients were more likely to have stenotic coronary arteries (OR: 3.49, 95% CI 1.71-7.12, I2 = 0%, P = 0.0006), progressed plaques (OR: 1.67, 95% CI 1.28-2.19, I2 = 0%, P = 0.002), and with more vessels involved (OR: 2.33, 95% CI 1.59-3.42, I2 = 0%, P < 0.0001). When calculated as a categorized variable, it appears that acute coronary syndrome (ACS) patients with higher TyG index levels may have a higher incidence rate of MACE [hazard ratio (HR): 2.09, 95% CI 1.68-2.62, I2 = 87%, P < 0.00001], whereas chronic coronary syndrome (CCS) or stable CAD patients with higher TyG index levels showed a trend towards an increased incidence rate of MACE (HR: 1.24, 95% CI 0.96-1.60, I2 = 85%, P = 0.09). When calculated as a continuous variable, ACS patients had an HR of 2.28 per 1-unit/1-standard deviation increment of the TyG index (95% CI 1.44-3.63, I2 = 95%, P = 0.0005). Similarly, CCS or stable CAD patients had an HR of 1.49 per 1-unit/1-standard deviation increment of the TyG index (95% CI 1.21-1.83, I2 = 75%, P = 0.0001). Myocardial infarction with non-obstructive coronary arteries patients had an HR of 1.85 per 1-unit increment of the TyG index (95% CI 1.17-2.93, P = 0.008). CONCLUSIONS The TyG index is a simple new synthetic index that has been proven to be a valuable tool in the whole-course management of CAD patients. Patients with higher TyG index levels are at a higher risk of CAD, more severe coronary artery lesions, and worse prognosis compared to those with lower TyG index levels.
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Affiliation(s)
- Shichu Liang
- Department of Cardiology, West China Hospital, Sichuan University, No.37 GuoXue Alley, Chengdu, 610041, China
| | - Cui Wang
- Department of Endocrinology & Metabolism, Laboratory of Endocrinology & Metabolism, and Rare Disease Center, West China Hospital, Sichuan University, Chengdu, China
| | - Jing Zhang
- Department of Cardiology, West China Hospital, Sichuan University, No.37 GuoXue Alley, Chengdu, 610041, China
- West China School of Nursing, Sichuan University, Chengdu, China
| | - Zhiyue Liu
- Department of Cardiology, West China Hospital, Sichuan University, No.37 GuoXue Alley, Chengdu, 610041, China
| | - Yanlin Bai
- West China School of Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Zhonglan Chen
- Department of Cardiology, West China Hospital, Sichuan University, No.37 GuoXue Alley, Chengdu, 610041, China
- West China School of Nursing, Sichuan University, Chengdu, China
| | - He Huang
- Department of Cardiology, West China Hospital, Sichuan University, No.37 GuoXue Alley, Chengdu, 610041, China.
| | - Yong He
- Department of Cardiology, West China Hospital, Sichuan University, No.37 GuoXue Alley, Chengdu, 610041, China.
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Liu Y, Zhu B, Zhou W, Du Y, Qi D, Wang C, Cheng Q, Zhang Y, Wang S, Gao C. Triglyceride-glucose index as a marker of adverse cardiovascular prognosis in patients with coronary heart disease and hypertension. Cardiovasc Diabetol 2023; 22:133. [PMID: 37296406 PMCID: PMC10257289 DOI: 10.1186/s12933-023-01866-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 05/25/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND The triglyceride-glucose (TyG) index has been proposed as a potential predictor of adverse prognosis of cardiovascular diseases (CVDs). However, its prognostic value in patients with coronary heart disease (CHD) and hypertension remains unclear. METHODS A total of 1467 hospitalized patients with CHD and hypertension from January 2021 to December 2021 were included in this prospective and observational clinical study. The TyG index was calculated as Ln [fasting triglyceride level (mg/dL) × fasting plasma glucose level (mg/dL)/2]. Patients were divided into tertiles according to TyG index values. The primary endpoint was a compound endpoint, defined as the first occurrence of all-cause mortality or total nonfatal CVDs events within one-year follow up. The secondary endpoint was atherosclerotic CVD (ASCVD) events, including non-fatal stroke/transient ischemic attack (TIA) and recurrent CHD events. We used restricted cubic spline analysis and multivariate adjusted Cox proportional hazard models to investigate the associations of the TyG index with primary endpoint events. RESULTS During the one-year follow-up period, 154 (10.5%) primary endpoint events were recorded, including 129 (8.8%) ASCVD events. After adjusting for confounding variables, for per standard deviation (SD) increase in the TyG index, the risk of incident primary endpoint events increased by 28% [hazard ratio (HR) = 1.28, 95% confidence interval (CI) 1.04-1.59]. Compared with subjects in the lowest tertile (T1), the fully adjusted HR for primary endpoint events was 1.43 (95% CI 0.90-2.26) in the middle (T2) and 1.73 (95% CI 1.06-2.82) in highest tertile (T3) (P for trend = 0.018). Similar results were observed in ASCVD events. Restricted cubic spline analysis also showed that the cumulative risk of primary endpoint events increased as TyG index increased. CONCLUSIONS The elevated TyG index was a potential marker of adverse prognosis in patients with CHD and hypertension.
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Affiliation(s)
- Yahui Liu
- Department of Cardiology, Zhengzhou University People's Hospital, Henan Provincial People's Hospital, Zhengzhou, China
- Henan Provincial Key Lab for Control of Coronary Heart Disease, Zhengzhou University Central China Fuwai Hospital, Zhengzhou, 451464, China
| | - Binbin Zhu
- Department of Cardiology, Zhengzhou University People's Hospital, Henan Provincial People's Hospital, Zhengzhou, China
- Henan Provincial Key Lab for Control of Coronary Heart Disease, Zhengzhou University Central China Fuwai Hospital, Zhengzhou, 451464, China
| | - Weicen Zhou
- Henan Provincial Key Lab for Control of Coronary Heart Disease, Zhengzhou University Central China Fuwai Hospital, Zhengzhou, 451464, China
| | - Yao Du
- Henan Provincial Key Lab for Control of Coronary Heart Disease, Zhengzhou University Central China Fuwai Hospital, Zhengzhou, 451464, China
| | - Datun Qi
- Department of Cardiology, Zhengzhou University People's Hospital, Henan Provincial People's Hospital, Zhengzhou, China
- Henan Provincial Key Lab for Control of Coronary Heart Disease, Zhengzhou University Central China Fuwai Hospital, Zhengzhou, 451464, China
| | - Chenxu Wang
- Henan Provincial Key Lab for Control of Coronary Heart Disease, Zhengzhou University Central China Fuwai Hospital, Zhengzhou, 451464, China
| | - Qianqian Cheng
- Henan Provincial Key Lab for Control of Coronary Heart Disease, Zhengzhou University Central China Fuwai Hospital, Zhengzhou, 451464, China
| | - You Zhang
- Henan Provincial Key Lab for Control of Coronary Heart Disease, Zhengzhou University Central China Fuwai Hospital, Zhengzhou, 451464, China
| | - Shan Wang
- Henan Provincial Key Lab for Control of Coronary Heart Disease, Zhengzhou University Central China Fuwai Hospital, Zhengzhou, 451464, China
| | - Chuanyu Gao
- Department of Cardiology, Zhengzhou University People's Hospital, Henan Provincial People's Hospital, Zhengzhou, China.
- Henan Provincial Key Lab for Control of Coronary Heart Disease, Zhengzhou University Central China Fuwai Hospital, Zhengzhou, 451464, China.
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Liu X, Abudukeremu A, Jiang Y, Cao Z, Wu M, Ma J, Sun R, He W, Chen Z, Chen Y, Yu P, Zhu W, Zhang Y, Wang J. U-shaped association between the triglyceride-glucose index and atrial fibrillation incidence in a general population without known cardiovascular disease. Cardiovasc Diabetol 2023; 22:118. [PMID: 37208737 DOI: 10.1186/s12933-023-01777-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 02/20/2023] [Indexed: 05/21/2023] Open
Abstract
OBJECTIVE The triglyceride-glucose (TyG) index has been shown to be a new alternative measure for insulin resistance. However, no study has attempted to investigate the association of the TyG index with incident atrial fibrillation (AF) in the general population without known cardiovascular diseases. METHODS Individuals without known cardiovascular diseases (heart failure, coronary heart disease, or stroke) from the Atherosclerosis Risk in Communities (ARIC) cohort were recruited. The baseline TyG index was calculated as the Ln [fasting triglycerides (mg/dL) × fasting glucose (mg/dL)/2]. The association between the baseline TyG index and incident AF was examined using Cox regression. RESULTS Of 11,851 participants, the mean age was 54.0 years; 6586 (55.6%) were female. During a median follow-up of 24.26 years, 1925 incidents of AF cases (0.78/per 100 person-years) occurred. An increased AF incidence with a graded TyG index was found by Kaplan‒Meier curves (P < 0.001). In multivariable-adjusted analysis, both < 8.80 (adjusted hazard ratio [aHR] = 1.15, 95% confidence interval [CI] 1.02, 1.29) and > 9.20 levels (aHR 1.18, 95% CI 1.03, 1.37) of the TyG index were associated with an increased risk of AF compared with the middle TyG index category (8.80-9.20). The exposure-effect analysis confirmed the U-shaped association between the TyG index and AF incidence (P = 0.041). Further sex-specific analysis showed that a U-shaped association between the TyG index and incident AF still existed in females but not in males. CONCLUSIONS A U-shaped association between the TyG index and AF incidence is observed in Americans without known cardiovascular diseases. Female sex may be a modifier in the association between the TyG index and AF incidence.
