scholarly journals The triglyceride glucose index is a simple and low-cost marker associated with atherosclerotic cardiovascular disease: a population-based study

BMC Medicine ◽  
2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Sangmo Hong ◽  
Kyungdo Han ◽  
Cheol-Young Park
Keyword(s):  
Insulin Resistance ◽  
Cardiovascular Disease ◽  
Large Scale ◽  
Large Population ◽  
Surrogate Marker ◽  
Cox Proportional Hazards ◽  
Atherosclerotic Cardiovascular Disease ◽  
Tyg Index ◽  
The Relationship

Abstract Background The triglyceride glucose (TyG) index is an inexpensive clinical surrogate marker for insulin resistance. However, the relationship between TyG index and atherosclerotic cardiovascular disease (CVD) remains unclear. We evaluated the relationship between TyG index and CVD using a large-scale population dataset from the National Health Information Database (NHID). Methods We performed a retrospective observational cohort study of 5,593,134 persons older than 40 years from 2009 to 2017 using the NHID. We divided the participants into TyG index quartiles. Outcome variables were stroke, myocardial infarction, and both. The incidence of outcomes was estimated for each TyG quartile over the total follow-up period. All outcomes were analyzed by Cox proportional hazards regression analysis while controlling for baseline covariates. Results During 8.2 years of mean follow-up, stroke was diagnosed in 89,120 (1.59%), MI in 62,577 (1.12%), and both stroke and MI in 146,744 (2.62%) participants. Multivariate-adjusted hazard ratios (HRs) for patients in the highest TyG index quartile demonstrated that these patients were at higher risk for stroke (HR = 1.259; 95% confidence interval [CI] 1.233–1.286), for MI (HR = 1.313; 95% CI 1.28–1.346), and for both (HR = 1.282; 95% CI 1.261–1.303) compared with participants in the lowest TyG index quartile. These effects were independent of age, sex, smoking, alcohol consumption, physical activity, body mass index, systolic blood pressure, and total cholesterol. Conclusions In our large population study, TyG index, a simple measure reflecting insulin resistance, was potentially useful in the early identification of individuals at high risk of experiencing a cardiovascular event.

scholarly journals The insulin resistance by triglyceride glucose index and risk for dementia: population-based study

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Sangmo Hong ◽  
Kyungdo Han ◽  
Cheol-Young Park
Keyword(s):  
Insulin Resistance ◽  
Effect Size ◽  
Large Scale ◽  
Smoking Status ◽  
Large Population ◽  
Surrogate Marker ◽  
Population Based ◽  
Tyg Index ◽  
Increased Risk ◽  
Small Effect Size

Abstract Background Insulin resistance is suggested to have negative effects on cognition; however, results from large population studies are lacking. In this study, the potential relationships between the triglyceride glucose (TyG) index, a simple surrogate marker of insulin resistance, and dementia were evaluated using a large-scale population dataset. Methods This was a retrospective, observational, cohort study using data from the National Health Information Database from 2009 to 2015 and included 5,586,048 participants 40 years age or older. The TyG index was used as a measure of insulin resistance, and participants were divided into quartiles based on TyG index. The incidence of dementia was assessed using hazard ratios (HRs) estimated with Cox proportional hazard modeling. Results During a median follow-up of 7.21 years, dementia was diagnosed in 142,714 (2.55%) participants. Alzheimer’s disease (AD) and vascular dementia (VD) were diagnosed in 74.3% and 12.5% of the participants. Multivariate-adjusted HRs for patients in the TyG index 4th quartile were higher for dementia (HRs = 1.14; 95% confidence interval [CI] 1.12–1.16), AD (HRs = 1.12; 95% CI 1.09–1.14), and VD (HRs = 1.18; 95% CI 1.12–1.23) compared with the 1st quartile of TyG index; however, this had a small effect size (Cohen’s d = 0.10, 0.08, and 0.13, respectively). These effects were independent of age, sex, smoking status, physical activity, body mass index, systolic blood pressure, and total cholesterol. Conclusion In this large population study, TyG index was associated with an increased risk of dementia, including AD and VD, that was independent of traditional cardiovascular risk factors, although the effect size of the TyG index was small.

scholarly journals Circulating Proangiogenic Cell Activity Is Associated with Cardiovascular Disease Risk

