Guo Congfang, Li Mingming, Wang Lili, Bai Yuting, Rong Yudong, Zhang Minying, Guo Fenghua, Guo Xiang, Guo Jie, Zhang Li, Zhao Yiyan
Health Management Center, Tianjin First Central Hospital, Tianjin, China.
Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Third Hospital of Shanxi Medical University, Tongji Shanxi Hospital, Taiyuan, China.
Front Cardiovasc Med. 2025 Jun 6;12:1611466. doi: 10.3389/fcvm.2025.1611466. eCollection 2025.
The triglyceride-glucose (TyG) index, a simple surrogate marker of insulin resistance (IR), has been associated with cardiovascular risk factors and atherosclerosis. However, its relationship with carotid atherosclerosis (CA), including carotid intima thickening (CMT), plaques, and stenosis, remains inadequately studied in the general population.
This study aimed to evaluate the association between the TyG index and CA.
A retrospective cross-sectional study was conducted among 8,600 participants undergoing health checkups and carotid ultrasonography. CA was defined as the presence of CMT, plaques, or stenosis (>50%). The TyG index was calculated using fasting triglycerides and glucose levels. Multivariate logistic regression and subgroup analyses were performed to assess the association between the TyG index and CA. We constructed fitting curves to evaluate the dose-response relationship between the TyG index and CA in different subgroups. All statistical analyses were executed using R Statistical Software and the Free Statistics analysis platform.
The TyG index was positively associated with CA (OR = 1.22, 95% CI: 1.08-1.38, = 0.003), plaques (OR = 1.28, 95% CI: 1.12-1.47, < 0.001), and stenosis (OR = 2.49, 95% CI: 1.86-3.32, < 0.001), but not with CMT. Subgroup analyses revealed stronger associations in younger individuals (<49 years), males, and those without hypertension, dyslipidemia, or hyperglycemia. A nonlinear relationship between TyG and CA was observed in lean/normal-weight individuals, with a threshold effect at TyG = 8.112. We found that if TyG below 8.112, each unit increasing in TyG reduced CA risk (OR = 0.26, 95% CI: 0.07-0.96, = 0.043), while above it, the risk increased significantly (OR = 1.65, 95% CI: 1.06-2.57, = 0.025) in this study. Linear relationships between TyG index and CA were showed in different subgroups stratified by age, gender and different metabolic conditions and overweight/obesity individals.
The TyG index is a significantly association of CA, particularly in high-risk subgroups. The TyG index shows promise for CA risk stratification. Emphasizing the need for targeted interventions in specific populations ahead of time. The TyG index may complement existing tools, but further prospective validation is needed to assess its incremental value.
甘油三酯-葡萄糖（TyG）指数作为胰岛素抵抗（IR）的一种简单替代指标，已被证实与心血管危险因素及动脉粥样硬化相关。然而，在普通人群中，其与颈动脉粥样硬化（CA），包括颈动脉内膜增厚（CMT）、斑块及狭窄之间的关系仍未得到充分研究。
本研究旨在评估TyG指数与CA之间的关联。
对8600名接受健康体检及颈动脉超声检查的参与者进行了一项回顾性横断面研究。CA定义为存在CMT、斑块或狭窄（>50%）。TyG指数通过空腹甘油三酯和血糖水平计算得出。进行多因素逻辑回归及亚组分析以评估TyG指数与CA之间的关联。我们构建拟合曲线以评估不同亚组中TyG指数与CA之间的剂量反应关系。所有统计分析均使用R统计软件及免费统计分析平台执行。
TyG指数与CA（OR = 1.22，95%CI：1.08 - 1.38，P = 0.003）、斑块（OR = 1.28，95%CI：1.12 - 1.47，P < 0.001）及狭窄（OR = 2.49，95%CI：1.86 - 3.32，P < 0.001）呈正相关，但与CMT无关。亚组分析显示，在较年轻个体（<49岁）、男性以及无高血压、血脂异常或高血糖的个体中，关联更强。在体重正常/偏瘦个体中观察到TyG与CA之间存在非线性关系，TyG = 8.112时存在阈值效应。我们发现，在本研究中，如果TyG低于8.112，TyG每增加一个单位，CA风险降低（OR = 0.26，95%CI：0.07 - 0.96，P = 0.043），而高于该值时，风险显著增加（OR = 1.65，95%CI：1.06 - 2.57，P = 0.025）。在按年龄、性别及不同代谢状况分层的不同亚组以及超重/肥胖个体中，TyG指数与CA之间呈线性关系。
TyG指数与CA显著相关，尤其是在高危亚组中。TyG指数在CA风险分层方面具有潜力。强调提前对特定人群进行针对性干预的必要性。TyG指数可能补充现有工具，但需要进一步的前瞻性验证以评估其增量价值。