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Affiliation(s)
- Xiao Liu
- Department of Cardiology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangdong-Hong Kong Joint Laboratory for RNA Medicine, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, China
- Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, China
- Institute for the Study of Endocrinology and Metabolism in Jiangxi Province, The Second Affiliated Hospital of Nanchang University, Jiangxi, China
| | - Ayiguli Abudukeremu
- Department of Cardiology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Yuan Jiang
- Department of Cardiology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangdong-Hong Kong Joint Laboratory for RNA Medicine, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, China
- Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, China
| | - Zhengyu Cao
- Department of Cardiology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, China
- Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, China
| | - Maoxiong Wu
- Department of Cardiology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, China
- Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, China
| | - Jianyong Ma
- Department of Pharmacology and Systems Physiology, University of Cincinnati College of Medicine, Cincinnati, USA
| | - Runlu Sun
- Department of Cardiology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, China
- Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, China
| | - Wanbing He
- Department of Cardiology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, China
- Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, China
| | - Zhiteng Chen
- Department of Cardiology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, China
- Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, China
| | - Yangxin Chen
- Department of Cardiology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangdong-Hong Kong Joint Laboratory for RNA Medicine, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, China
- Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, China
| | - Peng Yu
- Institute for the Study of Endocrinology and Metabolism in Jiangxi Province, The Second Affiliated Hospital of Nanchang University, Jiangxi, China.
- Department of Endocrine, The Second Affiliated Hospital of Nanchang University, Jiangxi, China.
| | - Wengen Zhu
- Department of Cardiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
| | - Yuling Zhang
- Department of Cardiology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, China.
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangdong-Hong Kong Joint Laboratory for RNA Medicine, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, China.
- Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, China.
| | - Jingfeng Wang
- Department of Cardiology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, China.
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangdong-Hong Kong Joint Laboratory for RNA Medicine, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, China.
- Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, China.
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Liu F, Ling Q, Xie S, Xu Y, Liu M, Hu Q, Ma J, Yan Z, Gao Y, Zhao Y, Zhu W, Yu P, Luo J, Liu X. Association between triglyceride glucose index and arterial stiffness and coronary artery calcification: a systematic review and exposure-effect meta-analysis. Cardiovasc Diabetol 2023; 22:111. [PMID: 37179288 PMCID: PMC10183133 DOI: 10.1186/s12933-023-01819-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 03/30/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND The triglyceride and glucose (TyG) index has been linked to various cardiovascular diseases. However, it's still unclear whether the TyG index is associated with arterial stiffness and coronary artery calcification (CAC). METHODS We conducted a systematic review and meta-analysis of relevant studies until September 2022 in the PubMed, Cochrane Library, and Embase databases. We used a random-effects model to calculate the pooled effect estimate and the robust error meta-regression method to summarize the exposure-effect relationship. RESULTS Twenty-six observational studies involving 87,307 participants were included. In the category analysis, the TyG index was associated with the risk of arterial stiffness (odds ratio [OR]: 1.83; 95% CI 1.55-2.17, I2 = 68%) and CAC (OR: 1.66; 95% CI 1.51-1.82, I2 = 0). The per 1-unit increment in the TyG index was also associated with an increased risk of arterial stiffness (OR: 1.51, 95% CI 1.35-1.69, I2 = 82%) and CAC (OR: 1.73, 95% CI 1.36-2.20, I2 = 51%). Moreover, a higher TyG index was shown to be a risk factor for the progression of CAC (OR = 1.66, 95% CI 1.21-2.27, I2 = 0, in category analysis, OR = 1.47, 95% CI 1.29-1.68, I2 = 41% in continuity analysis). There was a positive nonlinear association between the TyG index and the risk of arterial stiffness (Pnonlinearity < 0.001). CONCLUSION An elevated TyG index is associated with an increased risk of arterial stiffness and CAC. Prospective studies are needed to assess causality.
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Affiliation(s)
- Fuwei Liu
- Department of Cardiology, The Affiliated Ganzhou Hospital of Nanchang University, Jiangxi, China
| | - Qin Ling
- Department of Cardiology, The Affiliated Ganzhou Hospital of Nanchang University, Jiangxi, China
- The Second Clinical Medical College of Nanchang University, The Second Affiliated Hospital of Nanchang University, Nanchang, 330006, China
| | - Shaofeng Xie
- Department of Cardiology, The Affiliated Ganzhou Hospital of Nanchang University, Jiangxi, China
| | - Yi Xu
- The Second Clinical Medical College of Nanchang University, The Second Affiliated Hospital of Nanchang University, Nanchang, 330006, China
| | - Menglu Liu
- Department of Cardiology, Seventh People's Hospital of Zhengzhou, Zhengzhou, Henan, China
| | - Qingwen Hu
- The Second Clinical Medical College of Nanchang University, The Second Affiliated Hospital of Nanchang University, Nanchang, 330006, China
| | - Jianyong Ma
- Department of Pharmacology and Systems Physiology, University of Cincinnati College of Medicine, Cincinnati, USA
| | - Zhiwei Yan
- Department of Sports Rehabilitation, College of Human Kinesiology, Shenyang Sport University, Shenyang, China
- Provincial University Key Laboratory of Sport and Health Science, School of Physical Education and Sport Sciences, Fujian Normal University, Fuzhou, Fujian, China
| | - Yan Gao
- Department of Sports Rehabilitation, College of Human Kinesiology, Shenyang Sport University, Shenyang, China
| | - Yujie Zhao
- Department of Cardiology, Seventh People's Hospital of Zhengzhou, Zhengzhou, Henan, China
| | - Wengen Zhu
- Department of Cardiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Peng Yu
- Department of Endocrine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Jun Luo
- Department of Cardiology, The Affiliated Ganzhou Hospital of Nanchang University, Jiangxi, China.
| | - Xiao Liu
- Department of Cardiology, The Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China
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18
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Nádasdi Á, Gál V, Masszi T, Somogyi A, Firneisz G. PNPLA3 rs738409 risk genotype decouples TyG index from HOMA2-IR and intrahepatic lipid content. Cardiovasc Diabetol 2023; 22:64. [PMID: 36944955 PMCID: PMC10031960 DOI: 10.1186/s12933-023-01792-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 03/06/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND Recent reports suggested a different predictive value for TyG index compared to HOMA-IR in coronary artery calcification (CAC) and other atherosclerotic outcomes, despite that both indices are proposed as surrogate markers of insulin resistance. We hypothesized a key role for liver pathology as an explanation and therefore assessed the relationship among the two indices and the intrahepatic lipid content stratified by PNPLA3 rs738409 genotypes as a known non-alcoholic fatty liver disease (NAFLD) genetic risk. METHODS Thirty-nine women from a prior GDM-genetic study were recalled with PNPLA3 rs738409 CC and GG genotypes for metabolic phenotyping and to assess hepatic triglyceride content (HTGC). 75 g OGTT was performed, fasting lipid, glucose, insulin levels and calculated insulin resistance indices (TyG and HOMA2-IR) were used. HTGC was measured by MR based methods. Mann-Whitney-U, χ2 and for the correlation analysis Spearman rank order tests were applied. RESULTS The PNPLA3 rs738409 genotype had a significant effect on the direct correlation between the HOMA2-IR and TyG index: the correlation (R = 0.52, p = 0.0054) found in the CC group was completely abolished in those with the GG (NAFLD) risk genotype. In addition, the HOMA2-IR correlated with HTGC in the entire study population (R = 0.69, p < 0.0001) and also separately in both genotypes (CC R = 0.62, p = 0.0006, GG: R = 0.74, p = 0.0058). In contrast, the correlation between TyG index and HTGC was only significant in rs738409 CC genotype group (R = 0.42, p = 0.0284) but not in GG group. A similar pattern was observed in the correlation between TG and HTGC (CC: R = 0.41, p = 0.0335), when the components of the TyG index were separately assessed. CONCLUSIONS PNPLA3 rs738409 risk genotype completely decoupled the direct correlation between two surrogate markers of insulin resistance: TyG and HOMA2-IR confirming our hypothesis. The liver lipid content increased in parallel with the HOMA2-IR independent of genotype, in contrast to the TyG index where the risk genotype abolished the correlation. This phenomenon seems to be related to the nature of hepatic fat accumulation and to the different concepts establishing the two insulin resistance markers.
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Affiliation(s)
- Ákos Nádasdi
- Translational Medicine Institute, Faculty of Medicine, Semmelweis University, Budapest, Hungary
- Department of Internal Medicine and Haematology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Viktor Gál
- Brain Imaging Centre, Research Centre for Natural Sciences, Eötvös Loránd Research Network, Budapest, Hungary
- Medical Imaging Centre, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Tamás Masszi
- Department of Internal Medicine and Haematology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Anikó Somogyi
- Department of Internal Medicine and Haematology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Gábor Firneisz
- Translational Medicine Institute, Faculty of Medicine, Semmelweis University, Budapest, Hungary.
- Department of Internal Medicine and Haematology, Faculty of Medicine, Semmelweis University, Budapest, Hungary.
