Huo Guijun, Zheng Jin, Cao Junjie, Zhang Lili, Yao Zhichao, Zeng Yuqi, Tang Yao, Liu Zhanao, Tan Ziyi, Zhou Dayong
The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital Jiangsu China.
J Am Heart Assoc. 2025 Feb 4;14(3):e037970. doi: 10.1161/JAHA.124.037970. Epub 2025 Jan 23.
The triglyceride-glucose (TyG) index has been proposed as a reliable marker of insulin resistance. However, its value in patients with carotid plaque stability remains unclear. This study investigated the association between the TyG index and unstable carotid plaque.
A total of 12 068 participants were enrolled. Carotid ultrasound was used to determine the stability of carotid plaque. Logistic regression was used to analyze the relationship between the TyG index and unstable carotid plaque. The relationship between the TyG index and unstable carotid plaque was evaluated according to sex, age, and glucose metabolism states. Further, the dose-response relationship between the TyG index and unstable carotid plaque was also determined by restrictive cubic splines.
Of the 12 068 participants, 11 601 had stable carotid plaque and 467 had unstable carotid plaque. In several different adjustment models, the TyG index is significantly related to the risk of unstable carotid plaque. The association between the TyG index and an unstable carotid plaque was similar between men and women, despite the fact that the odds ratio (OR) tended to be higher in men (OR, 2.80 [95% CI, 2.04-3.83]) than women (OR, 2.07 [95% CI, 1.51-2.82]), and higher in older patients (aged >60 years; (OR, 3.59 [95% CI, 2.74-4.70]) than middle-aged patients (aged ≤60 years) (OR, 2.00 [95% CI, 1.36-2.95]). The TyG index of patients with different glycemic status was significantly correlated with the risk of unstable carotid plaque, among which the OR value of diabetes (OR, 2.51 [95% CI, 1.87-3.36]) was the highest. The restrictive cubic spline analysis indicated a nonlinear relationship between the TyG index and unstable carotid plaque, with TyG index >8.63 identified as an independent risk factor for unstable carotid plaque.
The TyG index has a significant association with unstable carotid plaque. The association between the TyG index and unstable carotid plaque is similar between men and women, and the association in older patients is higher than that in middle-aged patients. In different glycemic status, the association between the TyG index and unstable carotid plaque is highest in patients with diabetes.
甘油三酯-葡萄糖（TyG）指数已被提出作为胰岛素抵抗的可靠标志物。然而，其在颈动脉斑块稳定性患者中的价值仍不清楚。本研究调查了TyG指数与不稳定颈动脉斑块之间的关联。
共纳入12068名参与者。采用颈动脉超声确定颈动脉斑块的稳定性。使用逻辑回归分析TyG指数与不稳定颈动脉斑块之间的关系。根据性别、年龄和糖代谢状态评估TyG指数与不稳定颈动脉斑块之间的关系。此外，还通过限制性立方样条确定TyG指数与不稳定颈动脉斑块之间的剂量反应关系。
在12068名参与者中，11601人有稳定的颈动脉斑块，467人有不稳定的颈动脉斑块。在几种不同的调整模型中，TyG指数与不稳定颈动脉斑块的风险显著相关。TyG指数与不稳定颈动脉斑块之间的关联在男性和女性中相似，尽管男性的优势比（OR）（OR，2.80[95%CI，2.04-3.83]）往往高于女性（OR，2.07[95%CI，1.51-2.82]），且老年患者（年龄>60岁；OR，3.59[95%CI，2.74-4.70]）高于中年患者（年龄≤60岁）（OR，2.00[95%CI，1.36-2.95]）。不同血糖状态患者的TyG指数与不稳定颈动脉斑块的风险显著相关，其中糖尿病患者的OR值最高（OR，2.51[95%CI，1.87-3.36]）。限制性立方样条分析表明TyG指数与不稳定颈动脉斑块之间存在非线性关系，TyG指数>8.63被确定为不稳定颈动脉斑块的独立危险因素。
TyG指数与不稳定颈动脉斑块显著相关。TyG指数与不稳定颈动脉斑块之间的关联在男性和女性中相似，老年患者中的关联高于中年患者。在不同血糖状态下，TyG指数与不稳定颈动脉斑块之间的关联在糖尿病患者中最高。
