Background. e aging population is increasingly susceptible to cardiovascular disease (CVD). Visit-to-visit variability in glucose and lipid levels both contributed to CVD risk independent of their mean values. However, whether variability in the triglycerideglucose (TyG) index is a risk factor for CVD remains unknown. Research Design and Methods. In this retrospective study of electronic health records, 27,520 participants aged over 60 years were enrolled. e visit-to-visit variability of TyG index was calculated from annual health examination data and de ned as average real variability (ARV), standard deviation (SD), or the coe cient of variability (CV). CVD events were identi ed from the chronic disease registry or follow-up database and included myocardial infarction, angina, coronary, and stroke. Multivariate Cox regression was used to examine the correlation between TyG variability and incident CVD. Results. Over a median follow-up of 6.2 years, there were 2,178 CVD events. When participants were divided into four quartiles according to their TyG variability, after adjusting for established CVD risk factors, subjects in the top quartile had (HR 1.18, 95% CI 1.05-1.34, P 0.005) signi cantly higher CVD risk than those in the bottom quartile. e association remained signi cant in overweight individuals or those without diabetes (P < 0.005 and P < 0.01, respectively). Conclusions. High variability in TyG was signi cantly associated with elevated CVD risk in the elderly, independent of average TyG and other risk factors. Close monitoring variability in TyG might be informative to identify old individuals at high risk of CVD.
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