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19
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Shen J, Feng B, Fan L, Jiao Y, Li Y, Liu H, Hou X, Su Y, Li D, Fu Z. Triglyceride glucose index predicts all-cause mortality in oldest-old patients with acute coronary syndrome and diabetes mellitus. BMC Geriatr 2023; 23:78. [PMID: 36747129 PMCID: PMC9901061 DOI: 10.1186/s12877-023-03788-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 02/01/2023] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Acute coronary syndrome (ACS) and diabetes mellitus (DM) are the leading health risks for the elderly. Triglyceride-glucose (TyG) index is a novel and reliable indicator of insulin resistance (IR). This study aims to explore the relationship between the TyG index and all-cause mortality in oldest-old patients with ACS and DM. METHODS Seven hundred twenty hospitalized patients with ACS aged ≥ 80 years were enrolled, and 699 patients signed informed consent for the study. During the follow-up period, 37 were lost to follow-up, and the follow-up rate was 94.7%. 231 ACS patients with DM were selected for the study's analyses. Kaplan-Meier curve, Cox regression model and receiver operating characteristic (ROC) curve were used to analyze the association between the TyG index and all-cause mortality. RESULTS The mean age of participants was 81.58 ± 1.93 years, and 32.47% were women. Compared to TyG tertile 1, the Hazard Ratio (HR) [95% confidence interval (CI)] of all-cause mortality was 2.04 (1.09, 3.81) for TyG tertile 3 in the fully adjusted model. For the TyG index per standard deviation (SD) increment, the HR (95% CI) of all-cause mortality was 1.44 (1.13, 1.83). Further, the association between the TyG index and all-cause mortality was dose-response (P for trend = 0.026). ROC curve analyses indicated that the TyG index outperformed FBG and TG in the prediction of mortality risk and improved the prognostic value of the Gensini score combined with LVEF. CONCLUSION The TyG index predicts the risk of all-cause mortality in the oldest-old ACS patients with DM.
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Affiliation(s)
- Jian Shen
- grid.488137.10000 0001 2267 2324Senior Department of Cardiology, the Sixth Medical Center, Chinese PLA General Hospital and Chinese PLA Medical School, 100853 Beijing, China ,Outpatient Department of Tongzhou Retired Cadres Rest Center, Beijing, 101149 China
| | - Bin Feng
- grid.488137.10000 0001 2267 2324Senior Department of Cardiology, the Sixth Medical Center, Chinese PLA General Hospital and Chinese PLA Medical School, 100853 Beijing, China
| | - Li Fan
- grid.488412.3Department of Nutrition, Children’s Hospital of Chongqing Medical University, Chongqing, 400014 China
| | - Yang Jiao
- grid.488137.10000 0001 2267 2324Senior Department of Cardiology, the Sixth Medical Center, Chinese PLA General Hospital and Chinese PLA Medical School, 100853 Beijing, China
| | - Ying Li
- grid.488137.10000 0001 2267 2324Senior Department of Cardiology, the Sixth Medical Center, Chinese PLA General Hospital and Chinese PLA Medical School, 100853 Beijing, China
| | - Henan Liu
- grid.488137.10000 0001 2267 2324Senior Department of Cardiology, the Sixth Medical Center, Chinese PLA General Hospital and Chinese PLA Medical School, 100853 Beijing, China
| | - Xiaoling Hou
- grid.488137.10000 0001 2267 2324Senior Department of Cardiology, the Sixth Medical Center, Chinese PLA General Hospital and Chinese PLA Medical School, 100853 Beijing, China
| | - Yongkang Su
- grid.488137.10000 0001 2267 2324Senior Department of Cardiology, the Sixth Medical Center, Chinese PLA General Hospital and Chinese PLA Medical School, 100853 Beijing, China
| | - Dongyun Li
- Department of the First Health Care, the Second Medical Center, Chinese PLA General Hospital, Beijing, 100853, China.
| | - Zhenhong Fu
- Senior Department of Cardiology, the Sixth Medical Center, Chinese PLA General Hospital and Chinese PLA Medical School, 100853, Beijing, China.
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20
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Yang Y, Huang X, Wang Y, Leng L, Xu J, Feng L, Jiang S, Wang J, Yang Y, Pan G, Jiang B, Wang Y, Chen L. The impact of triglyceride-glucose index on ischemic stroke: a systematic review and meta-analysis. Cardiovasc Diabetol 2023; 22:2. [PMID: 36609319 PMCID: PMC9825038 DOI: 10.1186/s12933-022-01732-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 12/28/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Strokes significantly impair quality of life and incur high economic and societal burdens. The triglyceride and glucose (TyG) index is a biochemical marker of insulin resistance (IR) and may have important value in the prediction of strokes, especially ischemic stroke (IS). Our study aims to investigate the relationship between TyG index and IS and ascertain whether TyG index is independently associated with IS adverse outcomes. METHODS The Cochrane, Embase, Medline, Web of Science, PubMed, and other relevant English databases and related websites were systematically searched for articles on ''TyG index'' and "stroke" published from inception to April 4, 2022. We reviewed the available literature on the TyG index and its relation to predicting IS occurrence in the general population and adverse clinical outcomes. We calculated odds ratios (OR) of TyG index and its predictability of IS occurrence and adverse outcomes. Statistical analyses were performed using the Meta Package in STATA, version 12.0. RESULTS A total of 18 studies and 592,635 patients were included in our analysis. The pooled effect values of all stroke types showed that higher TyG index was associated with increased the risk of IS in the general population (OR 1.37; 95% CI 1.22-1.54) in a total sample of 554,334 cases with a high level of heterogeneity (P = 0.000, I2 = 74.10%). In addition, compared to IS patients with a lower TyG index, IS patients with a higher TyG index was associated with higher risk of stroke recurrence (OR: 1.50; 95% CI 1.19-1.89) and increased risk of mortality (OR 1.40 95% CI 1.14-1.71). No correlation was found in the effect value combinations of poor functional outcomes (OR 1.12; 95% CI 0.88-1.43) and neurological worsening (OR: 1.76; 95% CI 0.79-3.95) in a total sample of 38,301 cases with a high level of heterogeneity (P = 0.000; I2 = 77.20%). CONCLUSIONS TyG index has potential value in optimizing risk stratification for IS in the general population. Furthermore, there is a significant association between high TyG index and many adverse outcomes of stroke, especially stroke recurrence and high mortality. Future studies should focus on multi-center and multi-regional designs in order to further explore the relationship between IS and TyG index.
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Affiliation(s)
- Ying Yang
- grid.415440.0Geriatric Diseases Institute of Chengdu/Cancer Prevention and Treatment Institute of Chengdu, Department of Neurology, Chengdu Fifth People’s Hospital, (The Second Clinical Medical College, Affiliated Fifth People’s Hospital of Chengdu University of Traditional Chinese Medicine), Chengdu, China ,grid.411587.e0000 0001 0381 4112School of Computer Science and Technology, Chongqing University of Posts and Telecommunications, Chongqing, China
| | - Xiangting Huang
- grid.440809.10000 0001 0317 5955Department of Medicine, Jinggangshan University, Ji’an, Jiangxi China ,grid.13291.380000 0001 0807 1581The Centre of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Yuge Wang
- grid.440809.10000 0001 0317 5955Department of Medicine, Jinggangshan University, Ji’an, Jiangxi China
| | - Lin Leng
- grid.459428.6Department of Nephrology, Fifth People’s Hospital of Chengdu, Chengdu, China
| | - Jiapei Xu
- grid.415440.0Geriatric Diseases Institute of Chengdu/Cancer Prevention and Treatment Institute of Chengdu, Department of Neurology, Chengdu Fifth People’s Hospital, (The Second Clinical Medical College, Affiliated Fifth People’s Hospital of Chengdu University of Traditional Chinese Medicine), Chengdu, China
| | - Lei Feng
- grid.415440.0Geriatric Diseases Institute of Chengdu/Cancer Prevention and Treatment Institute of Chengdu, Department of Neurology, Chengdu Fifth People’s Hospital, (The Second Clinical Medical College, Affiliated Fifth People’s Hospital of Chengdu University of Traditional Chinese Medicine), Chengdu, China
| | - Shixie Jiang
- grid.168010.e0000000419368956Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA USA
| | - Jiang Wang
- grid.440809.10000 0001 0317 5955Department of Medicine, Jinggangshan University, Ji’an, Jiangxi China
| | - Yanrong Yang
- grid.415440.0Geriatric Diseases Institute of Chengdu/Cancer Prevention and Treatment Institute of Chengdu, Department of Neurology, Chengdu Fifth People’s Hospital, (The Second Clinical Medical College, Affiliated Fifth People’s Hospital of Chengdu University of Traditional Chinese Medicine), Chengdu, China
| | - Gaofeng Pan
- grid.415440.0Geriatric Diseases Institute of Chengdu/Cancer Prevention and Treatment Institute of Chengdu, Department of Neurology, Chengdu Fifth People’s Hospital, (The Second Clinical Medical College, Affiliated Fifth People’s Hospital of Chengdu University of Traditional Chinese Medicine), Chengdu, China
| | - Bing Jiang
- grid.415440.0Geriatric Diseases Institute of Chengdu/Cancer Prevention and Treatment Institute of Chengdu, Department of Neurology, Chengdu Fifth People’s Hospital, (The Second Clinical Medical College, Affiliated Fifth People’s Hospital of Chengdu University of Traditional Chinese Medicine), Chengdu, China
| | - Yan Wang
- Geriatric Diseases Institute of Chengdu/Cancer Prevention and Treatment Institute of Chengdu, Department of Neurology, Chengdu Fifth People's Hospital, (The Second Clinical Medical College, Affiliated Fifth People's Hospital of Chengdu University of Traditional Chinese Medicine), Chengdu, China.
| | - Lan Chen
- Department of Neurology, Affiliated Hospital of Jinggangshan University, JingGangshan University, Ji'an, Jiangxi province, 343000, China, .
