Division of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, 877 Bangeojinsunhwando-ro, Dong-gu, Ulsan, 44033, Republic of Korea.
Division of Cardiology, Dong-A University Hospital, Busan, Republic of Korea.
Lipids Health Dis. 2020 Jan 14;19(1):7. doi: 10.1186/s12944-020-1187-0.
Atherosclerotic cardiovascular (CV) events commonly occur in individuals with a low CV risk burden. This study evaluated the ability of the triglyceride glucose (TyG) index to predict subclinical coronary artery disease (CAD) in asymptomatic subjects without traditional CV risk factors (CVRFs).
This retrospective, cross-sectional, and observational study evaluated the association of TyG index with CAD in 1250 (52.8 ± 6.5 years, 46.9% male) asymptomatic individuals without traditional CVRFs (defined as systolic/diastolic blood pressure ≥ 140/90 mmHg; fasting glucose ≥126 mg/dL; total cholesterol ≥240 mg/dL; low-density lipoprotein cholesterol ≥160 mg/dL; high-density lipoprotein cholesterol < 40 mg/dL; body mass index ≥25.0 kg/m; current smoking; and previous medical history of hypertension, diabetes, or dyslipidemia). CAD was defined as the presence of any coronary plaque on coronary computed tomographic angiography. The participants were divided into three groups based on TyG index tertiles.
The prevalence of CAD increased with elevating TyG index tertiles (group I: 14.8% vs. group II: 19.3% vs. group III: 27.6%; P < 0.001). Multivariate logistic regression models showed that TyG index was associated with an increased risk of CAD (odds ratio [OR] 1.473, 95% confidence interval [CI] 1.026-2.166); especially non-calcified (OR 1.581, 95% CI 1.002-2.493) and mixed plaques (OR 2.419, 95% CI 1.051-5.569) (all P < 0.05). The optimal TyG index cut-off for predicting CAD was 8.44 (sensitivity 47.9%; specificity 68.5%; area under the curve 0.600; P < 0.001). The predictive value of this cut-off improved after considering the non-modifiable factors of old age and male sex.
TyG index is an independent marker for predicting subclinical CAD in individuals conventionally considered healthy.
在低心血管风险负担的个体中，动脉粥样硬化性心血管（CV）事件通常会发生。本研究评估了甘油三酯葡萄糖（TyG）指数预测无症状无传统心血管危险因素（CVRFs）个体亚临床冠状动脉疾病（CAD）的能力。
这是一项回顾性、横断面和观察性研究，评估了 TyG 指数与 1250 名无症状个体（平均年龄 52.8±6.5 岁，46.9%为男性）CAD 的相关性，这些个体无传统 CVRFs（定义为收缩压/舒张压≥140/90mmHg；空腹血糖≥126mg/dL；总胆固醇≥240mg/dL；低密度脂蛋白胆固醇≥160mg/dL；高密度脂蛋白胆固醇<40mg/dL；体重指数≥25.0kg/m；当前吸烟；以及高血压、糖尿病或血脂异常的既往病史）。CAD 定义为冠状动脉计算机断层血管造影上存在任何冠状动脉斑块。根据 TyG 指数三分位数将参与者分为三组。
随着 TyG 指数三分位数的升高，CAD 的患病率也随之增加（第 I 组：14.8%；第 II 组：19.3%；第 III 组：27.6%；P<0.001）。多变量逻辑回归模型显示，TyG 指数与 CAD 风险增加相关（比值比[OR]1.473，95%置信区间[CI]1.026-2.166）；特别是非钙化（OR 1.581，95%CI 1.002-2.493）和混合斑块（OR 2.419，95%CI 1.051-5.569）（均 P<0.05）。预测 CAD 的最佳 TyG 指数截断值为 8.44（敏感性 47.9%；特异性 68.5%；曲线下面积 0.600；P<0.001）。考虑到年龄较大和男性等不可改变因素后，该截断值的预测价值提高。
TyG 指数是预测传统健康个体亚临床 CAD 的独立标志物。
