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. 2020 Sep 29;19(1):155.
doi: 10.1186/s12933-020-01121-5.

The impact of triglyceride-glucose index on incident cardiovascular events during 16 years of follow-up: Tehran Lipid and Glucose Study

Niloofar Barzegar  1 , Maryam Tohidi  2 , Mitra Hasheminia  1 , Fereidoun Azizi  3 , Farzad Hadaegh  1
Affiliations

The impact of triglyceride-glucose index on incident cardiovascular events during 16 years of follow-up: Tehran Lipid and Glucose Study

Niloofar Barzegar et al. Cardiovasc Diabetol. .

Abstract

Background: To investigate whether the Triglyceride-Glucose index (TyG-index) is associated with increased risk of cardiovascular diseases (CVD)/coronary heart disease (CHD).

Methods: A total of 7521 Iranians aged ≥ 30 years (male = 3367) were included in the study. Multivariate Cox regression analyses (adjusted for age, gender, waist circumference, body mass index, educational level, smoking status, physical activity, family history of CVD, type 2 diabetes, hypertension, low and high density lipoprotein cholesterol, and lipid lowering drugs) were used to assess the risk of incident CVD/CHD across quintiles and for 1-standard deviation (SD) increase in the TyG-index. The cut off point for TyG-index was assessed by the minimum value of [Formula: see text]. We also examined the added value of the TyG-index in addition to the Framingham risk score when predicting CVD.

Results: During follow-up, 1084 cases of CVD (male = 634) were recorded. We found a significant trend of TyG-index for incident CVD/CHD in multivariate analysis (both Ps for tend ≤ 0.002). Moreover, a 1-SD increase in TyG-index was associated with significant risk of CVD/CHD in multivariate analysis [1.16 (1.07-1.25) and 1.19 (1.10-1.29), respectively]. The cut-off value of TyG-index for incident CVD was 9.03 (59.2% sensitivity and 63.2% specificity); the corresponding value of TyG-index for incident CHD was 9.03 (60.0% sensitivity and 62.8% specificity), respectively. Although no interaction was found between gender and TyG-index for CVD/CHD in multivariate analysis (both Ps for interaction > 0.085), the significant trend of TyG-index was observed only among females for incident CVD (P = 0.035). A significant interaction was found between age groups (i.e. ≥ 60 vs < 60 years) and TyG-index for CVD outcomes in the multivariate model (P-value for interaction = 0.046). Accordingly, a significant association between the TyG-index and outcomes was found only among the younger age group. Among the population aged < 60 the addition of TyG-index to the Framingham risk score (FRS) did not show improvement in the predictive ability of the FRS, using integrated discrimination improvement.

Conclusion: The TyG-index is significantly associated with increased risk of CVD/CHD incidence; this issue was more prominent among the younger population. However, adding TyG-index to FRS does not provide better risk prediction for CVD.

Keywords: Cardiovascular disease; Coronary heart disease; TyG-index.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
HRs (95% CI) of incident CVD and CHD for covariates. HR: hazard ratio; CI: confidence interval; CVD: cardiovascular disease; CHD: coronary heart disease; TyG: triglyceride and glucose index; WC: waist circumference; BMI: body mass index; FHCVD: family history of CVD; T2D: type 2 diabetes; LDL-C: low-density lipoprotein cholesterol; HDL-C: high-density lipoprotein cholesterol
Fig. 2
Fig. 2
Receiver operative characteristic curves and cut off values of TyG-index for incident CVD/CHD
Fig. 3
Fig. 3
Association between TyG-index quintiles and incident CVD/CHD stratified by gender and age. Stratified analyses were adjusted for WC, BMI, education, smoking status, physical activity, family history of CVD, T2D, hypertension, lowering lipid drugs, LDL-C, and HDL-C plus “age” in gender-stratified and “gender” in age-stratified analyses. TyG-index: Triglyceride-Glucose index; CVD: cardiovascular disease; CHD: coronary heart disease; WC: waist circumference; BMI: body mass index; T2D: type 2 diabetes; LDL-C: low density lipoprotein cholesterol; HDLC: high density lipoprotein cholesterol; HR: hazard ratio; CI: confidence interval
See this image and copyright information in PMC

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