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

Abstract

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.

Quotient of Waist Circumference and Body Mass Index: A Valuable Indicator for the High-Risk Phenotype of Obesity

“…Mortality status for NHANES participants was ascertained through probabilistic record matching with the National Death Index (20). The primary outcome of this study was overall mortality and the secondary outcome was cardiovascular mortality, assessed via underlying causes of death with International Classification of Diseases, 10th Revision (ICD-10) codes I00-I09, I11, I13, I20-I51, and I60-I69 (21).…”

Predictive Value of the Atherogenic Index of Plasma (AIP) for the Risk of Incident Ischemic Heart Disease among Non-Diabetic Koreans

“…A well-established index of both CVD and IR is the triglyceride-glucose (TyG) index, the natural logarithm (Ln) of the product of plasma glucose and TG. The TyG index has been suggested to have a positive association with a higher prevalence of CVD, and it has also been used in healthy adults as a surrogate of IR [ 47 , 48 ]. Similar to the TyG index, AIP has recently been considered to be an independent predictor of subclinical coronary artery disease [ 49 ].…”

Rice bran oil could favorably ameliorate atherogenicity and insulin resistance indices among men with coronary artery disease: post hoc analysis of a randomized controlled trial

“…In particular, the TyG index that integrates serum fasting concentrations of triglycerides and glucose, has been broadly utilized as a substitute index for exploring resistance to insulin instead of Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) in the medical settings. Proposing a surrogate marker for insulin resistance would be helpful, given that HOMA-IR seems to be costly and time-consuming, and insulin serum concentrations measurement is required to be incorporated in [ 27 , 56 , 57 ]. Concerning this, in the current report, significant reductions in TyG index levels were detected after consuming 30 g of RBO for 8 weeks.…”