Triglyceride glucose index predicts coronary artery calcification better than other indices of insulin resistance in Korean adults: the Kangbuk Samsung Health Study

Abstract

Purpose: Insulin resistance is one of the most important mechanisms in the development of diabetes, and it is closely related to the presence and severity of coronary heart disease. Triglyceride glucose (TyG) index is a useful marker of insulin resistance; however, few studies have investigated the relationship between TyG and subclinical atherosclerosis. Therefore, we evaluated the association of TyG and subclinical coronary atherosclerosis as measured by coronary artery calcium score (CACS). Methods: Our study included 30,776 participants (mean age of 41 years, 80.4% male) enrolled in a health screening program, in whom CACS were measured. Homeostasis model assessment of insulin resistance (HOMA-IR), TyG index, TyG-body mass index (BMI), and TyG-waist circumference (WC) were subsequently analyzed. Indices were calculated using the following formulae: HOMA-IR = fasting insulin (μU/mL)×fasting plasma glucose (FPG; mmol/L)/22.5; TyG index = Ln [TG (mg/dL)×FPG (mg/dL)/2]; TyG-BMI = TyG index × BMI; and TyG-WC = TyG index × WC. CACS was measured using multidetector computed tomography, and the presence of coronary artery calcification (CAC) was defined by CACS > 0. Results: The prevalence of CAC was 14.4% in the study population. Multivariate logistic regression analysis showed that participants with TyG-BMI in the highest tertile were 1.638 times more likely to have CAC after adjustment for other metabolic parameters compared with participants with TyG-BMI in the lowest tertile (odds ratio, 1.612; 95% confidence interval, 1.465 to 1.774). The receiver operating characteristics curve for prediction of CAC showed that TyG-WC index had a higher area under the curve (AUC= 0.626) than other indices (AUC TyG = 0.617, AUC TyG-BMI = 0.616, AUC HOMA-IR = 0.562). Conclusion: TyG index predicted CAC better than other markers of insulin resistance, and could be a useful marker for predicting subclinical atherosclerosis.

Triglyceride Glucose-Waist Circumference Better Predicts Coronary Calcium Progression Compared with Other Indices of Insulin Resistance: A Longitudinal Observational Study

“…IR is one of the most important mechanisms in the development and advancement of cardiovascular disease by promoting atherogenesis and plaque progression [ 20 , 41 , 42 , 43 ]. HOMA-IR is a representative surrogate marker for insulin resistance with great utility in clinical and laboratory settings since the use of HEC, the gold standard for estimating insulin resistance, is limited due to the inconvenience and high cost [ 20 , 44 , 45 ]. However, conflicting results have been reported by previous reports on the association between HOMA-IR and CAC progression.…”

“…Insulin resistance was measured using the HOMA-IR according to the following equation: (fasting insulin [µIU/mL] × fasting glucose [mg/dL])/405 [ 24 ]. Other TyG-related markers were calculated using the following formulae: TyG index = Ln [TG (mg/dL) × FPG (mg/dL)/2]; TyG-BMI = TyG index × BMI (kg/m 2 ); and TyG-WC = TyG index × WC (cm) [ 20 ].…”

“…We hypothesized that TyG-related parameters combining obesity indices with the TyG index, such as TyG-BMI or TyG-WC, would be more efficient than the HOMA-IR or TyG index alone in the evaluation of cardiovascular risk. To date, a few studies have shown that TyG-related markers are positively associated with cardiometabolic disease, including CAC [ 16 , 19 , 20 ]. However, these studies were mostly cross-sectional in design; therefore, the causality between exposure and outcomes could not be evaluated.…”

Insulin resistance indices and coronary risk in adults from Maracaibo city, Venezuela: A cross sectional study

“…This behavior has also been determined in two Asian populations, where the TyG index was a better predictor of coronary arterial calcification than the HOMA-IR 23 , 24 , although in one of these populations, it was observed that by including another predictive variable, such as the abdominal circumference, the predictive capacity of this marker increased 24 . On the other hand, Sánchez-Íñigo et al .…”

The Effects of Two Exercise Modalities on Novel Cardiovascular Risk Factors in Overweight Women with Type 2 Diabetes: a Randomized Controlled Trial

“…Perhaps the most striking and novel finding form the present work was the similar improvements in TyG, TyG-BMI and TyG-WC indices. Although few studies have investigated the relationships between TyG indices and CVD risk [10,55], none of them has yet explored the effects of different exercise modalities on TyG indices. It has been shown that TyG index is a reliable predictor to identify insulin resistance and diabetes type 2 [9,56].…”