Gender difference in the association between TyG index and subclinical atherosclerosis: results from the I-Lan Longitudinal Aging Study

Abstract

Background Insulin resistance (IR) is a known risk factor for cardiovascular disease (CVD) in non-diabetic patients through the association of hyperglycemia or associated metabolic factors. The triglyceride glucose (TyG) index, which was defined by incorporating serum glucose and insulin concentrations, was developed as a surrogate marker of insulin resistance. We aimed to investigate the association between the TyG index and the early phase of subclinical atherosclerosis (SA) between the sexes. Methods The I-Lan Longitudinal Aging Study (ILAS) enrolled 1457 subjects aged 50–80 years. For each subject, demographic data and the TyG index {ln[fasting triglyceride (mg/dL) × fasting plasma glucose (mg/dL)]/2} were obtained. Patients were further stratified according to sex and the 50th percentile of the TyG index (≥ 8.55 or < 8.55). SA was defined as the mean carotid intima-media thickness (cIMT) at the 75th percentile of the entire cohort. Demographic characteristics and the presence of SA were compared between the groups. Logistic regression analysis was performed to assess the relationship between TyG index and SA. Results Patients with a higher TyG index (≥ 8.55) had a higher body mass index (BMI), hypertension (HTN) and diabetes mellitus (DM). They had higher lipid profiles, including total cholesterol (T-Chol) and low-density lipoprotein (LDL), compared to those with a lower TyG index (< 8.55). Gender disparity was observed in non-diabetic women who had a significantly higher prevalence of SA in the high TyG index group than in the low TyG index group. In multivariate logistic regression analysis, a high TyG index was independently associated with SA in non-diabetic women after adjusting for traditional risk factors [adjusted odds ratio (OR): 1.510, 95% CI 1.010–2.257, p = 0.045] but not in non-diabetic men. The TyG index was not associated with the presence of SA in diabetic patients, irrespective of sex. Conclusion A high TyG index was significantly associated with SA and gender disparity in non-diabetic patients. This result may highlight the need for a sex-specific risk management strategy to prevent atherosclerosis.

Correlation of physical and cognitive impairment in diabetic and hypertensive frail older adults

“…Our data indicate a primary role of diabetes and hypertension in the development of disability in a frail cohort of older adults. Furthermore, consistent with previous investigations [ 64 , 65 ], in our population we observed a robust impact of age (p < 0.001) and admission glycemia (p < 0.001), strongly suggesting that glycemic control is a goal to achieve for avoiding adverse outcomes in this class of patients. Indeed, hyperglycemia worsens a delicate balance in patients with multimorbidity such as frail elders [ 66 – 68 ].…”

Prognostic value of triglyceride glucose (TyG) index in patients with acute decompensated heart failure

“…Two studies showed that patients with elevated TyG index are more likely to develop hypertension [ 22 , 42 ], which was also confirmed in the present research. Moreover, Lu et al found that in a non-diabetic population, higher TyG index was significantly associated with subclinical atherosclerosis in women compared to men [ 43 ]. Further researches have shown that the TyG index is more substantially associated with arterial stiffness, coronary artery calcification, and carotid atherosclerosis than HOMA-IR [ 17 , 20 , 44 ].…”

Association between triglyceride glucose index and carotid artery plaque in different glucose metabolic states in patients with coronary heart disease: a RCSCD-TCM study in China

“…A high TyG index was independently associated with SA in non-diabetic female, but in NGT male. Regardless of sex, the TyG index is unrelated to the presence of SA in DM patients [ 40 ]. Higher TG and blood pressure had greater impact in both DM patients and those with NGT.…”