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. 2025 Sep 29;25(1):685.
doi: 10.1186/s12872-025-05112-w.

Association of triglyceride-glucose index with risk of cardiovascular disease among patients with prediabetes: population based prospective cohort study

Man Li #  1 , Hong-Peng Zhang #  2 , Yan-Mei Cheng #  3 , Li-Xia Sun  4 , Shuo-Hua Chen  5 , Xiang-Jie Duan  1 , Chun Xian  4 , Shou-Ling Wu  6 , Hai-Yan Yin  7   8
Affiliations

Association of triglyceride-glucose index with risk of cardiovascular disease among patients with prediabetes: population based prospective cohort study

Man Li et al. BMC Cardiovasc Disord. .

Abstract

Background: The triglyceride-glucose (TyG) index was associated with an increased risk of cardiovascular disease (CVD) in patients with prediabetes. However, this association has not yet been evaluated in prospective studies. Hence, we aimed to investigate the association between the TyG index and the risk of incident CVD in patients with prediabetes.

Methods: Participants with prediabetes were enrolled from the Kailuan study and were followed up for clinical events until 2022. The exposure variable was TyG index. The primary outcomes were the incidence of CVD events, including ischemic heart disease and stroke, while the secondary outcomes were each specific type of CVD events. Cox proportional hazards regression models and restricted cubic spline analysis were used to calculate multivariable-adjusted hazard ratios and investigate exposure-response association, respectively.

Results: Over a mean follow-up period of 14.19 years, 13.81% (n = 2,537) of the 18,364 participants with prediabetes developed CVD events. Compared with participants in the lowest TyG index quartile (Q1, TyG index < 8.45), those in Q2 (TyG index 8.45-8.81), Q3 (TyG index 8.81-9.23), and Q4 (TyG index ≥ 9.23) were associated with an increased risk of CVD, with hazard ratios (HRs) of 1.18 (95% confidence interval [CI] 1.05-1.34), 1.29 (95% CI 1.15-1.46), and 1.45 (95% CI 1.28-1.63), respectively. For each unit increase in TyG index, the risk of CVD events increased by 12% in prediabetes patients. We also found a linear association between baseline TyG index and CVD events in prediabetes patients (P-non-linear = 0.12).

Conclusions: TyG index is an independent risk factor for incident CVD in the prediabetes patients.

Keywords: Cardiovascular disease; Cohort study; Insulin resistance; Prediabetes; Triglyceride glucose index.

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Conflict of interest statement

Declarations. Ethics approval and consent participate: This study was conducted in accordance with the guidelines from the Helsinki Declaration and approved by the Ethics Committees of the Kailuan General Hospital (Approval No: 2006–05). Written informed consent was obtained from all participants. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow chart of study participants
Fig. 2
Fig. 2
Cumulative incidence of cardiovascular diseases and its subtypes according to categories of TyG index in prediabetes patients Panel A: Cardiovascular diseases; Panel B: Ischemic heart disease; Panel C: Stroke; Panel D: Ischemic stroke; Panel E: Hemorrhagic stroke
Fig. 3
Fig. 3
Associations of TyG index with the risk of cardiovascular diseases and its subtypes using restricted cubic spline regression models (Model 3) Panel A: Cardiovascular diseases; Panel B: Ischemic heart disease; Panel C: Stroke; Panel D: Ischemic stroke; Panel E: Hemorrhagic stroke Point estimates (solid lines) and 95% confidence intervals (dashed lines) were obtained from restricted cubic spline regression models adjusted for covariates in Model 3
Fig. 4
Fig. 4
Forest plot of multivariate-adjusted hazard ratios for the association between TyG index categories and cardiovascular diseases across different stratifications Model adjusted for age, sex, current smoking, current drinking, physical activity, education, snoring, CVD family history, BMI, hypertension, total cholesterol, low density lipoprotein cholesterol, high density lipoprotein cholesterol, log hs-CRP, antihypertensive, and lipid-lowering drugs. For the stratified analyses, the stratification factor was not included in the model
See this image and copyright information in PMC

References

    1. Pratte KA, Johnson A, Beals J, Bullock A, Manson SM, Jiang L. Regression to normal glucose regulation in American Indians and Alaska natives of a diabetes prevention program. Diabetes Care. 2019;42(7):1209–16. - PMC - PubMed
    1. Wu YL, Lin ZJ, Li CC, et al. Epigenetic regulation in metabolic diseases: mechanisms and advances in clinical study. Signal Transduct Target Ther. 2023;8(1): 98. - PMC - PubMed
    1. Ogurtsova K, da Rocha Fernandes JD, Huang Y, et al. IDF diabetes atlas: global estimates for the prevalence of diabetes for 2015 and 2040. Diabetes Res Clin Pract. 2017;128:40–50. - PubMed
    1. Yang W, Lu J, Weng J, et al. Prevalence of diabetes among men and women in China. N Engl J Med. 2010;362(12):1090–101. - PubMed
    1. Wang L, Peng W, Zhao Z, et al. Prevalence and treatment of diabetes in China, 2013–2018. JAMA. 2021;326(24):2498–506. - PMC - PubMed

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