Association Between Triglyceride Glucose Index and Carotid Artery Plaque in Different Glucose Metabolic States in Patients with Coronary Heart Disease — A RCSCD-TCM Study in China

BackgroundThe triglyceride glucose (TyG) index serves as a surrogate indicator of insulin resistance. However, there are limited data on the association between TyG index and carotid artery plaque (CAP) in patients with coronary heart disease (CHD).MethodsA total of 10,535 CHD patients were included in this study. TyG index was divided into quartiles, Q1: TyG index ＜ 8.52, Q2: 8.52 ≤ TyG index ＜ 8.93, Q3: 8.93 ≤ TyG index ≤ 9.40, Q4: TyG index ＞9.40. Logistic regression was used to analyze the relationship between TyG index and CAP in CHD patients, and further analyzed the relationship between TyG index and CAP in different genders, different age groups and different glucose metabolism states. ResultsA baseline analysis of CHD patients divided into four groups according to the quartile of the TyG index showed that there were significant differences in related parameters between the groups. As the TyG index increases, the incidence of CAP increases significantly. After adjustment for multivariate, TyG index levels for Q3 and Q4 correlated with increased OR in CAP, which Q4 has the highest correlation (OR: 1.42; 95% CI: 1.33 -1.53). The correlation between the Tyg index of female (OR:1.38; 95% CI: 1.31-1.45) and CAP was higher than that of male (OR:1.23; 95% CI: 1.16, 1.30). The OR value of middle-aged (≤ 60 years old) patients (OR:1.14; 95% CI: 1.07-1.22) is higher than that of elderly (＞dayu 60 years old) patients (OR:1.07; 95% CI: 1.02-1.13). Under different glucose metabolism states, the TyG index of CHD patients was significantly related to the risk of CAP, and the OR value of diabetes (DM) was the highest (OR: 1.35; 95% CI: 1.26-1.45).ConclusionsThere is a significant correlation between the TyG index and CAP in CHD patients. In addition, the correlation between TyG index and CAP in CHD patients is higher in female than in male, and the correlation in middle-aged and elderly patients is higher than that in elderly patients. Under the condition of DM, the correlation between TyG index and carotid artery plaque in CHD patients is higher.

Evaluation of the long-term prognostic ability of triglyceride-glucose index for elderly acute coronary syndrome patients: a cohort study

Background With the advancement of the world population aging, more attention should be paid to the prognosis of elderly patients with acute coronary syndrome (ACS). Triglyceride-glucose (TyG) index is a reliable indicator of insulin resistance (IR) and is closely related to traditional risk factors of cardiovascular disease (CVD). However, the effect of TyG index on the prognosis of long-term adverse events in elderly ACS patients has not been reported. This study evaluated the prognostic power of TyG index in predicting adverse events in elderly ACS patients. Methods In this study, 662 ACS patients > 80 years old who were hospitalized from January 2006 to December 2012 were enrolled consecutively and the general clinical data and baseline blood biochemical indicators were collected. The follow-up time after discharge was 40–120 months (median, 63 months; interquartile range, 51‒74 months). In addition, the following formula was used to calculate the TyG index: Ln [fasting TG (mg/dL) × FBG (mg/dL)/2], and patients were divided into three groups according to the tertile of the TyG index. Results The mean age of the subjects was 81.87 ± 2.14 years, the proportion of females was 28.10%, and the mean TyG index was 8.76 ± 0.72. The TyG index was closely associated with the traditional risk factors of CVD. In the fully-adjusted Cox regression model, the Hazard ratio (95% CI) of all-cause mortality (in tertile 3) was 1.64 (1.06, 2.54) and major adverse cardiac event (MACE) (in tertile 3) was 1.36 (1.05, 1.95) for each SD increase in the TyG index. The subgroup analyses also confirmed the significant association of the TyG index and long-term prognosis. Conclusion The TyG index is an independent predictor of long-term all-cause mortality and MACE in elderly ACS patients.

Predictive Value of Triglyceride-Glucose Index for In-hospital Mortality in Patients With Severe Fever With Thrombocytopenia Syndrome: A Multi-Center Observational Study

