Meng Juan, Lu Yuting, Gao Xuewei, Hao Juan, Li Xiao, Ning Xianjia, Zhang Wenjuan, Wang Jinghua
Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, 300052, People's Republic of China.
Department of Geriatric Medicine, Shenzhen Third People's Hospital and the Second Hospital Affiliated with the Southern University of Science and Technology, Shenzhen, Guangdong, People's Republic of China.
Risk Manag Healthc Policy. 2025 Jun 17;18:1979-1990. doi: 10.2147/RMHP.S522995. eCollection 2025.
Atherosclerotic cardiovascular disease (ASCVD) is a major global health burden. The triglyceride-glucose (TyG) index, as a surrogate marker of insulin resistance, is associated with atherosclerosis, but its role in predicting carotid plaque and intima-media thickness (IMT) changes remains unclear. This study aimed to assess the relationship between the TyG index and carotid plaque incidence and IMT changes over a six-year period in a cohort of middle-aged and elderly individuals with low income and low education in rural China.
The study was conducted from 2014 to 2020 in 18 rural villages in Tianjin, China. A total of 2702 participants were included in the IMT analysis, and after excluding those with carotid plaques at baseline, 1595 participants were included in the plaque incidence analysis. Multivariate logistic regression was used to assess the relationship between the TyG index and outcomes. Subgroup analyses were based on significant indicators from the multivariate adjustment.
During the six-year follow-up, 551 new cases of carotid plaque were identified, with an incidence rate of 34.5%. Univariate analysis showed a significant association between the TyG index and increased plaque incidence. However, after adjusting for multiple confounders, the TyG index emerged as an independent predictor only for IMT increase. Each 1-unit increase in TyG was associated with a 49% increased risk (RR: 1.49; 95% CI: 1.05-2.13; P = 0.026), with this association being particularly strong in males, individuals aged ≥60 years, and those without hypertension.
Results highlight the importance of incorporating the TyG index into cardiovascular risk assessments, especially for IMT changes in specific subpopulations. The study underscores the need for targeted prevention strategies in rural, low-education and low-income populations. Future research is needed to elucidate the potential interactions between the TyG index and other metabolic factors in ASCVD.
动脉粥样硬化性心血管疾病（ASCVD）是一项重大的全球健康负担。甘油三酯-葡萄糖（TyG）指数作为胰岛素抵抗的替代标志物，与动脉粥样硬化相关，但其在预测颈动脉斑块和内膜中层厚度（IMT）变化方面的作用仍不明确。本研究旨在评估中国农村低收入和低教育水平的中老年人群队列中，TyG指数与六年期间颈动脉斑块发生率及IMT变化之间的关系。
该研究于2014年至2020年在中国天津的18个乡村进行。共有2702名参与者纳入IMT分析，在排除基线时患有颈动脉斑块的参与者后，1595名参与者纳入斑块发生率分析。采用多因素逻辑回归评估TyG指数与结局之间的关系。亚组分析基于多因素调整后的显著指标。
在六年随访期间，共发现551例新发颈动脉斑块病例，发生率为34.5%。单因素分析显示TyG指数与斑块发生率增加之间存在显著关联。然而，在调整多个混杂因素后，TyG指数仅成为IMT增加的独立预测因素。TyG每增加1个单位，风险增加49%（风险比：1.49；95%置信区间：1.05 - 2.13；P = 0.026），这种关联在男性、年龄≥60岁的个体以及无高血压者中尤为明显。
结果强调了将TyG指数纳入心血管风险评估的重要性，特别是对于特定亚人群的IMT变化。该研究强调了在农村、低教育和低收入人群中制定针对性预防策略的必要性。未来需要开展研究以阐明TyG指数与ASCVD中其他代谢因素之间的潜在相互作用。
