Cho Yun Kyung, Kim Hwi Seung, Park Joong-Yeol, Lee Woo Je, Kim Ye-Jee, Jung Chang Hee
Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea.
Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
J Obes Metab Syndr. 2022 Jun 30;31(2):178-186. doi: 10.7570/jomes21086. Epub 2022 Jun 13.
This study assesses the prognostic value of the triglyceride-glucose (TyG) index for cardiovascular (CV) risk in subgroups based on metabolic health and obesity status.
Originally, 514,866 participants were enrolled from the Korean National Health Insurance Service-National Health Screening Cohort. The study participants were categorized into four groups: metabolically healthy non-obese (MHNO), metabolically unhealthy non-obese (MUNO), metabolically healthy obese (MHO), and metabolically unhealthy obese (MUO). The TyG index was calculated using the following formula: ln (fasting triglyceride [mg/dL]×fasting plasma glucose [mg/dL]/2). Participants were followed from 2009 to 2015 for CV events and CV mortality according to the TyG index.
After exclusions, the final study cohort contained 292,206 people. During the follow-up, 9,138 CV events and 1,163 CV deaths were documented. When the high and low TyG groups were compared, the high TyG group had a substantially increased risk of CV events among the MUNO and MUO participants (multivariable-adjusted hazard ratio [HR], 1.18; 95% confidence interval [CI], 1.07-1.30 and 1.27 [1.14-1.42], respectively). In participants with MUO status, CV mortality was also significantly increased in the high TyG group compared with the corresponding low TyG group (multivariable-adjusted HR, 1.48; 95% CI, 1.13-1.93). In contrast, a high TyG index was not related to CV mortality in the MHNO, MHO, and MUNO groups.
The predictive value of the TyG index can vary across populations. Among MUO participants, the TyG index was significantly and positively correlated with unfavorable CV outcomes.
本研究评估了基于代谢健康和肥胖状况的亚组中甘油三酯-葡萄糖（TyG）指数对心血管（CV）风险的预后价值。
最初，从韩国国民健康保险服务-国民健康筛查队列中纳入了514,866名参与者。研究参与者被分为四组：代谢健康非肥胖（MHNO）、代谢不健康非肥胖（MUNO）、代谢健康肥胖（MHO）和代谢不健康肥胖（MUO）。TyG指数使用以下公式计算：ln（空腹甘油三酯[mg/dL]×空腹血糖[mg/dL]/2）。根据TyG指数，对参与者在2009年至2015年期间进行随访，观察心血管事件和心血管死亡率。
排除后，最终研究队列包含292,206人。在随访期间，记录了9138例心血管事件和1163例心血管死亡。当比较高TyG组和低TyG组时，高TyG组在MUNO和MUO参与者中发生心血管事件的风险显著增加（多变量调整风险比[HR]，分别为1.18；95%置信区间[CI]，1.07 - 1.30和1.27[1.14 - 1.42]）。在MUO状态参与者中，高TyG组的心血管死亡率与相应的低TyG组相比也显著增加（多变量调整HR，1.48；95%CI，1.13 - 1.93）。相比之下，高TyG指数与MHNO、MHO和MUNO组的心血管死亡率无关。
TyG指数的预测价值在不同人群中可能有所不同。在MUO参与者中，TyG指数与不良心血管结局显著正相关。
