Impact of Visit-to-Visit Triglyceride-Glucose Index Variability on the Risk of Cardiovascular Disease in the Elderly

Abstract

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.

Association of triglyceride-glucose index trajectory and frailty in urban older residents: evidence from the 10-year follow-up in a cohort study

“…The triglyceride-glucose (TyG) index, conveniently calculated by triglyceride and fasting glucose levels, has been regarded as a good alternative surrogate marker for the established parameters of IR [ 7 ]. Accumulating evidence indicated that the TyG index is associated with cardiovascular and metabolic risk, predominantly cardiovascular disease [ 8 – 11 ], type 2 diabetes mellitus [ 12 ], stroke [ 13 , 14 ], arterial stiffness [ 11 , 15 , 16 ], vascular damage [ 17 , 18 ] and even death [ 19 ]. Recently, a few studies reported that a higher TyG index was also associated with an increased risk of sarcopenia or low muscle mass in older populations [ 20 – 22 ].…”

Association of long-term triglyceride-glucose index level and change with the risk of cardiometabolic diseases

“…It was recently noted that the variability and longitudinal trajectory in the TyG-index, both regarded as novel and important indicators for outcome events, had strong predictive effects for cardiovascular diseases ( 39 – 42 ). With either variability or longitudinal trajectory in the TyG-index, the effects on CMDs risk in this research are consistent with a previous study that found those indicators (variability and trajectory) to be associated with CMDs risk.…”

Association of long-term triglyceride-glucose index level and change with the risk of cardiometabolic diseases

“…Second, owing to the possibility of reverse causality, participants in the TyG level loss category were more inclined to be at high risk for having a CMDs, such as drinkers and smokers (Supplementary Table S7), who have greater odds of receiving health education about CMDs prevention and consciously lowering TyG levels. Furthermore, this phenomenon may be related to metabolic memory caused by FBG [34], considering the TyG-index calculated using the parameters FBG and TG. Notably, although we have tried to adjust for confounders adequately, there are still some force majeure factors, such as insidious disease, that may cause unintentional TyG level loss during the protracted or chronic course of the disease.…”