Triglyceride–glucose index and the incidence of atherosclerotic cardiovascular diseases: a meta-analysis of cohort studies

Abstract

Background Insulin resistance has been demonstrated to be involved in the pathogenesis of atherosclerotic cardiovascular diseases (ASCVDs). This study evaluated the association between the triglyceride–glucose (TyG) index, a novel surrogate indicator of insulin resistance, and the incidence of ASCVDs in people without ASCVDs at baseline by performing a meta-analysis. Methods Cohort studies reporting the multivariate-adjusted association between the TyG index and the incidence of ASCVDs were obtained by searching the PubMed and Embase databases. A random-effects model incorporating intra-study heterogeneity was applied to combine the results. Results Eight cohort studies comprising 5,731,294 participants were included in this meta-analysis. The results showed that compared to those with the lowest TyG index category, participants with the highest TyG index category were independently associated with a higher risk of ASCVDs [hazard ratio (HR): 1.61, 95% confidence interval (CI) 1.29–2.01, I2 = 80%, P < 0.001]. This finding was consistent with the meta-analysis results with the TyG index analyzed as a continuous variable (HR per 1-unit increment of the TyG index: 1.39, 95% CI 1.18–1.64, I2 = 89%, P < 0.001). Subgroup analyses suggested that the age, sex, and diabetic status did not significantly affect the association (for subgroup analyses, all P > 0.05). Moreover, participants with the highest TyG index category were independently associated with a higher risk of coronary artery disease [(CAD), HR: 1.95, 95% CI 1.47–2.58, I2 = 92%, P < 0.001] and stroke (HR: 1.26, 95% CI 1.23–1.29, I2 = 0%, P < 0.001). Conclusions A higher TyG index may be independently associated with a higher incidence of ASCVDs, CAD, and stroke in people without ASCVDs at baseline.

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

“…The accuracy of TyG index in the diagnosis of insulin resistance was consistent with that of HIEC and HOMA-IR (4). A recent meta-analysis involving 5,731,294 participants reported that a higher TyG index might be independently associated with a higher incidence of atherosclerotic cardiovascular diseases (ASCVDs), CAD, and stroke in people without ASCVDs at baseline (24). To the best of our knowledge, this study is the first study to evaluate the relationship between the TyG index and adverse outcomes within the population of hypertensive patients without diabetes.…”

Association between triglyceride-glucose index and risk of arterial stiffness: a cohort study

“…In our study, we compared the diagnostic values of the TyG index, FBG, and TG for arterial stiffness by receiver operating characteristics curve and the area under the curve, and found that TyG index had a better predictive value than FBG and TG alone (data not shown), which was consistent with previous studies [ 39 – 41 ]. With an increasing number of studies supporting the strong predictive value of TyG index for the development of CVDs and other chronic diseases such as type 2 diabetes [ 42 , 43 ], TyG index has been widely recognized as a simple and effective marker for disease prediction and prevention. A high TyG index could alert people to establish early lifestyle changes able to reduce the progression or incidence of disease.…”

Prognostic Significance of Triglyceride-Glucose Index for Adverse Cardiovascular Events in Patients With Coronary Artery Disease: A Systematic Review and Meta-Analysis

“…As for the risk of stroke associated with elevated TyG index, an earlier meta-analysis showed that a higher TyG index was associated with a 26% increased risk of stroke among participants without atherosclerotic cardiovascular diseases at baseline ( 52 ). Similarly, in a cross-sectional study with a general population, the incidence of ischemic stroke increased by 22.8% for each additional SD in the TyG index ( 53 ).…”