Triglyceride Glucose Index for the Detection of Asymptomatic Coronary Artery Stenosis in Patients With Type 2 Diabetes

Abstract

Background: Triglyceride Glucose (TyG) index has been associated with an increased risk in cardiovascular events. Silent coronary disease is common in patients with type 2 diabetes. In Vietnam, a low-middle income country, the burden of cardiovascular disease is growing simultaneously with the epidemiologic transition. Our aim was to assess the prevalence of coronary stenoses (CS) in patients with type 2 diabetes and no history or symptom of cardiovascular disease and to investigate the association between TyG index and cardiovascular risk factors and both the presence and severity of CS. Futhermore, we assessed the value of TyG index in predicting subclinical CS. Methods: This was a cross-sectional observational study. We recruited 166 patients at Ninh Thuan General Hospital, Vietnam. TyG index and HOMA-IR were calculated, and a coronary computed tomography angiography (CCTA) was performed.Results: The population was classified according to tertiles of TyG index. The highest TyG values were associated with higher BMI, waist circumference, total cholesterol, LDL-cholesterol, triglycerides, plasma glucose, HbA1c levels and HOMA-IR, lower HDL-cholesterol, a higher incidence of metabolic syndrome and less frequent physical activity (p<0.05 to <0.0001). TyG index correlated with logHOMA-IR (p<0.0001). CS ≥50% were present in 60 participants and 32 had coronary artery stenosis ≥70%. TyG index and HOMA-IR were significantly higher in patients with CS ≥70%. The number of narrowed coronary arteries and the degree of stenosis were associated with higher TyG index levels (p=0.04 and <0.005 respectively). A TyG index ≥ 10 was significantly associated with an increased risk of multiple coronary artery disease and of more severe CS. After adjusting for confounding factors, including logHOMA-IR, these risks remained mostly significant. A TyG index threshold at 10 resulted in 57% sensitivity and 75% specificity for predicting the presence of CS ≥ 70%. In subgroup analysis TyG index ≥ 10 was associated with an increased risk in CS ≥ 70% in patients treated with statin or antiplatelet therapy.Conclusion: More than one third of asymptomatic patients with type 2 diabetes had significant CS on CCTA. TyG index may be considered as a marker for insulin resistance and increased TyG index could identify patients with high risk of coronary artery stenoses and is associated with the number and the severity of artery stenoses.

Assessment of preferred methods to measure insulin resistance in Asian patients with hypertension

“…27,29,32,34,36,37 In Rongjiong Zheng, Yushan Mao studied the TyG index of 4686 people for 9 years, showing the significance of TyG in predicting hypertension in the Chinese population. 34 Other centers in the Asian region also examined the TyG index in clinical practice although in a small number of patients, 38,41 and also examined the role of TyG index in the patients with hypertension. 29,37,39 All studies show the value of the TyG index when compared to the HOMA-IR index in assessing IR.…”

Triglyceride Glucose Index is Independently Associated with Aorta Intima-Media Thickness in Patients without Clinical Manifestations of Cardiovascular Disease Running Head: Triglyceride Glucose Index and Intima-Media Thickness

“…Other cardiovascular disease surrogate measures related to the TyG index include coronary artery calcium score [20], IMT of carotid arteries, and arterial stiffness [21,22]. A few studies have found a link between the TyG index and cardiovascular disease in high-risk patients with diabetes and chronic renal disease [23][24][25]. To our knowledge, our study is the rst to show an independent relationship between the TyG index and the thoracic aorta IMT.…”

Triglyceride Glucose Index Was Associated With the Risk of Peripheral Artery Disease

“…18 The TyG index was reported to be related to a higher risk of cardiovascular diseases and mortality. 19 In addition, some studies showed that the TyG index was significantly associated with the severity of coronary artery stenosis, 20 arterial stiffness, 21 and vascular calcification. 22 A study found that the TyG index was an independent predictor of PAD complexity based on a small sample size of 71 PAD patients.…”