2012 ◽  
Vol 17 (9) ◽  
pp. 1163-1170 ◽  
Author(s):  
Kreton Mavromatis ◽  
Konstantinos Aznaouridis ◽  
Ibhar Al Mheid ◽  
Emir Veledar ◽  
Saurabh Dhawan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Bone Marrow ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Cell Activity ◽  
Atherosclerotic Cardiovascular Disease ◽  
Cvd Risk ◽  
The Relationship

Vascular injury mobilizes bone marrow–derived proangiogenic cells into the circulation, where these cells can facilitate vascular repair and new vessel formation. We sought to determine the relationship between a new biomarker of circulating bone marrow–derived proangiogenic cell activity, the presence of atherosclerotic cardiovascular disease (CVD) and its risk factors, and clinical outcomes. Circulating proangiogenic cell activity was estimated using a reproducible angiogenic colony-forming unit (CFU-A) assay in 532 clinically stable subjects aged 20 to 90 years and ranging in the CVD risk spectrum from those who are healthy without risk factors to those with active CVD. CFU-A counts increased with the burden of CVD risk factors ( p < 0.001). CFU-A counts were higher in subjects with symptomatic CVD than in those without ( p < 0.001). During follow-up of 232 subjects with CVD, CFU-A counts were higher in those with death, myocardial infarction, or stroke than in those without (110 [70–173] vs 84 [51–136], p = 0.01). Therefore, we conclude that circulating proangiogenic cell activity, as estimated by CFU-A counts, increases with CVD risk factor burden and in the presence of established CVD. Furthermore, higher circulating proangiogenic cell activity is associated with worse clinical outcome in those with CVD.

Abstract 13714: Clinical Utility of the Triglyceride-glucose Index Which is a Novel Marker of Insulin Resistance for Predicting the Neointimal Vulnerability After Everolimus-eluting Stent Implantation

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Naotaka Akutsu ◽  
Riku Arai ◽  
Daisuke Fukamachi ◽  
Yasuo Okumura
Keyword(s):  
Insulin Resistance ◽  
Stent Implantation ◽  
Tyg Index ◽  
Index Group ◽  
Triglyceride Glucose Index ◽  
Coronary Angioscopy ◽  
High Insulin ◽  
Grade 3 ◽  
The Relationship

Introduction: Insulin resistance has been recognized as the cause of cardiovascular disease, but little is known about the influence of insulin resistance to neointimal characteristics after stent implantation. Hypothesis: The high triglyceride-glucose index (TyG index) has been reported to indirectly represent a high insulin resistance. It was hypothesized that in-stent neointimal characteristics in the high TyG index patients may be unstable more than the low TyG index patients. Methods: In 100 patients, we investigated the relationship between the neointimal characteristics and the TyG index using coronary angioscopy (CAS) and optical coherence tomography (OCT) during follow-up angiography after stent implantation. We divided into 2 groups according to the median value of TyG index (8.8). Results: The high TyG index group (n=48) had the higher yellow grade and the higher prevalence of yellow grade 3 by CAS than the low TyG index group (n=52). The prevalence of heterogeneous and layered patterns were more often observed by OCT in the high TyG index group than in the low TyG index group (Figure). Conclusions: The high TyG index strongly associated with neointimal vulnerability evaluating by CAS and OCT. The TyG index can be a useful predictor for the neointimal vulnerability after stent implantation.

scholarly journals The Triglyceride-Glucose Index, an Insulin Resistance Marker, Was Non-linear Associated With All-Cause and Cardiovascular Mortality in the General Population

2021 ◽  
Vol 7 ◽  
Author(s):  
Xiao-cong Liu ◽  
Guo-dong He ◽  
Kenneth Lo ◽  
Yu-qing Huang ◽  
Ying-qing Feng
Keyword(s):  
Insulin Resistance ◽  
Cardiovascular Disease ◽  
Cox Regression ◽  
Piecewise Linear ◽  
Threshold Value ◽  
Cardiovascular Death ◽  
Tyg Index ◽  
Significant Difference ◽  
Non Linear ◽  
The Relationship

