Department of Family Medicine, Yonsei University College of Medicine, Yongin Severance Hospital, 363 Dongbaekjukjeondae-ro, Giheung-gu, Yongin-si, Gyeonggi-do, 16995, Republic of Korea.
Department of Family Medicine, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea.
Cardiovasc Diabetol. 2020 Dec 10;19(1):210. doi: 10.1186/s12933-020-01186-2.
Ischemic heart disease (IHD) without diabetes is considered an important challenge to human health and is associated with a poor prognosis, as well as a lack of health awareness. We prospectively investigated the relationship between the triglyceride-glucose (TyG) index, a surrogate marker of early insulin resistance, and incident IHD risk in a large cohort of nondiabetic Korean adults using National Health Insurance Service data.
We assessed 16,455 participants (8426 men and 8029 women) without diabetes using data from a health risk assessment study (HERAS) and Korea Health Insurance Review and Assessment (HIRA) data. The participants were divided into four groups according to TyG index quartiles, calculated as ln [fasting triglycerides (mg/dL) × fasting plasma glucose (mg/dL)/2]. We prospectively assessed hazard ratios (HRs) with 95% confidence intervals (CIs) for IHD using multivariate Cox proportional-hazards regression models over a 50-month period that followed the baseline survey.
During the follow-up period, 322 (2.0%) participants developed IHD. HRs of IHD for TyG index quartiles 2-4 were 1.61 (95% CI 1.05-2.48), 1.85 (95% CI 1.21-2.81), and 2.29 (95% CI 1.50-3.51), respectively, after adjusting for age, sex, body mass index, smoking status, alcohol intake, and physical activity.
A higher TyG index precedes and significantly predicts future IHD among nondiabetic Koreans. Accordingly, the TyG index may be a useful measure in assessing cardiovascular risk for nondiabetic adults in the preclinical stage.
非糖尿病性缺血性心脏病（IHD）被认为是对人类健康的重要挑战，与预后不良以及健康意识缺乏有关。我们使用国民健康保险服务数据，前瞻性地研究了非糖尿病韩国成年人中，作为早期胰岛素抵抗替代标志物的甘油三酯-葡萄糖（TyG）指数与 IHD 发病风险之间的关系。
我们使用健康风险评估研究（HERAS）和韩国健康保险审查与评估（HIRA）数据评估了 16455 名无糖尿病参与者（8426 名男性和 8029 名女性）。根据 TyG 指数四分位数（ln[空腹甘油三酯（mg/dL）×空腹血糖（mg/dL）/2]）将参与者分为四组。我们使用多变量 Cox 比例风险回归模型，在基线调查后 50 个月的时间内，前瞻性评估了 IHD 的危险比（HR）及其 95%置信区间（CI）。
在随访期间，322（2.0%）名参与者发生了 IHD。校正年龄、性别、体重指数、吸烟状况、饮酒和身体活动后，TyG 指数四分位数 2-4 组发生 IHD 的 HR 分别为 1.61（95%CI 1.05-2.48）、1.85（95%CI 1.21-2.81）和 2.29（95%CI 1.50-3.51）。
较高的 TyG 指数预示着非糖尿病韩国人未来会发生 IHD，且具有显著意义。因此，TyG 指数可能是评估非糖尿病成年人临床前心血管风险的有用指标。