Background: Triglyceride-glucose (TyG) index has been proposed as a reliable indicator for insulin resistance and proved to be closely associated with the severity and mortality risk of infectious diseases. It remains indistinct whether TyG index performs an important role in predicting in-hospital mortality in patients with severe fever with thrombocytopenia syndrome (SFTS).Methods: The current study retrospectively recruited patients who were admitted for SFTS from January to December 2019 at five medical centers. TyG index was calculated in accordance with the description of previous study: Ln [fasting triglyceride (TG) (mg/dl) × fasting blood glucose (FBG) (mg/dl)/2]. The observational endpoint of the present study was defined as the in-hospital death.Results: In total, 79 patients (64.9 ± 10.5 years, 39.2% female) who met the enrollment criteria were enrolled in the current study. During the hospitalization period, 17 (21.5%) patients died in the hospital. TyG index remained a significant and independent predictor for in-hospital death despite being fully adjusted for confounders, either being taken as a nominal [hazard ratio (HR) 5.923, 95% CI 1.208–29.036, P = 0.028] or continuous (HR 7.309, 95% CI 1.854–28.818, P = 0.004) variate. TyG index exhibited a moderate-to-high strength in predicting in-hospital death, with an area under the receiver operating characteristic curve (AUC) of 0.821 (95% CI 0.712–0.929, P < 0.001). The addition of TyG index displayed significant enhancement on the predictive value for in-hospital death beyond a baseline model, manifested as increased AUC (baseline model: 0.788, 95% CI 0.676–0.901 vs. + TyG index 0.866, 95% CI 0.783–0.950, P for comparison = 0.041), increased Harrell's C-index (baseline model: 0.762, 95% CI 0.645–0.880 vs. + TyG index 0.813, 95% CI 0.724–0.903, P for comparison = 0.035), significant continuous net reclassification improvement (NRI) (0.310, 95% CI 0.092–0.714, P = 0.013), and significant integrated discrimination improvement (0.111, 95% CI 0.008–0.254, P = 0.040).Conclusion: Triglyceride-glucose index, a novel indicator simply calculated from fasting TG and FBG, is strongly and independently associated with the risk of in-hospital death in patients with SFTS.

The Triglycerides and Glucose Index is Negatively Associated with Insulin Secretion in Young Adults with Normal Weight

Several studies have supported the usefulness of the triglycerides and glucose (TyG) index as a surrogate measure of insulin resistance; however, it has not been evaluated in insulin secretion. The aim of this study was to assess the association between the TyG index and insulin secretion in young adults with normal weight. Apparently healthy non-pregnant women and men, aged 18 to 23 years, were enrolled in a cross-sectional study. Overweight, obesity, pregnancy, smoking, alcohol consumption, diabetes, liver disease, renal disease, cardiovascular disease, and neoplasia were the exclusion criteria. Normal weight was defined by a body mass index (BMI)≥18.5<25.0 kg/m2 and the TyG index was calculated as the Ln [fasting triglycerides (mg/dl) x fasting glucose (mg/dl)]/2. A total of 1676 young adults with normal-weight, 1141 (68%) women, and 535 (32%) men were enrolled. Of them, 269 (16%) individuals exhibited insulin resistance; 213 (12.7%) women and 56 (3.3%) men. The linear regression analysis adjusted by gender, BMI, and waist circumference showed a significant association between the TyG index and HOMA-B (B=−35.90; 95% CI:−68.25 to−3.54, p=0.03) in the overall population. An additional analysis adjusted by BMI and waist circumference revealed that the TyG index is significantly associated with HOMA-B in subjects with and without insulin resistance (B=−104.73; 95% CI:−204.28 to−5.18, p=0.03 and B=−74.72; 95% CI:−108.04 to−41.40, p<0.001). The results of this study showed that the TyG index is negatively associated with insulin secretion in young adults with normal weight.

Association of Triglyceride–Glucose Index and the Presence of Sarcopenia in Type 2 Diabetes Patients

Objective: Triglyceride–glucose index (TyG index) has been used in healthy individuals as a marker of insulin resistance. Type 2 diabetes mellitus (T2DM) showed an increased risk of developing sarcopenia compared to control subjects. This study is performed to determine the association of TyG index with the presence of sarcopenia in T2DM patients. Method: This study included 1098 T2DM patients who were recruited from the inpatients in Qilu Hospital (Qingdao). Skeletal muscle index (SMI) was measured using dual energy X-ray absorptiometry. Serum triglyceride (TG) and fasting plasma glucose (FPG) were measured and used to calculate TyG index.Result: 119 male subjects (20.2%) had sarcopenia, while 72 female subjects (14.1%) had sarcopenia in T2DM patients. TyG index was correlated with a decreased risk of sarcopenia in both male and female T2DM groups. TyG index was found to be positively correlated with SMI after multivariate adjustment in male subjects. When TyG index was ≤9.5, TyG index was positively correlated with SMI. However, when TyG index was >9.5, there was not a significant association between TyG index and SMI. Moreover, TyG index was not correlated with SMI after multivariate analysis in female subjects. However, TyG index was positively correlated with SMI when TyG index was ≤9. When TyG index was >9, TyG index was negatively correlated with SMI, however, the correlation was not statistically significant. Conclusion: TyG index is inversely correlated with the presence of sarcopenia in type 2 diabetes patients.

