Institute of Cardiovascular Diseases & Department of Cardiology, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610072, China.
Int J Obes (Lond). 2024 Oct;48(10):1498-1505. doi: 10.1038/s41366-024-01612-5. Epub 2024 Aug 14.
The triglyceride-glucose (TyG) index performs better at reflecting insulin resistance when combined with waist circumference (WC), body mass index (BMI), and waist-to-height ratio (WHtR) than when used alone. This study aimed to prospectively examine the relationships between TyG, TyG-BMI, TyG-WC, and TyG-WHtR with the incidence of myocardial infarction (MI) and its subtypes.
This cohort study included 370,390 participants from the UK Biobank. The Cox proportional hazards model and restricted cubic spline regression model were used to assess the associations of TyG, TyG-BMI, TyG-WC, and TyG-WHtR with MI, ST-elevation MI (STEMI) and non-ST-elevation MI (NSTEMI). The receiver operating characteristic (ROC) curve and the area under the curve (AUC) were employed to examine the predictive value of four indicators.
The hazard ratios (HRs) and 95% confidence intervals (CIs) of MI in the highest quartiles for TyG, TyG-BMI, TyG-WC, and TyG-WHtR were 1.36 (1.28-1.44), 1.47 (1.39-1.56), 1.53 (1.43-1.64), and 1.58 (1.48-1.68) in the fully-adjusted model. Comparable findings were observed when the outcomes were reclassified as STEMI or NSTEMI. However, the associations of TyG-BMI, TyG-WC, and TyG-WHtR with the risk of STEMI were weaker than MI and NSTEMI. A linear dose-response association between TyG and the risk of MI and NSTEMI were demonstrated. TyG-BMI, TyG-WC, and TyG-WHtR all showed nonlinear patterns in their associations with the risk of MI, STEMI, and NSTEMI. TyG-WC was most effective in diagnosing MI (AUC: 0.648, 95% CI: 0.644-0.653), STEMI (AUC: 0.631, 95% CI: 0.622-0.639), and NSTEMI (AUC: 0.647, 95% CI: 0.641-0.654).
The TyG index was linearly associated with increased risk of MI and NSTEMI, whereas TyG-BMI, TyG-WC, and TyG-WHtR were nonlinearly associated with increased risk of MI and NSTEMI. There were distinct patterns in the relationships between these indicators with STEMI. TyG-WC provided the best diagnostic effectiveness for MI, STEMI, and NSTEMI.
与单独使用相比，甘油三酯-葡萄糖（TyG）指数与腰围（WC）、体重指数（BMI）和腰高比（WHtR）结合使用时，在反映胰岛素抵抗方面表现更好。本研究旨在前瞻性研究 TyG、TyG-BMI、TyG-WC 和 TyG-WHtR 与心肌梗死（MI）及其亚型发病之间的关系。
本队列研究纳入了来自英国生物库的 370390 名参与者。使用 Cox 比例风险模型和限制性立方样条回归模型评估 TyG、TyG-BMI、TyG-WC 和 TyG-WHtR 与 MI、ST 段抬高型 MI（STEMI）和非 ST 段抬高型 MI（NSTEMI）的相关性。使用受试者工作特征（ROC）曲线和曲线下面积（AUC）来评估四个指标的预测价值。
在完全调整模型中，TyG、TyG-BMI、TyG-WC 和 TyG-WHtR 的最高四分位数与 MI 的 HRs（95%置信区间）分别为 1.36（1.28-1.44）、1.47（1.39-1.56）、1.53（1.43-1.64）和 1.58（1.48-1.68）。当结局重新分类为 STEMI 或 NSTEMI 时，观察到类似的发现。然而，与 STEMI 和 NSTEMI 相比，TyG-BMI、TyG-WC 和 TyG-WHtR 与 STEMI 风险的相关性较弱。TyG 与 MI 和 NSTEMI 风险之间存在线性剂量反应关系。TyG-BMI、TyG-WC 和 TyG-WHtR 与 MI、STEMI 和 NSTEMI 风险的相关性均呈非线性模式。TyG-WC 在诊断 MI（AUC：0.648，95%CI：0.644-0.653）、STEMI（AUC：0.631，95%CI：0.622-0.639）和 NSTEMI（AUC：0.647，95%CI：0.641-0.654）方面最有效。
TyG 指数与 MI 和 NSTEMI 风险增加呈线性相关，而 TyG-BMI、TyG-WC 和 TyG-WHtR 与 MI 和 NSTEMI 风险增加呈非线性相关。这些指标与 STEMI 之间的关系存在明显的模式。TyG-WC 对 MI、STEMI 和 NSTEMI 的诊断效果最佳。
