Graduate School, North China University of Science and Technology, Tangshan, China.
School of Medicine, Nankai University, Tianjin, China.
Endocrine. 2022 Feb;75(2):392-399. doi: 10.1007/s12020-021-02862-3. Epub 2021 Sep 20.
Previous studies suggest that triglyceride-glucose index (TyG) index, as a marker of insulin resistance, may have associations with the risk of cardiovascular diseases (CVD) in elderly population. Given the paucity of data, it remains controversial, especially in general Chinese population. We aimed to further assess whether TyG index is an independent risk factor for CVD.
We conducted a prospective cohort study that enrolled a total of 96,541 participants from the Kailuan Study. TyG index was calculated as ln (fasting triglyceride [mg/dL] × fasting glucose [mg/dL]/2). Participants were divided into four groups (Q1, Q2, Q3, and Q4) by quartiles of the TyG index. Any CVD events occurred during 2006-2017 were recorded, including myocardial infarction (MI) and stroke. We assessed the association of TyG index with the risk of CVD and the subtypes of CVD by using Cox models estimated hazard ratios (HRs) and 95% confidence interval (CIs).
During a median follow-up of 10.33 years, totally 6421 CVD events, 1493 MIs, and 5083 stroke events occurred. Multivariate Cox regression analysis showed that compared with Q1, HR (95% CI) for CVD events was 1.12 (95%, 1.03-1.21) in Q2, 1.28 (95%, 1.18-1.38) in Q3, and 1.34 (95%, 1.23-1.45) in Q4. In a time-dependent Cox Model we also found that compared with Q1, HR (95% CI) for CVD events was 1.09 (95%, 1.02-1.18) in Q2, 1.18 (95%, 1.09-1.27) in Q3, and 1.20 (95%, 1.11-1.30) in Q4. Similar results were showed in MI and stroke.
TyG index as a marker of insulin resistance was an independent risk factor for CVD. This may help in the early identification of people at high risk of CVD and be applicable to the primordial and primary prevention.
先前的研究表明，三酰甘油-葡萄糖指数（TyG）作为胰岛素抵抗的标志物，与老年人群心血管疾病（CVD）的风险可能存在关联。鉴于数据有限，其相关性仍存在争议，尤其是在普通中国人群中。我们旨在进一步评估 TyG 指数是否是 CVD 的独立危险因素。
我们进行了一项前瞻性队列研究，共纳入了来自开滦研究的 96541 名参与者。TyG 指数的计算方法为 ln（空腹三酰甘油[mg/dL]×空腹血糖[mg/dL]/2）。参与者按 TyG 指数的四分位数分为四组（Q1、Q2、Q3 和 Q4）。记录 2006-2017 年期间发生的任何 CVD 事件，包括心肌梗死（MI）和中风。我们使用 Cox 模型评估 TyG 指数与 CVD 风险和 CVD 亚型之间的关系，估计风险比（HR）和 95%置信区间（CI）。
在中位随访 10.33 年期间，共发生 6421 例 CVD 事件、1493 例 MI 和 5083 例中风事件。多变量 Cox 回归分析显示，与 Q1 相比，Q2（95%CI，1.03-1.21）、Q3（95%CI，1.18-1.38）和 Q4（95%CI，1.23-1.45）的 CVD 事件 HR 分别为 1.12（95%CI）、1.28（95%CI）和 1.34（95%CI）。在时间依赖性 Cox 模型中，我们还发现与 Q1 相比，Q2（95%CI，1.02-1.18）、Q3（95%CI，1.09-1.27）和 Q4（95%CI，1.11-1.30）的 CVD 事件 HR 分别为 1.09（95%CI）、1.18（95%CI）和 1.20（95%CI）。MI 和中风也有类似的结果。
作为胰岛素抵抗标志物的 TyG 指数是 CVD 的一个独立危险因素。这有助于早期识别 CVD 高危人群，适用于原始和初级预防。
