Association between triglyceride-glucose index trajectories and carotid atherosclerosis progression

Abstract

Background The triglyceride-glucose (TyG) index has been recognized as being an alternative cardiometabolic biomarker for insulin resistance associated with the development and prognosis of cardiovascular disease (CVD). However, the prospective relationship between baseline and long-term trajectories of the TyG index and carotid atherosclerosis (CAS) progression has yet to be investigated. Methods This longitudinal prospective cohort study included 10,380 adults with multiple general health checks at Peking University Third Hospital from January 2011 to December 2020. The TyG index was calculated as ln (fasting triglyceride [mg/dL] × fasting glucose [mg/dL]/2). The latent class trajectory modeling method was used to analyze the TyG index trajectories over the follow-up. Based on univariate and multivariate Cox proportional hazards analyses, hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated for the baseline and trajectory of the TyG index. Results During a median follow-up period of 757 days, 1813 participants developed CAS progression. Each 1-standard deviation (SD) increase in the TyG index was associated with a 7% higher risk of CAS progression after adjusting for traditional CVD risk factors (HR = 1.067, 95% CI 1.006–1.132). Similar results were observed when the TyG index was expressed as quartiles. According to different trajectory patterns, participants were categorized into low-stable, moderate-stable, and high-increasing groups. After multivariate adjustment, the moderate-stable group had a 1.139-fold (95% CI 1.021–1.272) risk of CAS progression. The high-increasing trajectory of the TyG index tended to be associated with CAS progression (HR = 1.206, 95% CI 0.961–1.513). Conclusions Participants with higher baseline and moderate-stable trajectory of the TyG index were associated with CAS progression. Long-term trajectories of the TyG index can help to identify individuals at a higher risk of CAS progression who deserve specific preventive and therapeutic approaches.

The triglyceride glucose index trajectory is associated with hypertension: a retrospective longitudinal cohort study

“…Using the latent class trajectory modeling method, 10,380 adults with multiple general health checks were categorized to 3 distinct trajectories of the TyG index. Gao et al further con rmed the moderate-stable trajectory of the TyG index was associated with carotid atherosclerosis (CAS) progression [34]. Moreover, one large prospective study had investigated the association of longitudinal pattern of the TyG index and stroke risk among patients with hypertension, and the results showed that high TyG index trajectory had a higher risk of stroke and ischemic stroke during the follow-up of 10 years [23].…”

The triglyceride glucose index as a sensitive predictor for the risk of MACCEs in patients with diabetic foot ulcers: An ambispective longitudinal cohort study

“…Accumulating evidence has confirmed an independent association between the TyG index and MACCEs 26–29 . Compared to TG or FBG biomarkers alone, the TyG index, distinguished by combined fasting TG and FBG levels, is a better potential predictor of prognosis in patients with T2DM 30 .…”

The association between the triglyceride–glucose index and the risk of cardiovascular disease in US population aged ≤ 65 years with prediabetes or diabetes: a population-based study

“…Similarly, Cai et al identified a connection between a high TyG index and elevated risks of all-cause mortality and cardiovascular death among those at high risk of CVD [ 28 ]. Furthermore, Yu et al established a positive association between a higher TyG index at baseline and the progression of carotid atherosclerosis, particularly in participants with a moderate stabilization trajectory [ 29 ]. Notably, TyG indices have also demonstrated positive associations with adverse cardiovascular outcomes in patients with stable cardiovascular disease [ 30 ].…”