Background: The triglyceride glucose (TyG) index is a new marker associated with atherosclerosis. This study aimed to assess the association between the TyG index and the severity of coronary artery disease (CAD) in patients with coronary heart disease (CHD) and further explore the association between the TyG index and CAD severity in different glucose metabolic states.Methods: This multi-centre retrospective study included 731 CHD patients between September 1, 2014 to September 30, 2020 in China. All patients were stratified into groups based on the tertiles of the TyG index (T1:5.48 ≤ TyG index ≤ 7.17; T2: 7.18 ≤ TyG ≤ 7.76; T3: 7.77 ≤ TyG ≤ 10.82) and the number of diseased vessels [1-vessel disease (VD), 2-VD and 3-VD] represented the severity of CAD. The relationship between the TyG index and CAD severity was analysed using logistic regression. The associations between the TyG index and CAD severity based on different glucose metabolic status were also assessed. Receiver operating characteristic (ROC) curves were performed to evaluate the accuracy of the TyG index for detecting the CAD severity.Results: The baseline analysis results showed significant differences in clinical and biological characteristics of CHD patients according to the TyG index tertiles (P < 0.05 to < 0.001). The TyG index was significantly related to the risk of multiple diseased coronary arteries and more severe coronary stenoses (CS) (P < 0.001). The TyG index was significantly associated with the risk of 3-VD in patients with CHD. The odds ratio (OR) of 3-VD for the TyG index T3 compared to T1 was 2.27 (95% confidence interval [CI] 1.497-3.452; P for trend <0.001). Among different states of glucose metabolism, the association between the TyG index and 3-VD observed was significant in diabetes (OR: 1.662; 95% CI 1.166–2.369). A TyG index threshold for predicting 3-VD (95% [CI] 0.554-0.664; P < 0.001 ) was 7.0 and was 8.1 in diabetes state (95% [CI] 0.523-0.646; P < 0.001 ).Conclusion: The TyG index is associated with CAD severity in CHD patients and an increased TyG index could identify CHD patients with a high risk of 3-VD. The association between the TyG index and CAD severity in the condition of diabetes is higher than in non-diabetes.

BackgroundThyroid hormone influences glucose homeostasis through central and peripheral regulations. So far, the association between thyroid hormone sensitivity and elevated blood glucose (EBG) in patients with coronary heart disease (CHD) remains unknown. The purpose of this study is to investigate the association between thyroid hormone sensitivity and risk of EBG in patients with CHD, and to further explore their association in different sexes and ages.MethodsThis large multicenter retrospective study included 30,244 CHD patients (aged from 30 to 80) between January 1, 2014 and September 30, 2020. The study calculated the parameters representing central and peripheral sensitivity to thyroid hormones. Central sensitivity to thyroid hormones was assessed by calculating the thyroid feedback quantile-based index (TFQI), thyroid stimulating hormone index (TSHI), and thyrotropin thyroxine resistance index (TT4RI), and peripheral sensitivity to thyroid hormones was evaluated by the ratio of FT3/FT4. Taking normal glucose tolerance (NGT) as a reference, participants with diabetes or prediabetes were assigned to the EBG group. The study used logistic regression to analyze the relationship between central and peripheral thyroid hormone sensitivity and EBG in CHD patients.ResultsAmong the 30,244 participants, 15,493 (51.23%) had EBG. The risk of EBG was negatively associated with TSHI (OR: 0.86; 95%CI: 0.85 to 0.87; P < 0.001), TT4RI (OR: 0.99; 95% CI: 0.99 to 0.99; P<0.001), TFQI (OR: 0.72; 95%CI: 0.70 to 0.73; P <0.001) and PTFQI (OR: 0.60; 95%CI: 0.58 to 0.61; P<0.001). Compared to males and people aged 60 and below, the OR value for EBG was lower in females and those aged over 60 years old. Conversely, EBG risk was positively associated with FT3/FT4 (OR: 1.25; 95% CI: 1.24 to 1.26; P <0.001) and in the sex-categorized subgroups, males had higher OR values than females.ConclusionsThis study shows that the increase in central thyroid hormone sensitivity is associated with the reduced risk of EBG in CHD patients, among which females and people aged over 60 years old are at higher risk.

