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. 2022 Dec;37(16):4153-4159.
doi: 10.1007/s11606-022-07681-4. Epub 2022 Jun 8.

Evaluating Triglyceride and Glucose Index as a Simple and Easy-to-Calculate Marker for All-Cause and Cardiovascular Mortality

Kyung-Soo Kim  1 , Sangmo Hong  2 , You-Cheol Hwang  3 , Hong-Yup Ahn  4 , Cheol-Young Park  5
Affiliations

Evaluating Triglyceride and Glucose Index as a Simple and Easy-to-Calculate Marker for All-Cause and Cardiovascular Mortality

Kyung-Soo Kim et al. J Gen Intern Med. 2022 Dec.

Abstract

Objective: The triglyceride and glucose (TyG) index is a useful marker of insulin resistance and is a predictor of several metabolic diseases. The aim of this study was to evaluate the association between the TyG index and all-cause or cardiovascular mortality using a large population-based cohort study database.

Methods: A total of 255,508 subjects in the Kangbuk Samsung Health Study cohort were enrolled. Cox proportional hazards models were used to analyze the risk of mortality.

Results: During a median 5.7-year follow-up, the cumulative all-cause and cardiovascular mortality was 0.47% and 0.07%. There was a nonlinear relationship between the TyG index and death, and moving from moderate to high, the TyG index levels were associated with an increase in the risk of death. The hazard ratio (HR) for all-cause and cardiovascular mortality of the TyG index was 1.21 [95% confidence interval (CI) 1.14-1.28] and 1.45 (95% CI 1.26-1.66) in the unadjusted model, respectively. After adjustment for covariates, the association between the TyG index and all-cause and cardiovascular mortality was attenuated. In the multivariable-adjusted model, the TyG index was associated with an elevated risk of all-cause mortality in women (HR 1.13, 95% CI 1.02-1.26) and a decreased risk in men (HR 0.92, 95% CI 0.85-0.99). The association between cardiovascular mortality and the TyG index was not statistically significant among either men or women in the multivariable-adjusted model.

Conclusions: The TyG index in a young, relatively healthy, population is associated with an elevated risk of all-cause and cardiovascular mortality. This association between the TyG index and all-cause mortality persists in women after multivariable adjustment.

Keywords: glucose; homeostasis model assessment of insulin resistance (HOMA-IR); insulin resistance; mortality; triglycerides.

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Conflict of interest statement

The authors declare that they do not have a conflict of interest.

Figures

Figure 1
Figure 1
All-cause (A) and cardiovascular (B) survival rates according to the triglyceride and glucose (TyG) index quartile in the unadjusted model (P < 0.001, respectively). Q1, broken line; Q2, solid line; Q3 bold broken line; Q4, bold solid line.
Figure 2
Figure 2
Restricted cubic spline curve of the risk for all-cause (A) and cardiovascular mortality (B) according to the triglyceride and glucose (TyG) index in the unadjusted model. Dotted lines represent 95% confidence interval (CI). HR, hazard ratio.
See this image and copyright information in PMC

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