Associations between Triglyceride-Glucose Index and Micro- and Macro-Angiopathies in Type 2 Diabetes Mellitus

Chiu, Hsuan; Tsai, Hung-Chin; Huang, Jiun-Chi; Wu, Pei‐Yu; Hsu, Wei-Hao; Lee, Mei‐Yueh; Chen, Szu-Chia

doi:10.3390/nu12020328

Cited by 36 publications

(31 citation statements)

References 61 publications

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“…Moreover, the TyG index has been strongly associated with coronary artery calcification progression [39]. In addition, the TyG index has been correlated with micro-and macrovascular damage, such as arterial stiffness, nephric microvascular damage, cardiac autonomic neuropathy and cerebrovascular disease [40][41][42], all of the conditions known to increase the risk of adverse CVEs. Nevertheless, in this study, patients with higher TyG indices were younger and less likely to have PCI history and prior MI.…”

Section: Discussionmentioning

confidence: 99%

Triglyceride-glucose index predicts adverse cardiovascular events in patients with diabetes and acute coronary syndrome

Wang

Cong

Zhang

et al. 2020

Cardiovasc Diabetol

224

209

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Background: The triglyceride-glucose index (TyG index) has been regarded as a reliable alternative marker of insulin resistance and an independent predictor of cardiovascular outcomes. Whether the TyG index predicts adverse cardiovascular events in patients with diabetes and acute coronary syndrome (ACS) remains uncertain. The aim of this study was to investigate the prognostic value of the TyG index in patients with diabetes and ACS. Methods: A total of 2531 consecutive patients with diabetes who underwent coronary angiography for ACS were enrolled in this study. Patients were divided into tertiles according to their TyG index. The primary outcomes included the occurrence of major adverse cardiovascular events (MACEs), defined as all-cause death, non-fatal myocardial infarction and non-fatal stroke. The TyG index was calculated as the ln (fasting triglyceride level [mg/dL] × fasting glucose level [mg/dL]/2). Results: The incidence of MACE increased with TyG index tertiles at a 3-year follow-up. The Kaplan-Meier curves showed significant differences in event-free survival rates among TyG index tertiles (P = 0.005). Multivariate Cox hazards regression analysis revealed that the TyG index was an independent predictor of MACE (95% CI 1.201-1.746; P < 0.001). The optimal TyG index cutoff for predicting MACE was 9.323 (sensitivity 46.0%; specificity 63.6%; area under the curve 0.560; P = 0.001). Furthermore, adding the TyG index to the prognostic model for MACE improved the C-statistic value (P = 0.010), the integrated discrimination improvement value (P = 0.001) and the net reclassification improvement value (P = 0.019). Conclusions: The TyG index predicts future MACE in patients with diabetes and ACS independently of known cardiovascular risk factors, suggesting that the TyG index may be a useful marker for risk stratification and prognosis in patients with diabetes and ACS.

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Section: Discussionmentioning

confidence: 99%

Triglyceride-glucose index predicts adverse cardiovascular events in patients with diabetes and acute coronary syndrome

Wang

Cong

Zhang

et al. 2020

Cardiovasc Diabetol

224

209

View full text Add to dashboard Cite

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“…When compared to HOMA-IR, Lee et al found that TyG index is a better indicator of arterial stiffness in Korean adults ( 18 ). Chiu et al and Zhao et al found that TyG index was associated with macrovascular and microvascular damage ( 30 , 31 ). TyG index was also found to associate with CVD incidence ( 14 , 32 ), hypertension, diabetes, as well as metabolic syndrome ( 11 , 12 , 33 ).…”

Section: Discussionmentioning

confidence: 99%

The Triglyceride-Glucose Index, an Insulin Resistance Marker, Was Non-linear Associated With All-Cause and Cardiovascular Mortality in the General Population

Liu

et al. 2021

Front. Cardiovasc. Med.