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21
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Liao C, Xu H, Jin T, Xu K, Xu Z, Zhu L, Liu M. Triglyceride-glucose index and the incidence of stroke: A meta-analysis of cohort studies. Front Neurol 2023; 13:1033385. [PMID: 36686534 PMCID: PMC9845890 DOI: 10.3389/fneur.2022.1033385] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 12/05/2022] [Indexed: 01/05/2023] Open
Abstract
Background Insulin resistance (IR) is involved in the pathogenesis of atherosclerosis. As a new indicator, the triglyceride-glucose (TyG) index has greater operability for the evaluation of insulin resistance. Previous studies have shown inconsistent results in evaluating the association between the TyG index and stroke incidence in people without stroke at baseline. Therefore, this study aimed to systematically assess this association through a meta-analysis. Methods Cohort studies with the multivariate-adjusted hazard ratio (HR) association between the TyG index and stroke were obtained by searching the PubMed, Cochrane Library, and EMBASE databases before 16 December 2021. We pooled the adjusted HR along with 95% CI using a random-effects model. The primary outcome was stroke including ischemic and hemorrhagic stroke. We conducted subgroup analyses stratified by study design, ethnicity, characteristics of participants, weight of studies, and length of follow-up duration. Review Manager 5.3 and Stata 17 were used to perform the meta-analysis. Results Eight cohort studies with 5,804,215 participants were included. The results showed that participants with the highest TyG index category at baseline compared to those with the lowest TyG index category were independently associated with a higher risk of stroke (HR: 1.26, 95% CI: 1.24-1.29, I2 = 0%, P < 0.001). This finding was consistent with the results of the meta-analysis with the TyG index analyzed as a continuous variable (HR per each-unit increment of the TyG index: 1.13, 95% CI 1.09-1.18, I2 = 0%, P < 0.001). Subgroup analysis had no significant effects (for subgroup analysis, all P > 0.05). No significant heterogeneity was observed among the included cohort studies. Conclusion A higher TyG index may be independently associated with a higher risk of stroke in individuals without stroke at baseline. The aforementioned findings need to be verified by a large-scale prospective cohort study to further clarify the underlying pathophysiological mechanism between the TyG index and stroke.
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Wang L, Wang Y, Liu R, Xu L, Zhong W, Li L, Wang C, He C, Fu C, Wei Q. Influence of age on the association between the triglyceride-glucose index and all-cause mortality in patients with cardiovascular diseases. Lipids Health Dis 2022; 21:135. [PMID: 36496414 PMCID: PMC9741797 DOI: 10.1186/s12944-022-01738-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 11/16/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND In patients with cardiovascular diseases, it is reported that the triglyceride-glucose index (TGI) potentially indicates prognosis. However, the results are controversial. Moreover, whether age has an impact on the predictive value of TGI remains unclear. METHODS Participants with cardiovascular diseases were enrolled using the China Health and Retirement Longitudinal Study (CHARLS) registry. TGI was calculated as ln (triglyceride×glucose/2). The survival status was recorded every 2 years in the follow-up waves. Multivariate regression analysis was carried out to determine the relationship between TGI levels and long-term all-cause mortality in patients grouped by different age. Patients younger than 65 years old were regarded as middle-aged group. Otherwise, they were classified as old group. RESULTS In total, 2923 patients with cardiovascular diseases and baseline blood test results were included. After 7 years of follow-up, 242 (8.91%) patients died. Cox regression analysis revealed that higher TGI levels were associated with a higher risk of long-term all-cause mortality in middle-aged participants (hazard ratio [HR], 3.64; 95% confidence interval [CI] 1.44-9.22, P = 0.006) but not in old participants (HR 1.20, 95% CI 0.62-2.32, P = 0.594, P for interaction = 0.017), after adjusting physical activity and other factors. Kaplan-Meier estimate analysis and restricted cubic spline curves showed similar results. CONCLUSION TGI was a promising marker for predicting all-cause mortality in middle-aged patients after cardiovascular diseases. Patients younger than 65 years old who have a higher level of TGI may develop a higher risk of all-cause mortality, and they are encouraged to control vascular risk factors and take more physical activity to improve their prognosis. Additionally, whether intervention in regulating TGI levels is beneficial for the prognosis of these patients needs further investigation.
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Affiliation(s)
- Lu Wang
- grid.13291.380000 0001 0807 1581Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, PR China ,Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, PR China
| | - Yang Wang
- grid.13291.380000 0001 0807 1581Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, PR China ,Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, PR China
| | - Rui Liu
- grid.13291.380000 0001 0807 1581Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, PR China ,Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, PR China
| | - Lin Xu
- grid.13291.380000 0001 0807 1581Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, PR China ,Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, PR China
| | - Wen Zhong
- grid.13291.380000 0001 0807 1581Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, PR China ,Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, PR China
| | - Lijuan Li
- grid.13291.380000 0001 0807 1581Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, PR China ,Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, PR China
| | - Changyi Wang
- grid.13291.380000 0001 0807 1581Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, PR China ,Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, PR China
| | - Chengqi He
- grid.13291.380000 0001 0807 1581Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, PR China ,Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, PR China
| | - Chenying Fu
- grid.412901.f0000 0004 1770 1022National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Sichuan Chengdu, PR China ,grid.412901.f0000 0004 1770 1022Aging and Geriatric Mechanism Laboratory, West China Hospital, Sichuan University, Sichuan Chengdu, PR China
| | - Quan Wei
- grid.13291.380000 0001 0807 1581Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, PR China ,Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, PR China
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Hoshino T, Mizuno T, Ishizuka K, Takahashi S, Arai S, Toi S, Kitagawa K. Triglyceride-glucose index as a prognostic marker after ischemic stroke or transient ischemic attack: a prospective observational study. Cardiovasc Diabetol 2022; 21:264. [PMID: 36451149 PMCID: PMC9714168 DOI: 10.1186/s12933-022-01695-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Accepted: 11/14/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Triglyceride-glucose (TyG) index has been proposed as a simple and credible surrogate for insulin resistance and an independent predictor of cardiovascular outcomes. Due to lack of data on TyG index in stroke, we aimed to evaluate the predictive value of the index for recurrent vascular event risk among stroke patients. METHODS This was a prospective observational study, in which 866 patients (mean age, 70.1 years; male, 60.9%) with ischemic stroke (n = 781) or transient ischemic attack (n = 85) within 1 week of onset were consecutively enrolled and followed up for 1 year. The TyG index was calculated as ln (fasting triglycerides [mg/dL] × fasting glucose [mg/dL]/2). Patients were divided into 3 groups according to the tertile of TyG index levels: tertile 1, < 8.48; tertile 2, 8.48-9.01; and tertile 3, > 9.01. The primary outcome was a composite of major adverse cardiovascular events (MACE), including nonfatal stroke, nonfatal acute coronary syndrome, and vascular death. RESULTS The median TyG index was 8.74 (interquartile range, 8.34-9.16). Higher levels of TyG index were significantly associated with increased prevalence of ipsilateral extracranial carotid (P = 0.032) and intracranial (P = 0.003) atherosclerotic stenosis. There were significant differences in the MACE risk between the three groups (annual rate, 8.6%, 11.6%, and 17.3% in the tertile 1, tertile 2, tertile 3 groups, respectively; log-rank P = 0.005). After multivariable adjustments, the TyG index remains to be a significant predictor of MACE, with an adjusted hazard ratio for tertile 3 versus tertile 1 groups (95% confidence interval) of 2.01 (1.16-3.47). Similar results were also found for the risk of recurrent stroke. CONCLUSIONS TyG index is associated with cervicocerebral atherosclerosis and the MACE risk after a stroke, suggesting the potential value of TyG index to optimize the risk stratification of stroke patients. Trial registration URL: https://upload.umin.ac.jp . Unique identifier: UMIN000031913.
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Affiliation(s)
- Takao Hoshino
- grid.488555.10000 0004 1771 2637Department of Neurology, Tokyo Women’s Medical University Hospital, 8-1, Kawada-Cho, Shinjuku-Ku, Tokyo, 162-8666 Japan
| | - Takafumi Mizuno
- grid.488555.10000 0004 1771 2637Department of Neurology, Tokyo Women’s Medical University Hospital, 8-1, Kawada-Cho, Shinjuku-Ku, Tokyo, 162-8666 Japan
| | - Kentaro Ishizuka
- grid.488555.10000 0004 1771 2637Department of Neurology, Tokyo Women’s Medical University Hospital, 8-1, Kawada-Cho, Shinjuku-Ku, Tokyo, 162-8666 Japan
| | - Shuntaro Takahashi
- grid.488555.10000 0004 1771 2637Department of Neurology, Tokyo Women’s Medical University Hospital, 8-1, Kawada-Cho, Shinjuku-Ku, Tokyo, 162-8666 Japan
| | - Satoko Arai
- grid.488555.10000 0004 1771 2637Department of Neurology, Tokyo Women’s Medical University Hospital, 8-1, Kawada-Cho, Shinjuku-Ku, Tokyo, 162-8666 Japan
| | - Sono Toi
- grid.488555.10000 0004 1771 2637Department of Neurology, Tokyo Women’s Medical University Hospital, 8-1, Kawada-Cho, Shinjuku-Ku, Tokyo, 162-8666 Japan
| | - Kazuo Kitagawa
- grid.488555.10000 0004 1771 2637Department of Neurology, Tokyo Women’s Medical University Hospital, 8-1, Kawada-Cho, Shinjuku-Ku, Tokyo, 162-8666 Japan
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Yan F, Yan S, Wang J, Cui Y, Chen F, Fang F, Cui W. Association between triglyceride glucose index and risk of cerebrovascular disease: systematic review and meta-analysis. Cardiovasc Diabetol 2022; 21:226. [PMID: 36324146 PMCID: PMC9632026 DOI: 10.1186/s12933-022-01664-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 10/12/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The triglyceride glucose (TyG) index, which is a new surrogate indicator of insulin resistance (IR), is thought to be associated with many diseases, such as cardiovascular disease, but its relationship with cerebrovascular disease is still controversial. METHODS The PubMed, EMBASE, Cochrane Library, Web of Science and Medline databases were searched until March 2022 to evaluate the association between the TyG index and cerebrovascular disease risk. A random‒effects model was used to calculate the effect estimates and 95% confidence intervals (CIs). RESULTS A total of 19 cohort studies and 10 case‒control/cross‒sectional studies were included in our study, which included 11,944,688 participants. Compared with a low TyG index, a higher TyG index increased the risk of cerebrovascular disease (RR/HR = 1.22, 95% CI [1.14, 1.30], P< 0.001; OR = 1.15, 95% CI [1.07, 1.23], P< 0.001). Furthermore, the results of the dose-response analysis of the cohort study demonstrated that the risk of cerebrovascular disease increased by 1.19 times per 1 mg/dl increment of the TyG index (relative risk = 1.19, 95% CI [1.13,1.25], P< 0.001). CONCLUSION TyG index is related to cerebrovascular disease. More data and basic research are needed to confirm the association.
