Triglyceride–glucose index is associated with the risk of myocardial infarction: an 11-year prospective study in the Kailuan cohort

Abstract

Background The triglyceride–glucose (TyG) index, which is a simple surrogate marker of insulin resistance, has been suggested as a contributor of cardiovascular disease. However, evidence on the effect of long-term elevation of the TyG index exposure on myocardial infarction (MI) is limited. The current study aimed to evaluate the association of baseline and long-term elevation of the TyG index exposure with the risk of MI. Methods A total of 98,849 participants without MI at baseline (2006) were enrolled from the Kailuan study. The baseline TyG index was calculated as ln [fasting triglyceride (mg/dL) × fasting glucose (mg/dL)/2]. The long-term TyG index was characterized in two ways as follows. The updated mean TyG index was calculated as the mean of TyG index at all previous visits before MI occurred or the end of follow-up; alternatively, the TyG index was calculated as the number of visits with a high TyG index in 2006, 2008, and 2010, ranging from 0 (no exposure) to 3 (had high TyG index at all three study visits). Hazard ratio (HR) and 95% confidence interval (CI) was estimated using multivariable Cox proportion hazard models. Results During a median follow-up of 11.03 years, 1555 incident MI occurred. In the multivariable-adjusted model, the risk of MI increased with quartiles of the baseline and updated mean TyG index, the HR in quartile 4 versus quartile 1 was 2.08 (95% CI,1.77–2.45) and 1.58 (1.18–2.12), respectively. Individuals with a high TyG index at all three visits had a 2.04-fold higher risk (95% CI, 1.63–2.56) of MI compared with no exposure. Subgroup analyses showed that the associations were more pronounced in women than in men (Pinteraction = 0.0411). Conclusions Elevated levels of the baseline and long-term TyG index are associated with an increased risk of MI. This finding indicates that the TyG index might be useful in identifying people at high risk of developing MI.

Quantitative Analysis of Myocardial Work by Non-invasive Left Ventricular Pressure-Strain Loop in Patients With Type 2 Diabetes Mellitus

“…In addition, the levels of TG and LDL-C in the T2DM group were higher than those in the NC group. The free fatty acids produced by TG were able to further reduce insulin sensitivity, forming a vicious circle between TG levels and insulin resistance (14)(15)(16).…”

Comparison of various insulin resistance surrogates on prognostic prediction and stratification following percutaneous coronary intervention in patients with and without type 2 diabetes mellitus

“…(2) The study population was highly selected with strict enrollment criteria, which may result in selection bias and difficulties in generalizing the findings to other populations. (3) Despite dynamic changes [ 54 ] and the mean of multiple monitoring [ 55 ] of the TyG index during the follow-up having been proved to be closely associated with cardiovascular events, they were not accessible in the current analysis. Further group-based trajectory analysis is needed to provide more reliable findings.…”

Triglyceride-Glucose Index and HOMA-IR in Young Adulthood and Risk of Incident Congestive Heart Failure: The CARDIA Study

“…The TyG index can also predict the risk of diabetes mellitus [39]. Many studies demonstrated that the TyG index is closely related to the prognosis of acute coronary syndrome [40][41][42]. Acute coronary syndrome, hypertension, diabetes mellitus and other factors can cause cardiac function and structural disorders, leading to heart failure [43].…”