Background: The triglyceride-glucose (TyG) index could serve as a convenient substitute of insulin resistance (IR), but epidemiological evidence on its relationship with the long-term risk of mortality is limited.Methods: Participants from the National Health and Nutrition Examination Survey during 1999–2014 were grouped according to TyG index (&lt;8, 8–9, 9–10, &gt;10). Cox regression was conducted to compute the hazard ratios (HRs) and 95% confidence interval (CI). Restricted cubic spline and piecewise linear regression were performed to detect the shape of the relationship between TyG index and mortality.Results: A total of 19,420 participants (48.9% men) were included. On average, participants were followed-up for 98.2 months, and 2,238 (11.5%) and 445 (2.3%) cases of mortality due to all-cause or cardiovascular disease were observed. After adjusting for confounders, TyG index was independently associated with an elevated risk of all-cause (HR, 1.10; 95% CI, 1.00–1.20) and cardiovascular death (HR, 1.29; 95% CI, 1.05–1.57). Spline analyses showed that the relationship of TyG index with mortality was non-linear (All non-linear P &lt; 0.001), and the threshold value were 9.36 for all-cause and 9.52 for cardiovascular death, respectively. The HRs above the threshold point were 1.50 (95% CI, 1.29–1.75) and 2.35 (95% CI, 1.73–3.19) for all-cause and cardiovascular death. No significant difference was found below the threshold points (All P &gt; 0.05).Conclusion: Elevated TyG index reflected a more severe IR and was associated with mortality due to all-cause and cardiovascular disease in a non-linear manner.

scholarly journals Inverse Association Between Triglyceride Glucose Index and Muscle Mass in Korean Adults: 2008–2011 KNHANES

2020 ◽  
Author(s):  
Sung Ho Ahn ◽  
Jun hyuk Lee ◽  
JI WON LEE
Keyword(s):  
Insulin Resistance ◽  
Muscle Mass ◽  
Surrogate Marker ◽  
Multivariate Logistic Regression Model ◽  
Inverse Association ◽  
Tyg Index ◽  
Korean Adults ◽  
Triglyceride Glucose Index ◽  
Using Data ◽  
The Relationship

Abstract Aim: The early detection and prevention of sarcopenia is increasingly emphasized considering that sarcopenia is an important risk factor for falls or cardiovascular disease. Recently, there have been emerging evidences that support the relationship between sarcopenia, insulin resistance, and inflammation. The TyG index, a novel surrogate marker of insulin resistance and systemic inflammation, has not yet been verified for an association with sarcopenia. This study aimed to examine the relationship between the TyG index and muscle mass in Korean adults.Methods: This study included 15,741 non-diabetic adults over 19 years old using data from the 2008–2011 Korea National Health and Nutrition Examination Survey. Participants were divided into three groups according to tertiles of the TyG index. Low skeletal muscle mass index (LMSI) was defined by the Foundation for the National Institutes of Health (FNIH) Sarcopenia Project criteria. Weighted multivariate logistic regression model was used to analyze the relationship between TyG index tertiles and LSMI.Results: The ORs (95% CIs) for LSMI of the second and third tertiles, compared to first tertile, were 1.300 (1.001–1.689) and 1.448 (1.104–1.900), respectively, after adjusting for confounding factors. Higher TyG index was also associated with increased odds of LSMI in subgroups such as adults under 65-year old who did not exercise regularly, who consumed less than 30g alcohol per day, who did not currently smoke, and who ate less than 1.5g protein/kg/day.Conclusion: The TyG index was significantly and positively associated with LSMI in Korean adults.

scholarly journals Triglyceride-Glucose Index Mediates the Effect of General and Central Obesity on Cardiovascular Disease: A Prospective Cohort Study

2021 ◽  
Author(s):  
Anxin Wang ◽  
Xue Tian ◽  
Yingting Zuo ◽  
Shuohua Chen ◽  
Xia Meng ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Cardiovascular Disease ◽  
Survival Data ◽  
Central Obesity ◽  
Normal Weight ◽  
Mediating Effects ◽  
Mediation Analyses ◽  
Tyg Index ◽  
Triglyceride Glucose Index