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Affiliation(s)
- Feifei Yan
- grid.64924.3d0000 0004 1760 5735Department of Nutrition and Food Hygiene, School of Public Health, Jilin University, 1163 Xinmin Avenue, 130021 Changchun, P. R. China
| | - Shoumeng Yan
- grid.64924.3d0000 0004 1760 5735School of Nursing, Jilin University, 130021 Changchun, P. R. China
| | - Jing Wang
- grid.64924.3d0000 0004 1760 5735Department of Nutrition and Food Hygiene, School of Public Health, Jilin University, 1163 Xinmin Avenue, 130021 Changchun, P. R. China
| | - Yani Cui
- grid.64924.3d0000 0004 1760 5735Department of Nutrition and Food Hygiene, School of Public Health, Jilin University, 1163 Xinmin Avenue, 130021 Changchun, P. R. China
| | - Feinan Chen
- grid.64924.3d0000 0004 1760 5735Department of Nutrition and Food Hygiene, School of Public Health, Jilin University, 1163 Xinmin Avenue, 130021 Changchun, P. R. China
| | - Fang Fang
- grid.64924.3d0000 0004 1760 5735Department of Nutrition and Food Hygiene, School of Public Health, Jilin University, 1163 Xinmin Avenue, 130021 Changchun, P. R. China
| | - Weiwei Cui
- grid.64924.3d0000 0004 1760 5735Department of Nutrition and Food Hygiene, School of Public Health, Jilin University, 1163 Xinmin Avenue, 130021 Changchun, P. R. China
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Biter Hİ, Kalyoncuoğlu M, Tosu AR, Çakal S, Apaydın Z, Gümüşdağ A, Çınar T, Eyüpkoca F, Belen E, Can MM. Prognostic value of the TyG index for in-hospital mortality in nondiabetic COVID-19 patients with myocardial injury. Rev Assoc Med Bras (1992) 2022; 68:1297-1302. [PMID: 36228261 PMCID: PMC9575008 DOI: 10.1590/1806-9282.20220410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 07/02/2022] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE The purpose of this study was to explore the efficacy of the triglyceride glucose (TyG) index on in-hospital mortality in nondiabetic coronavirus disease 2019 (COVID-19) patients with myocardial injury. METHODS This was a retrospective study, which included 218 nondiabetic COVID-19 patients who had myocardial injury. The TyG index was derived using the following equation: log [serum triglycerides (mg/dL) ×fasting blood glucose (mg/dL)/2]. RESULTS Overall, 49 (22.4%) patients died during hospitalization. Patients who did not survive had a higher TyG index than survivors. In multivariate Cox regression analysis, it was found that the TyG index was independently associated with in-hospital death. A TyG index cutoff value greater than 4.97 was predicted in-hospital death in nondiabetic COVID-19 patients with myocardial damage, with 82% sensitivity and 66% specificity. A pairwise evaluation of receiver operating characteristic (ROC) curves demonstrated that the TyG index (AUC: 0.786) had higher discriminatory performance than both triglyceride (AUC: 0.738) and fasting blood glucose (AUC: 0.660) in predicting in-hospital mortality among these patients. CONCLUSIONS The TyG index might be used to identify high-risk nondiabetic COVID-19 patients with myocardial damage.
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Affiliation(s)
- Halil İbrahim Biter
- Health Sciences University, Sultangazi Haseki Training and Research Hospital, Department of Cardiology – Istanbul, Turkey
| | - Muhsin Kalyoncuoğlu
- Health Sciences University, Sultangazi Haseki Training and Research Hospital, Department of Cardiology – Istanbul, Turkey
| | - Aydın Rodi Tosu
- Health Sciences University, Sultangazi Haseki Training and Research Hospital, Department of Cardiology – Istanbul, Turkey
| | - Sinem Çakal
- Health Sciences University, Sultangazi Haseki Training and Research Hospital, Department of Cardiology – Istanbul, Turkey
| | - Ziya Apaydın
- Health Sciences University, Sultangazi Haseki Training and Research Hospital, Department of Cardiology – Istanbul, Turkey
| | - Ayça Gümüşdağ
- Health Sciences University, Sultangazi Haseki Training and Research Hospital, Department of Cardiology – Istanbul, Turkey
| | - Tufan Çınar
- Health Sciences University, Sultan Abdülhamid Han Training and Research Hospital, Department of Cardiology – Istanbul, Turkey.,Corresponding author:
| | | | - Erdal Belen
- Health Sciences University, Sultangazi Haseki Training and Research Hospital, Department of Cardiology – Istanbul, Turkey
| | - Mehmet Mustafa Can
- Health Sciences University, Sultangazi Haseki Training and Research Hospital, Department of Cardiology – Istanbul, Turkey
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The predictive value of the triglyceride-glucose index for cardiovascular events in patients with coronary chronic total occlusion. Cardiovasc Diabetol 2022; 21:149. [PMID: 35941586 PMCID: PMC9361584 DOI: 10.1186/s12933-022-01588-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 08/01/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Chronic total occlusion (CTO) of the coronary artery is a difficult problem in clinical practice. The triglyceride-glucose (TyG) index is an effective risk predictor of cardiovascular risk. However, the relationship between the TyG index and the prognosis of CTO patients remains unstudied. Thus, the present study aimed to investigate the relationship between the TyG index and cardiovascular risk in CTO patients. METHODS This was a single-centre, retrospective cohort study. We retrospectively enrolled 652 patients with CTO lesions diagnosed by angiography and who underwent revascularization through PCI. Patients were routinely followed up for 24 months unless meeting the endpoint. The primary endpoint was the composite of all-cause death, nonfatal myocardial infarction, unplanned revascularization, and nonfatal ischaemic stroke. To test the association of the TyG index with cardiovascular risk, the categorized TyG index and Cox proportional hazards regression models were utilized. RESULTS A total of 652 patients were enrolled in the final analysis (male: 83.7%, age: 58.2 ± 10.49 years). The average TyG index was 8.8 ± 0.57. CTO PCIs were procedurally successfully completed in 503 (77.15%) patients. During the follow-up period of 22.8 ± 3.84 months, 73 (11.19%) major adverse cardiovascular and cerebral events (MACCEs) occurred. When fully adjusted, there was a 2.09-fold risk for MACCEs among patients with the highest TyG index compared with those with the lowest TyG index [T2 vs. T1: hazard ratio (HR) 1.24, 95% confidence interval (CI) 0.65-2.38, P = 0.057; T3 vs. T1: HR 2.09, 95% CI 1.14-3.86, P = 0.018; P for trend = 0.036]. The restricted cubic spline (RCS) analysis showed that the HR for MACCEs increased as the TyG index increased over 8.71 [HR per standard deviation (SD) 1.740, 95% CI 1.23-2.46, P = 0.002]. The risk of MACCEs increased with increasing tertiles of TyG index in successful CTO PCI patients and nondiabetes mellitus (DM) patients (P < 0.05) but not in patients with failed CTO PCI and DM patients. CONCLUSION The study revealed that the TyG index had significant relevance to cardiovascular risk in CTO patients and suggests that the TyG index is feasible for predicting cardiovascular risk in CTO patients.
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27
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Zeng X, Han D, Zhou H, Xue Y, Wang X, Zhan Q, Bai Y, Huang X, Zeng Q, Zhang H, Ma Z, Ren H, Xu D. 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; 9:944258. [PMID: 35845059 PMCID: PMC9279654 DOI: 10.3389/fcvm.2022.944258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 06/06/2022] [Indexed: 11/25/2022] Open
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.
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Affiliation(s)
- Xianghui Zeng
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Dunzheng Han
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Haobin Zhou
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yuting Xue
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xiao Wang
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Qiong Zhan
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yujia Bai
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xingfu Huang
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Qingchun Zeng
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Hao Zhang
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Zhuang Ma
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Hao Ren
- Department of Rheumatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
- *Correspondence: Hao Ren,
| | - Dingli Xu
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
- Dingli Xu,
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28
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Sun M, Guo H, Wang Y, Ma D. Association of triglyceride glucose index with all-cause and cause-specific mortality among middle age and elderly US population. BMC Geriatr 2022; 22:461. [PMID: 35643423 PMCID: PMC9145102 DOI: 10.1186/s12877-022-03155-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 05/18/2022] [Indexed: 12/27/2022] Open
Abstract
Aims To investigate the association between the triglyceride glucose (TyG) index and all-cause and cause-specific mortality in middle age and elderly population. Methods and results A total of 9,254 participants with age ≥ 45 years were enrolled from the National Health and Nutrition Examination Survey cycle of 1999–2014. The TyG index was determined as ln [fasting triglycerides (mg/dL) x fasting glucose (mg/dL)/2]. Primary outcomes were all-cause mortality and cause-specific mortality (cardiovascular diseases and malignant neoplasms). The association between the levels of TyG and the risk of mortality was explored with Cox regression models. After a median follow-up of 7.6 years, 1,774 all-cause death occurred. Univariate analysis showed that the TyG was associated with all-cause mortality (hazard ratio [HR] 1.18, 95% confidence interval [CI] [1.11,1.26]; p < 0.001). Furthermore, multivariate-adjusted analysis found that the third TyG quartile (8.72 ~ 9.16) was associated with the lowest risk of all-cause mortality (HR 0.84, 95%CI [0.73, 0.98]; p < 0.05). Restricted cubic splines showed that the association between levels of TyG index and the risk of all-cause mortality was non-linear (p for nonlinearity < 0.001) and the inflection point was 9.18 using threshold effect analysis. The HR was 0.82 (95%CI [0.71,0.96]) below 9.18 while the HR was 1.32 (95%CI [1.12,1.55]) above 9.18. Conclusion TyG index was U-shaped associated with all-cause mortality and the TyG index associated with the lowest risk of all-cause mortality was 9.18.
