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Observational Study
. 2021 Jan 5;13(1):9.
doi: 10.1186/s13195-020-00758-4.

The insulin resistance by triglyceride glucose index and risk for dementia: population-based study

Sangmo Hong  1 , Kyungdo Han  2 , Cheol-Young Park  3
Affiliations
Observational Study

The insulin resistance by triglyceride glucose index and risk for dementia: population-based study

Sangmo Hong et al. Alzheimers Res Ther. .

Abstract

Background: Insulin resistance is suggested to have negative effects on cognition; however, results from large population studies are lacking. In this study, the potential relationships between the triglyceride glucose (TyG) index, a simple surrogate marker of insulin resistance, and dementia were evaluated using a large-scale population dataset.

Methods: This was a retrospective, observational, cohort study using data from the National Health Information Database from 2009 to 2015 and included 5,586,048 participants 40 years age or older. The TyG index was used as a measure of insulin resistance, and participants were divided into quartiles based on TyG index. The incidence of dementia was assessed using hazard ratios (HRs) estimated with Cox proportional hazard modeling.

Results: During a median follow-up of 7.21 years, dementia was diagnosed in 142,714 (2.55%) participants. Alzheimer's disease (AD) and vascular dementia (VD) were diagnosed in 74.3% and 12.5% of the participants. Multivariate-adjusted HRs for patients in the TyG index 4th quartile were higher for dementia (HRs = 1.14; 95% confidence interval [CI] 1.12-1.16), AD (HRs = 1.12; 95% CI 1.09-1.14), and VD (HRs = 1.18; 95% CI 1.12-1.23) compared with the 1st quartile of TyG index; however, this had a small effect size (Cohen's d = 0.10, 0.08, and 0.13, respectively). These effects were independent of age, sex, smoking status, physical activity, body mass index, systolic blood pressure, and total cholesterol.

Conclusion: In this large population study, TyG index was associated with an increased risk of dementia, including AD and VD, that was independent of traditional cardiovascular risk factors, although the effect size of the TyG index was small.

Keywords: Alzheimer’s disease; Dementia; Dementia, vascular; Insulin resistance; TyG index.

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Conflict of interest statement

No potential conflicts of interest relevant to this article were reported.

Figures

Fig. 1
Fig. 1
The cumulative incidence of dementia based on Kaplan-Meier. a Overall dementia. b AD. c VD during the average follow-up of 7.2 years based on the TyG index quartiles. Cumulative incidence probability is presented on the y-axis. Plots use different y-axis scales. The p value was calculated using the log-rank test. AD, Alzheimer’s disease; VD, vascular dementia; TyG, triglyceride glucose
Fig. 2
Fig. 2
Risk of dementia in AD and VD subgroups based on the increasing TyG index quartiles with various clinical variables (stratified based on age, sex, smoking status, alcohol consumption, presence of diabetes, hypertension, and dyslipidemia, BMI, and presence of abdominal obesity). HR, hazard ratio; CI, confidence interval; AD, Alzheimer’s disease; VD, vascular dementia; TyG, triglyceride glucose; BMI, body mass index
See this image and copyright information in PMC

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