Triglyceride and Glucose Index and Sex Differences in Relation to Major Adverse Cardiovascular Events in Hypertensive Patients Without Diabetes

Abstract

IntroductionStudies from recent decades have suggested that women have a lower risk of cardiovascular disease than men due to their characteristics, but hyperglycemia and hyperinsulinemia caused by IR (insulin resistance) might reverse this gender-protective effect. This study examined whether there were sex differences in the relationship between IR [evaluated by triglyceride and glucose index (TyG index)] and major adverse cardiovascular events (MACEs) in hypertensive patients without diabetes.MethodsThis was a post-hoc analysis of the Systolic Blood Pressure Intervention Trial (SPRINT). We explored the relationship between TyG index and MACEs by multivariate Cox proportional hazard regressions and two-piecewise linear regression models. The primary endpoint was MACEs, same as SPRINT, defined as a composite of myocardial infarction, stroke, heart failure, and/or death from cardiovascular causes. We used multiple adjustment models for all regressions.ResultsA total of 9,323 patients from the SPRINT were included in our analysis. TyG index was significantly related to the risk of MACEs in every adjusted model. Each 1 unit increase in TyG index increased the risk of MACEs in total participants (HR, 1.40; 95% CI, 1.20–1.64; P<0.01) and men (HR, 1.42; 95% CI, 1.18–1.71; P=0.02). However, TyG index was not associated with MACEs among female hypertensive patients (HR, 1.33; 95% CI, 0.97–1.82; P=0.0776). There was no interaction between the sex and TyG index (P for interaction= 0.73). We also used the two-stage linear regression model and did not find any threshold effect. There was no significant interaction in other confounders.ConclusionWe found the TyG index was associated with MACEs in the hypertensive patients, and there was no gender difference between the TyG index and MACEs.

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

“…All insulin replacement markers showed that good association with HOMA-IR of both sexes, and the association between female and HOMA-IR was stronger than that of male [ 38 ]. However, some studies have found that there was no sex difference between the TyG index and MACEs in patients with hypertension [ 39 ]. There has been an investigation of the association between the TyG index and the early stages of subclinical atherosclerosis (SA) between the sexes.…”

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

“…Studies have shown that all insulin replacement markers have a good correlation with HOMA-IR of both sexes, and the correlation between female is stronger than that of male [40]. However, some studies have found that there was no gender difference between the TyG index and MACEs in patients with hypertension [41]. There is an investigation of the association between the TyG index and the early stages of subclinical atherosclerosis (SA) between the sexes.…”

Correlation analysis of the triglyceride glucose index and heart failure with preserved ejection fraction in essential hypertensive patients

“…HFpEF was diagnosed as per the diagnostic criteria for HFpEF in the 2016 European Society of Cardiology guidelines. 14 Inclusion criteria are as follows: (1) | 937 congenital bicuspid aortic valve, ebstein anomaly, congenital aorticainus aneurysm, coronary artery fistulae, congenital tetralogy of Fallot); (4) severe heart valve disease (mitral stenosis, mitral regurgitation, aortic stenosis, and aortic incompetence); (5) restrictive cardiomyopathy; (6) hypertrophic cardiomyopathy; (7) pericardial diseases (acute pericarditis and constrictive pericarditis); (8) heart failure due to noncardiogenic factors (severe infection, anemia, and diseases of blood system); (9) thyroid dysfunction (hyperthyroidism and hypothyroidism); (10) severe liver damage (glutamic-propylene and glutamic-oxalacetic transaminases higher than three times the upper limit of normal); (11) heavy renal impairment (glomerular filtration rate <60 ml min −1 [1.73 m 2 ] −1 ); (12) drugs affecting blood glucose and blood lipids used before admission.…”

“…A recent study has demonstrated that TyG index is positively associated with type 2 diabetes and the incidence rate of cardiovascular diseases 11 . It has also been documented that TyG index is related to poor prognoses in patients with heart failure and type 2 diabetes 12 . However, little is known about the correlation between TyG index and the occurrence of HFpEF.…”

“…11 It has also been documented that TyG index is related to poor prognoses in patients with heart failure and type 2 diabetes. 12 However, little is known about the correlation between TyG index and the occurrence of HFpEF. This paper focuses on the observation of TyG index and HFpEF in hypertensive patients and further determines the relationship between TyG index and cardiac function.…”