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Tao LC, Xu JN, Wang TT, Hua F, Li JJ. Triglyceride-glucose index as a marker in cardiovascular diseases: landscape and limitations. Cardiovasc Diabetol 2022; 21:68. [PMID: 35524263 PMCID: PMC9078015 DOI: 10.1186/s12933-022-01511-x] [Citation(s) in RCA: 189] [Impact Index Per Article: 94.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 04/22/2022] [Indexed: 12/17/2022] Open
Abstract
The triglyceride-glucose (TyG) index has been identified as a reliable alternative biomarker of insulin resistance (IR). Recently, a considerable number of studies have provided robust statistical evidence suggesting that the TyG index is associated with the development and prognosis of cardiovascular disease (CVD). Nevertheless, the application of the TyG index as a marker of CVD has not systemically been evaluated, and even less information exists regarding the underlying mechanisms associated with CVD. To this end, in this review, we summarize the history of the use of the TyG index as a surrogate marker for IR. We aimed to highlight the application value of the TyG index for a variety of CVD types and to explore the potential limitations of using this index as a predictor for cardiovascular events to improve its application value for CVD and provide more extensive and precise supporting evidence.
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Affiliation(s)
- Li-Chan Tao
- The Third Affiliated Hospital of Soochow University, Juqian Road, Changzhou, 213000, China
| | - Jia-Ni Xu
- The Third Affiliated Hospital of Soochow University, Juqian Road, Changzhou, 213000, China
| | - Ting-Ting Wang
- The Third Affiliated Hospital of Soochow University, Juqian Road, Changzhou, 213000, China
| | - Fei Hua
- The Third Affiliated Hospital of Soochow University, Juqian Road, Changzhou, 213000, China.
| | - Jian-Jun Li
- State Key Laboratory of Cardiovascular Diseases, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No 167 BeiLiShi Road, XiCheng District, Beijing, 100037, China.
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Jung MH, Yi SW, An SJ, Yi JJ, Ihm SH, Han S, Ryu KH, Jung HO, Youn HJ. Associations between the triglyceride-glucose index and cardiovascular disease in over 150,000 cancer survivors: a population-based cohort study. Cardiovasc Diabetol 2022; 21:52. [PMID: 35429972 PMCID: PMC9013459 DOI: 10.1186/s12933-022-01490-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 04/04/2022] [Indexed: 01/04/2023] Open
Abstract
Background The prevention of subsequent cardiovascular disease (CVD) is an essential part of cancer survivorship care. We conducted the present study to investigate the association between the TyG index (a surrogate marker of insulin resistance) and the risk of cardiovascular disease (CVD) events in cancer survivors. Methods Adult cancer patients, who underwent routine health examinations during 2009–2010 and were survived for more than 5 years as of January 1, 2011, were followed for hospitalization of CVD (either ischemic heart disease, stroke, or heart failure) until December 2020. Cox model was used to calculate hazard ratios associated with baseline TyG index (loge [fasting triglyceride (mg) × fasting glucose (mg)/2]) for the CVD hospitalization. Results A total of 155,167 cancer survivors (mean age 59.9 ± 12.0 years, female 59.1%) were included in this study. A graded positive association was observed between TyG and CVD hospitalization. An 8% elevated risk for CVD hospitalization was observed for a TyG index of 8-8.4 (aHR 1.08 [95% CI 1.01–1.14]); 10% elevated risk for a TyG index of 8.5–8.9 (aHR 1.10 [95% CI 1.03–1.17]); 23% elevated risk for a TyG index of 9.0-9.4 (aHR 1.23 [95% CI 1.15–1.31]); 34% elevated risk for a TyG index of 9.5–9.9 (aHR 1.34 [95% CI 1.23–1.47]); and 55% elevated risk for a TyG index ≥ 10 compared to the reference group (TyG index < 8). Per 1-unit increase in the TyG index, a 16% increase in CVD hospitalization and a 45% increase in acute myocardial infarction hospitalization were demonstrated. Graded positive associations were evident for atherosclerotic CVD subtypes, such as ischemic heart disease, acute myocardial infarction, and ischemic stroke, but not for hemorrhagic stroke or heart failure. Conclusions The TyG index may serve as a simple surrogate marker for the risk stratification of future CVD events, particularly atherosclerotic subtypes, in cancer survivors. Supplementary Information The online version contains supplementary material available at 10.1186/s12933-022-01490-z.
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Feng X, Yao Y, Wu L, Cheng C, Tang Q, Xu S. Triglyceride-Glucose Index and the Risk of Stroke: A Systematic Review and Dose-Response Meta-Analysis. Horm Metab Res 2022; 54:175-186. [PMID: 35276743 DOI: 10.1055/a-1766-0202] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Insulin resistance (IR) is an independent risk factor of cardiovascular disease. Recent research has proposed a new inexpensive and reliable indicator of IR: triglyceride glucose index (TyG index). We aim to evaluate the dose-response association between the TyG index and stroke through meta-analysis. Literature published from inception until October 2021 were searched in PubMed, Embase, Cochrane Library and Web of science. Cohort studies published in English and focusing on the association between the TyG index and stroke were included in our meta-analysis. I2 statistic and Chi-square were used to assess the heterogeneity. When I2≥30% or p≤0.10, the random-effect model was used to pool the effect; otherwise, we chose the fixed-effect model. Eleven cohort studies, including 5 721 077 subjects and 95 490 stroke patients, were included in our study. After pooling the effect adjusted by multiple confounders, we found that compared with the lowest baseline TyG index group, the highest one was independently associated with increased stroke risk (RR: 1.27; 95% CI, 1.24 to 1.29; I2=6%). Dose-response meta-analysis showed that the association between the two variables had a non-linear trend (p-nonlinearity<0.0001; p-heterogeneity=0.28). Subgroup analysis showed that the risk of ischemic stroke was positively correlated with TyG index (RR: 1.48; 95% CI, 1.34 to 1.62; I2=15%), while we did not observe this correlation in hemorrhagic stroke patients. In patients with type 2 diabetes and acute coronary syndrome, the TyG index was linearly correlated with incident strokes. In conclusion, elevated TyG index is the independent risk factor for incident strokes (especially ischemic stroke).
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Affiliation(s)
- Xiao Feng
- Department of Neurology, Huazhong University of Science and Technology, Wuhan, China
| | - Yao Yao
- Department of Neurology, Huazhong University of Science and Technology, Wuhan, China
| | - Lingshan Wu
- Department of Neurology, Huazhong University of Science and Technology, Wuhan, China
| | - Chang Cheng
- Department of Neurology, Huazhong University of Science and Technology, Wuhan, China
| | - Qiaoqiao Tang
- Department of Neurology, Huazhong University of Science and Technology, Wuhan, China
| | - Shabei Xu
- Department of Neurology, Huazhong University of Science and Technology, Wuhan, China
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Hu J, Cai X, Li N, Zhu Q, Wen W, Hong J, Zhang D, Yao X, Luo Q, Sun L. Association Between Triglyceride Glucose Index-Waist Circumference and Risk of First Myocardial Infarction in Chinese Hypertensive Patients with Obstructive Sleep Apnoea: An Observational Cohort Study. Nat Sci Sleep 2022; 14:969-980. [PMID: 35615442 PMCID: PMC9126228 DOI: 10.2147/nss.s362101] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 05/06/2022] [Indexed: 11/23/2022] Open
Abstract
PURPOSE This study aimed to investigate the association between triglyceride glucose index-waist circumference (TyG-WC) and the risk of first myocardial infarction (MI) in Chinese hypertensive patients with obstructive sleep apnoea (OSA). METHODS This study was an observational cohort study. A total of 2224 Chinese hypertensive patients with OSA without a history of MI were included in this study. Hazard ratio (HR) and 95% confidence interval (CI) were estimated using multivariable Cox proportion hazard models. A generalized additive model was used to identify nonlinear relationships. Additionally, we performed hierarchical analysis and test for interaction. RESULTS During a median follow-up of 7.15 years, 85 incidents of MI developed. Overall, there was a positive association between TyG-WC and the risk of first MI. In the multivariable-adjusted model, the risk of MI increased with quartiles of the TyG-WC, the HR in quartile 4 versus quartile 1 was 4.29. A generalized additive model and a smooth curve fitting showed that there existed a similar J-shaped association between TyG-WC and the risk of first MI, with an inflection point at about 785. CONCLUSION Elevated levels of the baseline TyG-WC are associated with an increased risk of first MI. This finding indicates that the TyG-WC might be useful to identify the high risk of first MI in Chinese hypertensive patients with OSA.