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Background: The triglyceride-glucose (TyG) index could serve as a convenient substitute of insulin resistance (IR), but epidemiological evidence on its relationship with the long-term risk of mortality is limited.Methods: Participants from the National Health and Nutrition Examination Survey during 1999–2014 were grouped according to TyG index (<8, 8–9, 9–10, >10). Cox regression was conducted to compute the hazard ratios (HRs) and 95% confidence interval (CI). Restricted cubic spline and piecewise linear regression were performed to detect the shape of the relationship between TyG index and mortality.Results: A total of 19,420 participants (48.9% men) were included. On average, participants were followed-up for 98.2 months, and 2,238 (11.5%) and 445 (2.3%) cases of mortality due to all-cause or cardiovascular disease were observed. After adjusting for confounders, TyG index was independently associated with an elevated risk of all-cause (HR, 1.10; 95% CI, 1.00–1.20) and cardiovascular death (HR, 1.29; 95% CI, 1.05–1.57). Spline analyses showed that the relationship of TyG index with mortality was non-linear (All non-linear P < 0.001), and the threshold value were 9.36 for all-cause and 9.52 for cardiovascular death, respectively. The HRs above the threshold point were 1.50 (95% CI, 1.29–1.75) and 2.35 (95% CI, 1.73–3.19) for all-cause and cardiovascular death. No significant difference was found below the threshold points (All P > 0.05).Conclusion: Elevated TyG index reflected a more severe IR and was associated with mortality due to all-cause and cardiovascular disease in a non-linear manner.

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“…[1][2][3] Previous studies have considered that the TyG index was predictive of the development of cardiovascular events and nonalcoholic fatty-liver disease 19,20 and related to IR. 10,11 In contrast to our findings, a retrospective crosssectional study proposed that the TyG index was not associated with DR. 14 These inconsistent results may be due to differences in participant characteristics and study design. Notably, such findings should be interpreted with cautiou, due to unadjusted variables, such as duration of diabetes, IR, or DR severity.…”

Section: Discussionmentioning

confidence: 99%

“… 12 , 13 Recently, a retrospective cross-sectional study demonstrated that TyG was significantly associated with the risk of microalbuminuria and cerebrovascular disease, rather than DR, but these outcomes should be viewed with caution, due to study design, diagnostic methods, and adjusted confounders. 14 No relevant population-based or clinical investigation has focused on the impact of TyG on DR in patients with diabetes. In this study, we aimed to explore the relationship between the TyG index and DR by using comprehensive registry data with a nested case–control design in a study cohort of patients with type 2 diabetes in China.…”

Section: Introductionmentioning

confidence: 99%

The Triglyceride–Glucose Index is Associated with Diabetic Retinopathy in Chinese Patients with Type 2 Diabetes: A Hospital-Based, Nested, Case–Control Study

Yao¹,

Wang²,

Zhong³

et al. 2021

DMSO

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Background This study aimed to investigate the association between the triglyceride–glucose (TyG) index and diabetic retinopathy (DR) in Chinese patients with type 2 diabetes. Methods In this nested case–control study, all diabetic participants were registered hospitalizations during 2012–2018, including 596 with DR as cases and three matching controls per case. DR was assessed using Early Treatment Diabetic Retinopathy Study criteria. The TyG index was calculated: Ln (fasting blood glucose [mg/dL] × fasting triglycerides [mg/dL] ÷ 2). Multivariate logistic regression, a receiver-operating characteristic (ROC) curve, linear regression models, and mediation analysis were used to explore associations. Results The TyG index was lower in DR and decreased as its severity advanced among 2,112 subjects ( P =0.005). After confounders (sex, duration of diabetes, use of antidiabetic agents, heart rate, systolic blood pressure, pulse pressure, height, weight, body-mass index, and glycated hemoglobin) had been accounted for, there were significant associations between the TyG index and any-severity DR (OR 0.83, 95% CI 0.73–0.95; P =0.006), as well as vision-threatening DR (VTDR; OR 0.53, 95% CI 0.36–0.76; P =0.001). ROC analysis indicated that the TyG index showed significant discriminatory ability in any-severity DR (area under curve [AUC] 0.534, P =0.015) and VTDR (AUC 0.624, P =0.001). Conclusion The TyG index was associated with the presence and severity of DR. Our findings suggest that the TyG index may become a useful biomarker in evaluating and following the presence of DR and VTDR.

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Associations between Triglyceride-Glucose Index and Micro- and Macro-Angiopathies in Type 2 Diabetes Mellitus

Cited by 36 publications

References 61 publications

Triglyceride-glucose index predicts adverse cardiovascular events in patients with diabetes and acute coronary syndrome

Triglyceride-glucose index predicts adverse cardiovascular events in patients with diabetes and acute coronary syndrome

The Triglyceride-Glucose Index, an Insulin Resistance Marker, Was Non-linear Associated With All-Cause and Cardiovascular Mortality in the General Population

The Triglyceride–Glucose Index is Associated with Diabetic Retinopathy in Chinese Patients with Type 2 Diabetes: A Hospital-Based, Nested, Case–Control Study

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