Abstract Background: The mechanisms linking obesity to cardiovascular disease (CVD) are still not clearly defined. Individuals who are overweight or obese often develop insulin resistance, mediation of the association between obesity and CVD through the triglyceride-glucose (TyG) index (a simple surrogate of insulin resistance) seems plausible and has not been investigated. This study aimed to evaluate whether and to what extend the effect of general and central obesity is mediated by the TyG index.Methods: A total of 94,136 participants without CVD at baseline were recruited from the Kailuan study. The TyG index was calculated as ln [fasting triglyceride (mg/dL)×fasting glucose (mg/dL)/2]. Mediation analysis using a newly proposed 2-stage regression method for survival data was to explore the mediating effects of the TyG index on the association between obesity and CVD.Results: During a median follow-up of 13.01 years, we identified 7,327 cases of CVD. Mediation analyses showed that 45.60% of the total association (hazard ratio [HR], 1.24; 95% confidence interval [CI], 1.18-1.31) between overweight and CVD was mediated through the TyG index (HR [indirect association], 1.10; 95% CI, 1.08-1.11), and the proportion mediated was 38.30% for general obesity. For central obesity, analysis by waist circumference, waist/hip, and waist/height categories yielded an attenuated proportion mediated of 33.76%, 37.10%, and 33.10% for obesity, taken normal weight as reference. Similar results were observed for stroke and myocardial infarction.Conclusions: This study found that the association between obesity and CVD was mediated by the TyG index, suggesting proper control of insulin resistance can be effective to significantly reduce the effects of general and central obesity on CVD.

scholarly journals The Effects of Calculated Remnant-Like Particle Cholesterol on Incident Cardiovascular Disease: Insights from a General Chinese Population

2021 ◽  
Vol 10 (15) ◽  
pp. 3388
Author(s):  
Yanli Chen ◽  
Guangxiao Li ◽  
Xiaofan Guo ◽  
Nanxiang Ouyang ◽  
Zhao Li ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Renal Dysfunction ◽  
Large Scale ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards Model ◽  
Atherosclerotic Cardiovascular Disease ◽  
Cvd Risk ◽  
High Level ◽  
Nonlinear Association

Background: Growing evidence suggests that remnant cholesterol (RC) contributes to residual atherosclerotic cardiovascular disease (ASCVD) risk. However, the cutoff points to treat RC for reducing ASCVD are still unknown. This study aimed to investigate the relationships between RC and combined cardiovascular diseases (CVDs) in a general China cohort, with 11,956 subjects aged ≥ 35 years. Methods: Baseline RC was estimated with the Friedewald formula for 8782 subjects. The outcome was the incidence of combined CVD, including fatal and nonfatal stroke and coronary heart disease (CHD). The Cox proportional hazards model was used to calculate hazard ratios (HRs) with 95% confidence intervals. The restricted cubic spline (RCS) model was used to evaluate the dose–response relationship between continuous RC and the natural log of HRs. Results: After a median follow-up of 4.66 years, 431 CVD events occurred. In the Cox proportional models, participants with a high level of categorial RC had a significantly higher risk for combined CVD (HR: 1.37; 95% CI: 1.07–1.74) and CHD (HR: 1.63; 95% CI: 1.06–2.53), compared to those with a medium level of RC. In the stratification analyses, a high level of RC significantly increased combined CVD risk for subgroups females, age < 65 years, noncurrent smokers, noncurrent drinkers, normal weight, renal dysfunction, and no hyperuricemia. The same trends were found for CHD among subgroups males, age < 65 years, overweight, renal dysfunction, and no hyperuricemia; stroke among subgroup females. In RCS models, a significant linear association between RC and combined CVD and a nonlinear association between RC and CHD resulted. The risk of outcomes was relatively flat until 0.84 mmol/L of RC and increased rapidly afterwards, with an HR of 1.308 (1.102 to 1.553) for combined CVD and 1.411 (1.061 to 1.876) for CHD. Stratified analyses showed a significant nonlinear association between RC and CVD outcomes in the subgroup aged < 65 years or the diabetes subgroup. Conclusions: In this large-scale and long-term follow-up cohort study, participants with higher RC levels had a significantly worse prognosis, especially for the subgroup aged 35–65 years or the diabetes mellitus subgroup.

scholarly journals The effects of estimated remnant-like particle cholesterol on incident cardiovascular disease: Insights from a general Chinese population