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Affiliation(s)
- Junli Hu
- Hypertension Center, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Xinjiang Hypertension Institute, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,National Health Committee Key Laboratory of Hypertension Clinical Research, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Key Laboratory of Xinjiang Uygur Autonomous Region, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Xinjiang Clinical Medical Research Center for Hypertension Diseases, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China
| | - Xintian Cai
- Hypertension Center, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Xinjiang Hypertension Institute, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,National Health Committee Key Laboratory of Hypertension Clinical Research, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Key Laboratory of Xinjiang Uygur Autonomous Region, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Xinjiang Clinical Medical Research Center for Hypertension Diseases, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China
| | - Nanfang Li
- Hypertension Center, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Xinjiang Hypertension Institute, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,National Health Committee Key Laboratory of Hypertension Clinical Research, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Key Laboratory of Xinjiang Uygur Autonomous Region, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Xinjiang Clinical Medical Research Center for Hypertension Diseases, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China
| | - Qing Zhu
- Hypertension Center, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Xinjiang Hypertension Institute, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,National Health Committee Key Laboratory of Hypertension Clinical Research, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Key Laboratory of Xinjiang Uygur Autonomous Region, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Xinjiang Clinical Medical Research Center for Hypertension Diseases, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China
| | - Wen Wen
- Hypertension Center, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Xinjiang Hypertension Institute, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,National Health Committee Key Laboratory of Hypertension Clinical Research, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Key Laboratory of Xinjiang Uygur Autonomous Region, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Xinjiang Clinical Medical Research Center for Hypertension Diseases, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China
| | - Jing Hong
- Hypertension Center, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Xinjiang Hypertension Institute, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,National Health Committee Key Laboratory of Hypertension Clinical Research, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Key Laboratory of Xinjiang Uygur Autonomous Region, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Xinjiang Clinical Medical Research Center for Hypertension Diseases, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China
| | - Delian Zhang
- Hypertension Center, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Xinjiang Hypertension Institute, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,National Health Committee Key Laboratory of Hypertension Clinical Research, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Key Laboratory of Xinjiang Uygur Autonomous Region, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Xinjiang Clinical Medical Research Center for Hypertension Diseases, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China
| | - Xiaoguang Yao
- Hypertension Center, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Xinjiang Hypertension Institute, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,National Health Committee Key Laboratory of Hypertension Clinical Research, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Key Laboratory of Xinjiang Uygur Autonomous Region, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Xinjiang Clinical Medical Research Center for Hypertension Diseases, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China
| | - Qin Luo
- Hypertension Center, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China
| | - Le Sun
- Hypertension Center, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Xinjiang Hypertension Institute, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,National Health Committee Key Laboratory of Hypertension Clinical Research, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Key Laboratory of Xinjiang Uygur Autonomous Region, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.,Xinjiang Clinical Medical Research Center for Hypertension Diseases, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China
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Qin Z, Xu S, Yuan R, Wang Z, Lu Y, Xu Y, Lv Y, Yu F, Bai J, Zhang H, Zhang L, Zhang J, Tang J. Combination of TyG Index and GRACE Risk Score as Long-Term Prognostic Marker in Patients with ACS Complicated with T2DM Undergoing PCI. Diabetes Metab Syndr Obes 2022; 15:3015-3025. [PMID: 36196143 PMCID: PMC9527003 DOI: 10.2147/dmso.s376178] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 09/08/2022] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE We aimed to investigate the prognostic value of the triglyceride-glucose (TyG) index combined the with Global Registry of Acute Coronary Events (GRACE) score in adult acute coronary syndrome (ACS) patients with type 2 diabetes mellitus (T2DM) who underwent percutaneous coronary intervention (PCI). METHODS The study enrolled total 899 ACS patients with T2DM who underwent PCI. TyG index and the GRACE risk score were calculated and assessed by median. The correlation was analyzed by Spearman's rank correlation coefficient. The cumulative major adverse cardiovascular event (MACE) curve was generated using the Kaplan-Meier method. Multivariate Cox regression was used to identify predictors of MACEs. Additionally, the receiver operating characteristic curve (ROC), net reclassification index (NRI) and Integrated Discrimination Improvement (IDI) were applied to analyze the performance of each single factor index and combined multivariate index in predicting MACE. RESULTS In the ACS patients with T2DM after PCI, there were significant differences in the TyG index and GRACE risk score between the MACE group and the MACE-free group (P < 0.001). Kaplan-Meier analysis showed that the TyG index combined with the GRACE risk score was positively correlated with the occurrence of MACEs (log rank P < 0.001). Multivariate Cox regression analyses showed that the TyG index, the GRACE risk score, and the TyG index combined with the GRACE risk score were independent predictors of long-term MACEs (adjusted HR: 1.805; 95% CI: 1.479-2.203, P < 0.001; adjusted HR: 1.012; 95% CI: 1.009-1.016, P < 0.001; and adjusted HR: 2.337; 95% CI: 1.805-3.025, P < 0.001, respectively). Correlation analysis indicated that the TyG index was positively correlated with the GRACE risk score (R = 0.140, P < 0.001). The analysis of AUC, NRI and IDI revealed that the combined multivariate index performed better prognostic role than each single factor index in predicting the occurrence of MACE. CONCLUSION Both the GRACE risk score and the TyG index could be significant and independent predictors of clinical outcomes in ACS patients with T2DM after PCI. A combination of them could be enhanced predictions of clinical outcomes in these patients.
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Affiliation(s)
- Zhen Qin
- Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, People’s Republic of China
- Henan Province Key Laboratory of Cardiac Injury and Repair, Zhengzhou, Henan, 450052, People’s Republic of China
- Henan Province Clinical Research Center for Cardiovascular Diseases, Zhengzhou, Henan, 450018, People’s Republic of China
| | - Shuai Xu
- Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, People’s Republic of China
- Henan Province Key Laboratory of Cardiac Injury and Repair, Zhengzhou, Henan, 450052, People’s Republic of China
- Henan Province Clinical Research Center for Cardiovascular Diseases, Zhengzhou, Henan, 450018, People’s Republic of China
| | - Ruixia Yuan
- Clinical Big Data Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, People’s Republic of China
| | - Zeyu Wang
- Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, People’s Republic of China
- Henan Province Key Laboratory of Cardiac Injury and Repair, Zhengzhou, Henan, 450052, People’s Republic of China
- Henan Province Clinical Research Center for Cardiovascular Diseases, Zhengzhou, Henan, 450018, People’s Republic of China
| | - Yongzheng Lu
- Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, People’s Republic of China
- Henan Province Key Laboratory of Cardiac Injury and Repair, Zhengzhou, Henan, 450052, People’s Republic of China
- Henan Province Clinical Research Center for Cardiovascular Diseases, Zhengzhou, Henan, 450018, People’s Republic of China
| | - Yanyan Xu
- Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, People’s Republic of China
- Henan Province Key Laboratory of Cardiac Injury and Repair, Zhengzhou, Henan, 450052, People’s Republic of China
- Henan Province Clinical Research Center for Cardiovascular Diseases, Zhengzhou, Henan, 450018, People’s Republic of China
| | - Yan Lv
- Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, People’s Republic of China
- Henan Province Key Laboratory of Cardiac Injury and Repair, Zhengzhou, Henan, 450052, People’s Republic of China
- Henan Province Clinical Research Center for Cardiovascular Diseases, Zhengzhou, Henan, 450018, People’s Republic of China
| | - Fengyi Yu
- Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, People’s Republic of China
- Henan Province Key Laboratory of Cardiac Injury and Repair, Zhengzhou, Henan, 450052, People’s Republic of China
- Henan Province Clinical Research Center for Cardiovascular Diseases, Zhengzhou, Henan, 450018, People’s Republic of China
| | - Jing Bai
- Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, People’s Republic of China
- Henan Province Key Laboratory of Cardiac Injury and Repair, Zhengzhou, Henan, 450052, People’s Republic of China
- Henan Province Clinical Research Center for Cardiovascular Diseases, Zhengzhou, Henan, 450018, People’s Republic of China
| | - Hui Zhang
- Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, People’s Republic of China
- Henan Province Key Laboratory of Cardiac Injury and Repair, Zhengzhou, Henan, 450052, People’s Republic of China
- Henan Province Clinical Research Center for Cardiovascular Diseases, Zhengzhou, Henan, 450018, People’s Republic of China
| | - Li Zhang
- Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, People’s Republic of China
- Henan Province Key Laboratory of Cardiac Injury and Repair, Zhengzhou, Henan, 450052, People’s Republic of China
- Henan Province Clinical Research Center for Cardiovascular Diseases, Zhengzhou, Henan, 450018, People’s Republic of China
| | - Jinying Zhang
- Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, People’s Republic of China
- Henan Province Key Laboratory of Cardiac Injury and Repair, Zhengzhou, Henan, 450052, People’s Republic of China
- Henan Province Clinical Research Center for Cardiovascular Diseases, Zhengzhou, Henan, 450018, People’s Republic of China
- Jinying Zhang, Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, People’s Republic of China, Tel +86 13503830283, Email
| | - Junnan Tang
- Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, People’s Republic of China
- Henan Province Key Laboratory of Cardiac Injury and Repair, Zhengzhou, Henan, 450052, People’s Republic of China
- Henan Province Clinical Research Center for Cardiovascular Diseases, Zhengzhou, Henan, 450018, People’s Republic of China
- Correspondence: Junnan Tang, Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, People’s Republic of China, Tel +86 15890696166, Email
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Luo JW, Duan WH, Yu YQ, Song L, Shi DZ. Prognostic Significance of Triglyceride-Glucose Index for Adverse Cardiovascular Events in Patients With Coronary Artery Disease: A Systematic Review and Meta-Analysis. Front Cardiovasc Med 2021; 8:774781. [PMID: 34926622 PMCID: PMC8674619 DOI: 10.3389/fcvm.2021.774781] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 10/29/2021] [Indexed: 01/04/2023] Open
Abstract
Background: Insulin resistance (IR) represents a critical regulator in the development and progress of coronary artery disease (CAD). Triglyceride-glucose (TyG) index, a novel surrogate biomarker of IR, has been implicated in several cardiovascular diseases. Accordingly, we conduct a meta-analysis to elucidate the relationship between TyG index and adverse cardiovascular events in patients with CAD. Methods: To identify the studies examining the predictive capacity of the TyG index for adverse cardiovascular events in the setting of CAD, we performed a comprehensive literature retrieval of Scopus, PubMed, EMBASE, and Web of Science, from the inception of databases to October 5, 2021. We pooled the adjusted hazard ratio (HR) along with 95% CI using a random-effects model. The primary outcome was a composite of major adverse cardiovascular events (MACEs), including all-cause death, cardiovascular death (CV death), myocardial infarction (MI), stroke, hospitalization for unstable angina or heart failure, and revascularization. The secondary outcomes were all-cause death, CV death, MI, stroke, and revascularization. Additionally, we conducted subgroup analyses stratified by diabetes status, age, body mass index (BMI), low-density lipoprotein cholesterol (LDL-C), category of TyG index, sample size, follow-up duration, and study design. Results: About 12 studies involving 28,795 patients with CAD were finally taken into the quantitative analysis. Our findings showed that there was a 2.14-fold higher risk of MACEs among CAD populations in the highest TyG group compared with those in the lowest TyG group (HR: 2.14, 95% CI: 1.69–2.71, P < 0.001). A greater risk of MACEs was observed in participants with higher BMI than those with lower BMI (P = 0.03 for interaction). In the analysis of secondary outcomes, we also observed a markedly increased risk of MI, stroke, and revascularization in the highest TyG group compared with the lowest TyG group. No evidence of a significant association between TyG index and CV mortality or all-cause mortality in patients with CAD was identified. Conclusions: The elevated TyG index is a promising predictive factor of adverse cardiovascular events in patients with CAD. Systematic Review Registration:https://www.crd.york.ac.uk/PROSPERO, identifier: CRD42021228521.
