Mo-Im Kim Nursing Research Institute, Yonsei University, College of Nursing, Seoul, Republic of Korea.
Department of Information & Statistics, Chungbuk National University, Cheongju, Republic of Korea.
PLoS One. 2021 Nov 4;16(11):e0259212. doi: 10.1371/journal.pone.0259212. eCollection 2021.
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.
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.
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.
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.
甘油三酯-葡萄糖（TyG）指数是胰岛素抵抗的可靠指标。我们旨在研究 TyG 指数与心脑血管疾病（CCVDs）和死亡率的关系。
这项回顾性研究纳入了 114603 名受试者。根据性别将 TyG 指数分为四个四分位区间：男性 Q1：<8.249 和 <8.063；Q2：8.249-<8.614 和 8.063-<8.403；Q3：8.614-<8.998 和 8.403-<8.752；Q4：≥8.998 和≥8.752。为了计算主要结局（CCVDs 和全因死亡率）和次要结局（心血管疾病[CVDs]、脑血管疾病[CbVDs]、CCVD 相关死亡或全因死亡）的风险比（HRs）和 95%置信区间（CIs），采用 Cox 比例风险回归模型。
与 Q1 相比，男性 Q2、Q3 和 Q4 的主要结局 HRs（95%CI）分别为 1.062（0.981-1.150）、1.110（1.024-1.204）和 1.151（1.058-1.252），女性分别为 1.099（0.986-1.226）、1.046（0.938-1.166）和 1.063（0.954-1.184）。调整年龄、吸烟状况、饮酒状况、体力活动、体重指数、收缩压、低密度脂蛋白胆固醇、经济状况和抗高血压药物后，男性 Q2、Q3 和 Q4 的 CVDs 的全调整 HRs（95%CI）分别为 1.114（0.969-1.282）、1.185（1.031-1.363）和 1.232（1.068-1.422），女性分别为 1.238（1.017-1.508）、1.183（0.971-1.440）和 1.238（1.018-1.505）。男性 Q2、Q3 和 Q4 的缺血性 CbVDs 的调整 HRs（95%CI）分别为 1.005（0.850-1.187）、1.225（1.041-1.441）和 1.232（1.039-1.460），女性分别为 1.040（0.821-1.316）、1.226（0.981-1.532）和 1.312（1.054-1.634），而 TyG 指数与女性的出血性 CbVDs 呈负相关，但与男性无关。TyG 指数与男性或女性的 CCVD 相关死亡或全因死亡无显著相关性。
升高的 TyG 指数与男性的主要结局（CCVDs 和全因死亡率）呈正相关，并预测男女 CVDs 和缺血性 CbVDs 的风险增加。