2021 ◽  
Author(s):  
Yanli Chen ◽  
Guangxiao Li ◽  
Xiaofan Guo ◽  
Nanxiang Ouyang ◽  
Zhao Li ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Renal Dysfunction ◽  
Large Scale ◽  
Proportional Hazards Model ◽  
Cubic Spline ◽  
Cox Proportional Hazards Model ◽  
Atherosclerotic Cardiovascular Disease ◽  
Linear Association ◽  
High Level

Abstract Background Growing evidence suggests that remnant cholesterol (RC) may contribute to residual atherosclerotic cardiovascular disease (ASCVD) risk. But the cut-off point to treat RC for reducing ASCVD is still not known. This study was aimed to investigate the relationships between RC and combined cardiovascular diseases (CVDs) in a general China cohort, with 11,956 subjects aged ≥ 35 years. Methods Baseline RC was estimated with the Friedewald formula for 8782 subjects. The outcome was the incidence of combined CVD, including fatal and nonfatal stroke and coronary heart disease (CHD). Cox proportional hazards model was used to calculate hazard ratios (HRs) with 95% confidence intervals. Restricted cubic spline model was used to evaluate dose-response relationship between continuous RC and the natural log of HRs. Results After a mean follow-up of 4.66 years, 431 CVD events occurred. In the cox proportional models, participants with high level of categorial RC had significantly higher risk for combined CVD (HR: 1.37; 95% CI: 1.07–1.74) and CHD (HR: 1.63; 95% CI: 1.06–2.53), compared to those with medium level of RC. In the stratification analyses, high level of RC significantly increased combined CVD risk for subgroups females, age < 65years, non-current smokers, non-current drinkers, normal weight, renal dysfunction, and no hyperuricemia. Same trends were found for CHD among subgroups males, age < 65 years, overweight, renal dysfunction, and normal uric acid; stroke for subgroup females. In the restricted cubic spline models, significantly linear association between RC and combined CVD and non-linear association between RC and CHD were shown. The risk of outcomes was relatively flat until 0.84mmol/l of RC and increased rapidly afterwards, with HR of 1.308 (1.102 to 1.553) for combined CVD and 1.411 (1.061 to 1.876) for CHD. Stratified analyses showed significant nonlinearity association between RC and CVD outcomes in subgroup aged < 65 years or subgroup diabetes. Conclusions In this large-scale and long-term follow-up cohort study, participants with higher RC levels had significantly worse prognosis, especially for subgroup aged 35–65 years or subgroup diabetes mellitus.

scholarly journals Elevated plasma growth and differentiation factor 15 predicts incident anemia in older adults aged 60 years and older

2020 ◽  
Author(s):  
Yuko Yamaguchi ◽  
Marta Zampino ◽  
Toshiko Tanaka ◽  
Stefania Bandinelli ◽  
Yusuke Osawa ◽  
...  
Keyword(s):  
Older Adults ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Differentiation Factor ◽  
Hazards Model ◽  
Increased Risk ◽  
The Relationship

Abstract Background Anemia is common in older adults and associated with greater morbidity and mortality. The causes of anemia in older adults have not been completely characterized. Although elevated circulating growth and differentiation factor 15 (GDF-15) has been associated with anemia in older adults, it is not known whether elevated GDF-15 predicts the development of anemia. Methods We examined the relationship between plasma GDF-15 concentrations at baseline in 708 non-anemic adults, aged 60 years and older, with incident anemia during 15 years of follow-up among participants in the Invecchiare in Chianti (InCHIANTI) Study. Results During follow-up, 179 (25.3%) participants developed anemia. The proportion of participants who developed anemia from the lowest to highest quartile of plasma GDF-15 was 12.9%, 20.1%, 21.2%, and 45.8%, respectively. Adults in the highest quartile of plasma GDF-15 had an increased risk of developing anemia (Hazards Ratio 1.15, 95% Confidence Interval 1.09, 1.21, P&lt;.0001) compared to those in the lower three quartiles in a multivariable Cox proportional hazards model adjusting for age, sex, serum iron, soluble transferrin receptor, ferritin, vitamin B12, congestive heart failure, diabetes mellitus, and cancer. Conclusions Circulating GDF-15 is an independent predictor for the development of anemia in older adults.

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