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Affiliation(s)
- Jin-Wen Luo
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Science, Beijing, China
| | - Wen-Hui Duan
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Science, Beijing, China
| | - Yan-Qiao Yu
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Lei Song
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Da-Zhuo Shi
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Science, Beijing, China
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Kim J, Shin SJ, Kang HT. The association between triglyceride-glucose index, cardio-cerebrovascular diseases, and death in Korean adults: A retrospective study based on the NHIS-HEALS cohort. PLoS One 2021; 16:e0259212. [PMID: 34735502 PMCID: PMC8568280 DOI: 10.1371/journal.pone.0259212] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 10/14/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The triglyceride-glucose (TyG) index is a reliable indicator of insulin resistance. We aimed to investigate the TyG index in relation to cardio-cerebrovascular diseases (CCVDs and mortality. METHODS This retrospective study included 114,603 subjects. The TyG index was categorized into four quartiles by sex: Q1, <8.249 and <8.063; Q2, 8.249‒<8.614 and 8.063‒<8.403; Q3, 8.614‒< 8.998 and 8.403‒<8.752; and Q4, ≥8.998 and ≥8.752, in men and women, respectively. To calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for the primary outcomes (CCVDs and all-cause mortality) and secondary outcomes (cardiovascular diseases [CVDs], cerebrovascular diseases [CbVDs], CCVD-related deaths, or all-cause deaths), Cox proportional hazards regression models were adopted. RESULTS Compared to Q1, the HRs (95% CIs) for the primary outcomes of Q2, Q3, and Q4 were 1.062 (0.981‒1.150), 1.110 (1.024-1.204), and 1.151 (1.058-1.252) in men and 1.099 (0.986-1.226), 1.046 (0.938-1.166), and 1.063 (0.954-1.184) in women, respectively, after adjusted for age, smoking status, drinking status, physical activity, body mass index, systolic blood pressure, low-density lipoprotein cholesterol, economic status, and anti-hypertensive medications. Fully adjusted HRs (95% CIs) for CVDs of Q2, Q3, and Q4 were 1.114 (0.969-1.282), 1.185 (1.031-1.363), and 1.232 (1.068-1.422) in men and 1.238 (1.017-1.508), 1.183 (0.971-1.440), and 1.238 (1.018-1.505) in women, respectively. The adjusted HRs (95% CIs) for ischemic CbVDs of Q2, Q3, and Q4 were 1.005 (0.850-1.187), 1.225 (1.041-1.441), and 1.232 (1.039-1.460) in men and 1.040 (0.821-1.316), 1.226 (0.981-1.532), and 1.312 (1.054-1.634) in women, respectively, while the TyG index was negatively associated with hemorrhagic CbVDs in women but not in men. The TyG index was not significantly associated with CCVD-related death or all-cause death in either sex. CONCLUSIONS Elevated TyG index was positively associated with the primary outcomes (CCVDs and all-cause mortality) in men and predicted higher risk of CVDs and ischemic CbVDs in both sexes.
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Affiliation(s)
- Joungyoun Kim
- Mo-Im Kim Nursing Research Institute, Yonsei University, College of Nursing, Seoul, Republic of Korea
| | - Sang-Jun Shin
- Department of Information & Statistics, Chungbuk National University, Cheongju, Republic of Korea
| | - Hee-Taik Kang
- Department of Family Medicine, Chungbuk National University Hospital, Cheongju, Republic of Korea
- Department of Family Medicine, Chungbuk National University College of Medicine, Cheongju, Republic of Korea
- * E-mail:
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36
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Association between the triglyceride glucose index and coronary collateralization in coronary artery disease patients with chronic total occlusion lesions. Lipids Health Dis 2021; 20:140. [PMID: 34689767 PMCID: PMC8543811 DOI: 10.1186/s12944-021-01574-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 10/05/2021] [Indexed: 01/18/2023] Open
Abstract
Background Recent studies have substantiated the role of the triglyceride glucose (TyG) index in predicting the prognosis of coronary artery disease (CAD) patients, while no relevant studies have revealed the association between the TyG index and coronary collateralization in the event of coronary chronic total occlusion (CTO). The current study intends to explore whether, or to what extent, the TyG index is associated with impaired collateralization in CAD patients with CTO lesions. Methods The study enrolled 1093 CAD patients undergoing cardiac catheterization for at least one CTO lesion. Data were collected from the Beijing Anzhen Hospital record system. The degree of collaterals was determined according to the Rentrop classification system. The correlation between the TyG index and coronary collateralization was assessed. Results Overall, 318 patients were included in a less developed collateralization (Rentrop classification 0-1) group. The TyG index was significantly higher in patients with impaired collateralization (9.3±0.65 vs. 8.8±0.53, P<0.001). After adjusting for various confounding factors, the TyG index remained correlated with the occurrence of impaired collateralization, with odds ratios (ORs) of 1.59 and 5.72 in the T2 and T3 group compared with the first tertile group (P<0.001). In addition, subgroup analysis showed that higher TyG index values remained strongly associated with increased risk of less developed collateralization. To compare the risk assessment efficacy for the formation of collateralization between the TyG index and other metabolic abnormality indicators, an area under the receiver-operating characteristic (ROC) curve (AUC) was obtained. A significant improvement in the risk assessment performance for impaired collateralization emerged when adding the TyG index into a baseline model. Conclusions The increased TyG index is strongly associated with less developed collateralization in CAD patients with CTO lesions and its risk assessment performance is better than single metabolic abnormality indicators. Supplementary Information The online version contains supplementary material available at 10.1186/s12944-021-01574-x.
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37
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Yang J, Tang YD, Zheng Y, Li C, Zhou Q, Gao J, Meng X, Zhang K, Wang W, Shao C. The Impact of the Triglyceride-Glucose Index on Poor Prognosis in NonDiabetic Patients Undergoing Percutaneous Coronary Intervention. Front Endocrinol (Lausanne) 2021; 12:710240. [PMID: 34489866 PMCID: PMC8417234 DOI: 10.3389/fendo.2021.710240] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Accepted: 07/28/2021] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND The triglyceride-glucose index (TyG index) is a valuable marker for predicting adverse cardiovascular events in diabetic patients. However, for nondiabetic patients, whether the TyG index is independently related to poor prognosis remains unclear. This cohort study assessed the association of the TyG index with future cardiovascular risk in nondiabetic subjects who received percutaneous coronary intervention (PCI). METHODS We consecutively enrolled 5,489 nondiabetic patients who underwent PCI. All experimental subjects were divided into three groups based on their TyG index, which was determined by the equation ln (fasting triglyceride (mg/dl) × fasting blood glucose (mg/dl)/2). The primary endpoint was major adverse cardiovascular and cerebrovascular events (MACCE), including all-cause death, nonfatal myocardial infarction (MI), nonfatal stroke, and target vessel revascularization (TVR). RESULTS A total of 386 MACCE were documented during a median 29-month follow-up. The Kaplan-Meier survival results indicated that among the three groups, there was no obvious difference in any endpoints. Further Cox regression analyses suggested that the TyG index was not independently related to adverse cardiovascular outcomes for nondiabetic patients who underwent PCI (HR: 0.77, 95% CI 0.56-1.16, P = 0.210 for MACCE). Subgroup analysis suggested that the TyG index was independently relevant to MACCE for patients with low-density lipoprotein cholesterol (LDL-C) lower than 1.8 mmol/L. CONCLUSION The TyG index is not an effective predictive factor for adverse cardiovascular prognosis in nondiabetic patients who underwent PCI. However, in subjects with LDL-C lower than 1.8mmol/L, it may predict future cardiovascular risk.
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Affiliation(s)
- Jie Yang
- Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yi-Da Tang
- Department of Cardiology, Institute of Vascular Medicine, Peking University Third Hospital, Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, Beijing, China
| | - Yitian Zheng
- Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Chen Li
- Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qing Zhou
- Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jun Gao
- Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiangbin Meng
- Department of Cardiology, Zhengzhou University People's Hospital, Zhengzhou, China
- Department of Cardiology, Central China Fuwai Hospital, Central China Branch of the National Cardiovascular Center, Zhengzhou, China
- Department of Cardiology, Henan Provincial People's Hospital, Zhengzhou, China
| | - Kuo Zhang
- Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wenyao Wang
- Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Chunli Shao
- Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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