Triglyceride Glucose-Waist Circumference Is Superior to the Homeostasis Model Assessment of Insulin Resistance in Identifying Nonalcoholic Fatty Liver Disease in Healthy Subjects

The triglyceride glucose (TyG) index has been suggested as a marker for insulin resistance; however, few studies have investigated the clinical implications of markers that combine obesity markers with the TyG index. This study aimed to investigate the associations between non-alcoholic fatty liver disease (NAFLD) and TyG-related markers in healthy subjects in Korea. We enrolled 21,001 asymptomatic participants who underwent hepatic ultrasonography. The homeostasis model assessment of insulin resistance (HOMA-IR), TyG index, TyG-body mass index, and TyG-waist circumference (WC) were subsequently analyzed. NAFLD was diagnosed using hepatic ultrasonography. A multiple logistic regression analysis was performed to evaluate the associations between the quartiles of each parameter and the risk of NAFLD. The increase in the NAFLD risk was most evident when the TyG-WC quartiles were applied; the multivariate-adjusted odds ratios for NAFLD were 4.72 (3.65–6.10), 13.28 (10.23–17.24), and 41.57 (31.66–54.59) in the 2nd, 3rd, and 4th TyG-WC quartiles, respectively, when compared with the lowest quartile. The predictability of the TyG-WC for NAFLD was better than that of the HOMA-IR using the area under the curve. The TyG-WC index was superior to the HOMA-IR for identifying NAFLD in healthy Korean adults, especially in the non-obese population.

Adiposity and insulin resistance mediate the inverse association between legume intake and blood pressure in individuals: a cross-sectional analysis in secondary cardiovascular prevention

The legume food group has important bioactive components and amino acids that have beneficial effects on blood pressure. This study aimed to evaluate the association between legume intake and blood pressure, as well as the mediating role of cardiometabolic risk factors in patients in secondary cardiovascular prevention. Sociodemographic, anthropometric, clinical, and food intake data were collected from the baseline of the multicenter study Brazilian Cardioprotective Nutritional Program Trial - BALANCE (RCT: NCT01620398). The relationships between variables were explored through path analysis. In total, 2,247 individuals with a median age of 63.0 (45 - 91) years, 58.8% (n= 1,321) male, and 96.5% (n= 2,168) with diagnosis of hypertension were included. Negative associations were observed between histidine intake and systolic blood pressure (SBP) (SC= −0.057; p= 0.012), and between legume intake and body mass index (BMI) (SC= −0.061; p= 0.006). BMI was positively associated with TyG index (SC= 0.173; p< 0.001), SBP (SC= 0.144; p< 0.001) and diastolic blood pressure (DBP) (SC= 0.177; p< 0.001), and TyG index was positively associated with DBP (SC= 0.079; p= 0.001). A negative indirect effect was observed between the intake of legumes, SBP and DBP, mediated by BMI (SC = −0.009; p = 0.011; SC = −0.011; p = 0.010, respectively). In addition, an indirect negative effect was found between the intake of legumes and the DBP, mediated simultaneously by BMI and TyG index (SC = −0.001; p = 0.037). In conclusion, legume intake presented a negative indirect association with blood pressure, mediated by insulin resistance (TyG) and adiposity (BMI) in individuals of secondary care in cardiology.

Association of Two Indices of Insulin Resistance Marker with Abnormal Liver Function Tests: A Cross-Sectional Population Study in Taiwanese Adults

Background and objectives: Insulin resistance (IR) is frequently associated with chronic low-grade inflammation and has an important role as a mediator in the development of liver disease. Thus, this study aimed to explore the relationship between two indexes of IR and abnormal liver function parameters. Materials and Methods: This cross-sectional study obtained data of 41,510 men and 92,357 women aged ≥30 years from a private health screening institute in Taiwan. Two IR indexes namely triglyceride-glucose (TyG) index and triglycerides to high-density lipoprotein cholesterol (TG/HDL-C) ratio were used to examine their relationship to predict abnormal liver function parameters (aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transferase (GGT), and alkaline phosphatase (ALP)). Results: Positive trend was shown for the association of TyG index in the highest quintile (Q5) and risk of high AST (OR = 1.45, 95% CI: 1.33–1.57), high ALT (OR = 1.85, 95% CI: 1.73–1.97), high GGT (OR = 2.04, 95% CI: 1.93–2.15), and high ALP (OR = 1.13, 95% CI: 1.07–1.19) compared with the median quintile (Q3) in the fully adjusted model. Similarly, participants in the Q5 of the TG/HDL-C ratio were associated with 1.38 (95% CI: 1.27–1.49), 1.71 (95% CI: 1.61–1.82), 1.75 (95% CI: 1.66–1.84), and 1.21 (1.16–1.27) odds for having high AST, ALT, GGT, and ALP respectively. The AUC (95% CI) value of the TyG index for predicting high AST, high ALT, and high GGT was 0.699 (0.692–0.705), 0.738 (0.734–0.742), and 0.752 (0.749–0.755), respectively. Meanwhile, the AUC (95% CI) of the TG/HDL-C ratio for predicting high AST, high ALT, and high GGT was 0.680 (0.673–0.686), 0.738 (0.734–0.742), 0.734 (0.731–0.738), respectively. Conclusions: Our study supported that the TyG index and TG/HDL-C ratio may be useful as non-invasive methods to predict the existence of impaired liver function in the early stage.