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. 2022 Aug 12;21(1):155.
doi: 10.1186/s12933-022-01593-7.

High triglyceride-glucose index in young adulthood is associated with incident cardiovascular disease and mortality in later life: insight from the CARDIA study

Xinghao Xu #  1   2 , Rihua Huang #  1   2 , Yifen Lin #  1   2 , Yue Guo  1   2 , Zhenyu Xiong  1   2 , Xiangbin Zhong  1   2 , Xiaomin Ye  1   2 , Miaohong Li  1   2 , Xiaodong Zhuang  3   4 , Xinxue Liao  5   6
Affiliations

High triglyceride-glucose index in young adulthood is associated with incident cardiovascular disease and mortality in later life: insight from the CARDIA study

Xinghao Xu et al. Cardiovasc Diabetol. .

Abstract

Background: This study aimed to investigate the associations between the triglyceride-glucose (TyG) index in young adulthood with incident cardiovascular disease (CVD) and mortality.

Methods: We included 4,754 participants from the Coronary Artery Risk Development in Young Adults study at baseline. The TyG index was calculated as ln (fasting TG [mg/dl] × fasting glucose [mg/dl]/2), and the TyG index trajectories were identified by using the latent class growth mixture model. We evaluated the association between the baseline and trajectories of the TyG index with incident CVD events and all-cause mortality using Cox proportional hazards regression analysis. The added value of the TyG index included in pooled cohort equations for CVD prediction was also analyzed.

Results: Among 4754 participants (mean age 24.72 years, 45.8% male, 51.2% black), there were 158 incident CVD events and 246 all-cause mortality during a median 25 years follow-up. After adjusting for multiple confounding variables, each one-unit increase in the TyG index was associated with a 96% higher CVD risk (hazard ratio [HR] 1.96, 95% confidence interval [CI] 1.44-2.66) and a 85% higher all-cause mortality risk (HR 1.85, 95% CI 1.45-2.36). Three distinct trajectories of the TyG index along the follow-up duration were identified: low (44.0%), moderate (45.5%), and high (10.5%). Compared with those participants in the low TyG index trajectory group, those in the high TyG index trajectory group had a greater risk of CVD events (HR 2.35, 95% CI 1.34-4.12) and all-cause mortality (HR 3.04, 95% CI 1.83-5.07). The addition of baseline TyG index to pooled cohort equations for CVD improved the C-statistics (P < 0.001), integrated discrimination improvement value (P < 0.001), and category-free net reclassification improvement value (P = 0.003).

Conclusions: Higher baseline TyG index levels and higher long-term trajectory of TyG index during young adulthood were significantly associated with an increased risk of incident CVD events and all-cause mortality in later life.

Keywords: Cardiovascular disease; Mortality; Triglyceride-glucose index.

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Conflict of interest statement

All the authors declared no conflicting interests with respect to the research, authorship, or publication of this article.

Figures

Fig. 1
Fig. 1
Cumulative incidence of cardiovascular disease (A) and all-cause mortality (B) by quartiles of baseline TyG index
Fig. 2
Fig. 2
Adjusted hazard ratios of incident CVD events (A) and all-cause mortality (B) by baseline TyG index. Each hazard ratio was computed with a median baseline TyG index level of 7.8 (A and B). Both p for linearity < 0.01
Fig. 3
Fig. 3
Subgroup analysis of the association between baseline TyG index and incident CVD events. Subgroup analysis included sex (male or female), race (black or white), age (≤ 24 or ≥ 25 years), education (≤ high school or > high school), and BMI (≤ 28 or > 28 kg/m2)
Fig. 4
Fig. 4
Trajectories by TyG index in the Coronary Artery Risk Development in Young Adults study
See this image and copyright information in PMC

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