Objective: Type 2 diabetes (T2DM) is often accompanied by undiagnosed dyslipidemia. Research on the association and predictive value of unconventional lipid markers for prediabetes (pre-DM) and T2DM simultaneously is limited in CHD patients.Methods: We collected patients who were diagnosed with CHD. Their lipid levels including triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) were measured and non-traditional lipid parameters were calculated. The diabetic status was defined as: normoglycemic (NG), Pre-DM, T2DM, multiple logistic regression was used to evaluate the relationship between the various lipid parameters with diabetic status. Pearson correlation analysis and linear regression analysis were used to test the correlation between TG/HDL-C and clinical factors of glucose metabolism, and ROC curve was used to test the predictive value of non-traditional lipid parameters for pre-DM and T2DM.Results: Multiple logistic regression results showed that in addition to traditional lipid parameters, the non-traditional lipid parameters including non-HDL-C, LDL-C/HDL-C, TC/HDL-C, TG/HDL-C were all correlated with the risk of pre-DM and T2DM, meanwhile TG/HDL-C showed the strongest correlation (OR: 1.21; 95% CI 1.6-1.25), (OR: 1.35; 95% CI 1.30-1.39). When dividing TG/HDL-C into tertiles, using T1(< 1.1) as a reference, T3(> 1.89) was observed to have the highest association with both pre-DM and T2DM (OR: 1.60; 95% CI 1.48-1.74), (OR: 2.79; 95% CI 2.60-3.00). The association of TG/HDL-C with T2DM and pre-DM is independent of gender, age and lifestyle. TG/HDL-C was significantly correlated with FBG and HbA1c (P < 0.001). It was the strongest predictor of pre-DM and T2DM in unconventional lipid parameters. The cut-off points were 1.46 and 1.50.Conclusion: Elevated non-traditional lipid parameters were significantly associated with pre-DM and T2DM in CHD patients, elevated TG/HDL-C was the risk factor with the strongest correlation with the risk of pre-DM and T2DM. It is also a valid predictor of T2DM occurrence.

Background It has been reported that remnant cholesterol (RC) is associated with coronary artery disease (CAD) and diabetes mellitus(DM). However, there is limited evidence on the association between RC and glucose metabolism status in coronary heart disease (CHD) angina pectoris patients. Methods The study collected 11557 patients who were diagnosed with CHD angina pectoris in Tianjin, China. Participants were divided into normal glucose regulation (NGR), prediabetes (Pre-DM) and diabetes mellitus (DM) according to glucose metabolism status. RC was calculated as total cholesterol (TC) minus low-density lipoprotein cholesterol (LDL-C) minus low-density lipoprotein cholesterol (HDL-C). Linear regression analysis was used to explore the relationship between glucose metabolism [fasting blood glucose (FBG) and hemoglobin A1c (HbA1c)] and RC. Logistic regression was performed to analyze the relationship between the RC and Pre-DM and DM. Results Among all participants, 5883 (50.9%) were in DM status, 4034 (34.9%) wre in Pre-DM status and 1640 (14.2%) were in NGR status. FBG levels and HbA1c levels were positively related with RC in all participants (P < 0.001). NGR was used as a reference, multi-adjusted showed that RC was significantly associated with Pre-DM [Odds ratio (OR): 1.365; 95% confidence interval (CI) 1.290–1.672; P < 0.001] and DM (OR:1.468; 95% CI 1.290–1.672; P < 0.001). When considering RC as categorical variables (tertiles), using T1(< 1.1) as a reference, T3 had the highest relationship between RC and Pre-DM and DM in crude modle and multi-adjusted modle. The association between RC and pre-DM [(OR: 1.442; 95% CI 1.225–1.696) vs. (OR: 1.264; 95% CI 1.052–1.518)] and DM [(OR: 1.460; 95% CI 1.245–1.713) vs. (OR: 1.406; 95% CI 1.181–1.673)] in females was higher than males. The fully adjusted of OR value in the elderly patients was higher than that in the middle-aged patients in the Pre-DM (OR: 1.401 vs. OR: 1.360) and DM (OR: 1.485 vs. OR: 1.406). The relationship between RC and Pre-DM and DM was statistically significant by the different smoking and drinking stratification analyses (all P < 0.05). Conclusion The current study demonstrated that there was a significance association between RC and pre-DM and DM among CHD angina pectoris patients, and and the relationship was higher in females and elderly patients.