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Review
. 2021 Apr 3;20(1):76.
doi: 10.1186/s12933-021-01268-9.

Triglyceride-glucose index and the incidence of atherosclerotic cardiovascular diseases: a meta-analysis of cohort studies

Xiaobo Ding #  1 , Xiaozhen Wang #  2 , Jing Wu  3 , Manli Zhang  4 , Meizi Cui  5
Affiliations
Review

Triglyceride-glucose index and the incidence of atherosclerotic cardiovascular diseases: a meta-analysis of cohort studies

Xiaobo Ding et al. Cardiovasc Diabetol. .

Abstract

Background: Insulin resistance has been demonstrated to be involved in the pathogenesis of atherosclerotic cardiovascular diseases (ASCVDs). This study evaluated the association between the triglyceride-glucose (TyG) index, a novel surrogate indicator of insulin resistance, and the incidence of ASCVDs in people without ASCVDs at baseline by performing a meta-analysis.

Methods: Cohort studies reporting the multivariate-adjusted association between the TyG index and the incidence of ASCVDs were obtained by searching the PubMed and Embase databases. A random-effects model incorporating intra-study heterogeneity was applied to combine the results.

Results: Eight cohort studies comprising 5,731,294 participants were included in this meta-analysis. The results showed that compared to those with the lowest TyG index category, participants with the highest TyG index category were independently associated with a higher risk of ASCVDs [hazard ratio (HR): 1.61, 95% confidence interval (CI) 1.29-2.01, I2 = 80%, P < 0.001]. This finding was consistent with the meta-analysis results with the TyG index analyzed as a continuous variable (HR per 1-unit increment of the TyG index: 1.39, 95% CI 1.18-1.64, I2 = 89%, P < 0.001). Subgroup analyses suggested that the age, sex, and diabetic status did not significantly affect the association (for subgroup analyses, all P > 0.05). Moreover, participants with the highest TyG index category were independently associated with a higher risk of coronary artery disease [(CAD), HR: 1.95, 95% CI 1.47-2.58, I2 = 92%, P < 0.001] and stroke (HR: 1.26, 95% CI 1.23-1.29, I2 = 0%, P < 0.001).

Conclusions: A higher TyG index may be independently associated with a higher incidence of ASCVDs, CAD, and stroke in people without ASCVDs at baseline.

Keywords: Atherosclerotic cardiovascular diseases; Coronary artery disease; Insulin resistance; Meta-analysis; Triglyceride-glucose index.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart of the database search and study identification
Fig. 2
Fig. 2
Forest plots for the meta-analysis of the association between the TyG index and the risk of ASCVDs. a Meta-analysis with the TyG index analyzed as a categorical variable. b Meta-analysis with the TyG index analyzed as a continuous variable
Fig. 3
Fig. 3
Subgroup analyses for the association between the TyG index analyzed as a categorical variable and the risk of ASCVDs. a Subgroup analysis according to the age of the participants. b Subgroup analysis according to the sex of the participants. c Subgroup analysis according to the diabetic status of the participants
Fig. 4
Fig. 4
Forest plots for the meta-analysis of the association between the TyG index and the risk of CAD. a Meta-analysis with the TyG index analyzed as a categorical variable. b Meta-analysis with the TyG index analyzed as a continuous variable
Fig. 5
Fig. 5
Forest plots for the meta-analysis of the association between the TyG index analyzed as a categorical variable and the risk of stroke
Fig. 6
Fig. 6
Funnel plots for the publication bias underlying the meta-analysis of the association between the TyG index analyzed as a categorical variable and ASCVD and CAD. a Funnel plots for the meta-analysis of the TyG index and ASCVD risk. b Funnel plots for the meta-analysis of the TyG index and CAD risk
See this image and copyright information in PMC

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