Tang Xiaodi, Zhang Kexin, He Rong
Department of Cardiovascular Medicine, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, No. 168 Litang Road, Changping District, Beijing, China.
Cardiovasc Diabetol. 2025 Feb 6;24(1):54. doi: 10.1186/s12933-025-02621-y.
The association between triglyceride-glucose (TyG), triglyceride-glucose related indices and heart disease remains a topic of debate in the current literature. Existing evidence in Chinese people and in diabetes or non-diabetes patients regarding this association is limited, highlighting the need for further investigation.
A cohort study was conducted involving 7945 participants enrolled in the China Health and Retirement Longitudinal Study (CHARLS). The incidence of heart disease was collected by following up 9 years. TyG, TyG with body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR) were collected at baseline. Multivariate Cox proportional hazards models, restricted cubic spline (RCS), Kaplan-Meier (KM) curves, subgroup analysis and sensitivity analysis were used to analyze the associations between TyG, TyG related indices and the risk of heart disease in national participants and in type 2 diabetes (T2D) or non-T2D patients respectively.
During a 9-year follow-up, 1477 participants (18.6%) developed heart disease. Our analysis found a significant positive association between TyG-BMI, TyG-WC, and TyG-WHtR with heart disease risk in all participants. The adjusted hazard ratios (HR) for the highest quartile compared to the lowest were: TyG-BMI 1.73 (95% CI: 1.47-2.03), TyG-WC 1.46 (95% CI: 1.24-1.71), and TyG-WHtR 1.31 (95% CI: 1.11-1.54). However, TyG alone was not significantly associated with heart disease in all participants. In non-diabetic patients, the associations were consistent: TyG-BMI 1.75 (95% CI: 1.47-2.08), TyG-WC 1.47 (95% CI: 1.24-1.75), and TyG-WHtR 1.34 (95% CI: 1.13-1.60). However, in diabetes patients, no significant associations were found between TyG, TyG-WC, TyG-WHtR and heart disease risk except for the highest quartile of TyG-BMI (HR: 1.86, 95% CI: 1.02-3.40).
In the national population study, higher TyG-BMI, TyG-WC, and TyG-WHtR indices were significantly associated with an increased risk of heart disease, with TyG-BMI and TyG-WC showing stronger correlations. While this association was evident in non-T2D patients, only TyG-BMI was associated with heart disease incidence in T2D patients, underscoring the necessity for further investigation.
甘油三酯-葡萄糖（TyG）、甘油三酯-葡萄糖相关指数与心脏病之间的关联在当前文献中仍是一个有争议的话题。目前关于中国人以及糖尿病或非糖尿病患者中这种关联的现有证据有限，这凸显了进一步研究的必要性。
进行了一项队列研究，纳入了7945名参与中国健康与养老追踪调查（CHARLS）的参与者。通过9年的随访收集心脏病发病率。在基线时收集TyG、TyG与体重指数（BMI）、腰围（WC）、腰高比（WHtR）。分别使用多变量Cox比例风险模型、限制性立方样条（RCS）、Kaplan-Meier（KM）曲线、亚组分析和敏感性分析来分析TyG、TyG相关指数与全国参与者以及2型糖尿病（T2D）或非T2D患者心脏病风险之间的关联。
在9年的随访期间，1477名参与者（18.6%）患上了心脏病。我们的分析发现，在所有参与者中，TyG-BMI、TyG-WC和TyG-WHtR与心脏病风险之间存在显著的正相关。与最低四分位数相比，最高四分位数的调整后风险比（HR）分别为：TyG-BMI 1.73（95%置信区间：1.47-2.03），TyG-WC 1.46（95%置信区间：1.24-1.71），TyG-WHtR 1.31（95%置信区间：1.11-1.54）。然而，仅TyG在所有参与者中与心脏病无显著关联。在非糖尿病患者中，关联是一致的：TyG-BMI 1.75（95%置信区间：1.47-2.08），TyG-WC 1.47（95%置信区间：1.24-1.75），TyG-WHtR 1.34（95%置信区间：1.13-1.60）。然而，在糖尿病患者中，除了TyG-BMI最高四分位数外，未发现TyG、TyG-WC、TyG-WHtR与心脏病风险之间存在显著关联（HR：1.86，95%置信区间：1.02-3.40）。
在全国人群研究中，较高的TyG-BMI、TyG-WC和TyG-WHtR指数与心脏病风险增加显著相关，其中TyG-BMI和TyG-WC显示出更强的相关性。虽然这种关联在非T2D患者中很明显，但在T2D患者中只有TyG-BMI与心脏病发病率相关，这凸显了进一步研究的必要性。
