Triglyceride glucose and haemoglobin glycation index for predicting outcomes in diabetes patients with new-onset, stable coronary artery disease: a nested case-control study

Jin, Jing‐Lu; Sun, Di; Cao, Ye‐Xuan; Guo, Yuan‐Lin; Wu, Na‐Qiong; Zhu, Cheng‐Gang; Gao, Ying; Dong, Qiu‐Ting; Zhang, Huiwen; Geng, Long; Dong, Qian; Li, Jianjun

doi:10.1080/07853890.2018.1523549

Cited by 80 publications

(79 citation statements)

References 28 publications

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“…The Actions to Control Cardiovascular Risk in Diabetes (ACCORD) study reported that patients with type 2 diabetes with a high HGI had higher levels of diabetic retinopathy and nephropathy, as also previously reported in the Diabetes Control and Complication Trial (DCCT) . In addition, numerous studies have suggested an association between HGI and cardiovascular diseases in subjects with diabetes . Even in nondiabetic subjects, a high HGI has been associated with a higher risk of vascular atherosclerosis …”

Section: Discussionsupporting

confidence: 67%

The haemoglobin glycation index is associated with nonalcoholic fatty liver disease in healthy subjects

Yoo

Kang

Cho

et al. 2019

Clinical Endocrinology

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Objectives The hemoglobin glycation index (HGI) quantifies interindividual variations in glycated hemoglobin (HbA1c) and is associated with diabetic complications and metabolic diseases. However, information on the association between HGI and non‐alcoholic fatty liver disease (NAFLD) in healthy subjects is limited, particularly in Asian populations. This study aimed to investigate the association between HGI and NAFLD in a healthy Korean cohort. Design Subjects were stratified in quartiles according to their HGI level. NAFLD was diagnosed by hepatic ultrasonography, hepatic steatosis index and fatty liver index. Multiple logistic regression analysis was performed to evaluate the association between HGI quartiles and the risk of NAFLD. Patients Data from subjects without diabetes who underwent liver ultrasonography during routine health examinations were retrospectively reviewed. Results Data from 14 465 subjects were included in the analysis. The prevalence of NAFLD increased significantly with each HGI quartile (24.8%, 29.7%, 32.6% and 40.6% in quartiles 1‐4, respectively; P < 0.001). In comparison with the lowest HGI quartile group, the highest quartile exhibited worse metabolic parameters, including body weight, waist circumference, body mass index and lipid profiles. Multiple logistic regression analysis adjusted for multiple factors showed that the odds ratio of having NAFLD was 1.564 (95% CI: 1.350‐1.813, P < 0.001) in the highest HGI quartile. Conclusions Elevated HGI levels are independently associated with NAFLD in a healthy Asian population.

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Section: Discussionsupporting

confidence: 67%

The haemoglobin glycation index is associated with nonalcoholic fatty liver disease in healthy subjects

Yoo

Kang

Cho

et al. 2019

Clinical Endocrinology

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“…A cross-sectional study including 888 asymptomatic subjects with T2DM but without a previous history of CHD showed that a higher TyG index was associated with an increased risk of significant coronary artery stenosis [19]. A nested case-control study including 1282 patients with T2DM and stable CAD showed that the TyG index was positively associated with future CV events, which were defined as all-cause death, non-fatal MI, stroke and post-discharge revascularization [20]. Additionally, a cohort study including 25,969 participants without previous diabetes or CVD indicated substantial similarities in the inflammatory profiles associated with diabetes and CVD [24].…”

Section: Discussionmentioning

confidence: 99%

“…Numerous clinical studies have indicated that the TyG index is associated with CVD morbidity and mortality in the general population and many patient cohorts including both non-diabetic and diabetic patients [12][13][14][15][16][17][18][19][20]; however, no previous study has exclusively investigated the prognostic usefulness of the TyG index for CV events after PCI in patients with T2DM and ACS. Therefore, we examined the relationship between the baseline TyG index and adverse CV outcomes in patients with T2DM and ACS who underwent PCI.…”

Section: Introductionmentioning

confidence: 99%

Triglyceride glucose index for predicting cardiovascular outcomes after percutaneous coronary intervention in patients with type 2 diabetes mellitus and acute coronary syndrome

Dong

Shao

et al. 2020

Cardiovasc Diabetol

130

147

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Background: The triglyceride glucose (TyG) index, a simple surrogate estimate of insulin resistance, has been demonstrated to predict cardiovascular (CV) disease morbidity and mortality in the general population and many patient cohorts. However, to our knowledge, the prognostic usefulness of the TyG index after percutaneous coronary intervention (PCI) in patients with type 2 diabetes mellitus (T2DM) and acute coronary syndrome (ACS) has not been determined. This study aimed to evaluate the association of the TyG index with adverse CV outcomes in patients with T2DM and ACS who underwent PCI. Methods: The TyG index was calculated using the formula ln[fasting triglycerides (mg/dL) × fasting glucose (mg/ dL)/2]. The primary endpoint was the composite of all-cause mortality, non-fatal stroke, non-fatal myocardial infarction, or unplanned repeat revascularization. The association between the TyG index and adverse CV outcomes was assessed by Cox proportional hazards regression analysis. Results: In total, 776 patients with T2DM and ACS who underwent PCI (mean age, 61 ± 10 years; men, 72.2%) were included in the final analysis. Over a median follow-up of 30 months, 188 patients (24.2%) had at least 1 primary endpoint event. The follow-up incidence of the primary endpoint rose with increasing TyG index tertiles. The multivariate Cox proportional hazards regression analysis adjusted for multiple confounders revealed a hazard ratio for the primary endpoint of 2.17 (95% CI 1.45-3.24; P for trend = 0.001) when the highest and lowest TyG index tertiles were compared. Conclusions: The TyG index was significantly and positively associated with adverse CV outcomes, suggesting that the TyG index may be a valuable predictor of adverse CV outcomes after PCI in patients with T2DM and ACS.

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“…Moreover, TyG index has been recognized as an independent predictor for the risk of CVEs in patients with CVD [16][17][18][19]. Atherosclerotic CVD is the most cause of death in patients with diabetes.…”

Section: Baseline Characteristics Of Patientsmentioning

confidence: 99%

“…A number of studies have found a positive association between TyG index and cardiovascular risk, including systematic CAD, carotid atherosclerosis, hypertension, metabolic syndrome, arterial stiffness and coronary calcification [9][10][11][12][13][14][15]. Furthermore, recent data suggest that TyG index could provide significant prognostic information in patients with established CAD [16][17][18][19]. In fact, TyG index is associated with not only the incidence of cardiovascular disease (CVD) but also the development of type 2 diabetes [20][21][22][23][24][25].…”

Section: Introductionmentioning

confidence: 99%

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

Wang

Cong

Zhang

et al. 2020

Preprint

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Background: Triglyceride-glucose index (TyG index) has been regarded as a reliable alternative marker of insulin resistance and an independent predictor of cardiovascular outcomes. Whether TyG index predicts adverse cardiovascular events in patients with diabetes and acute coronary syndrome (ACS) remains uncertain. The aim of the present study was to investigate the prognostic value of 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 the study. Patients were divided into 3 tertiles according to TyG index. The primary outcomes included the occurrence of major adverse cardiovascular events (MACE), defined as all-cause death, non-fatal myocardial infarction and non-fatal stroke. The TyG index was calculated as ln (fasting triglyceride level (mg/dL) ×fasting glucose level (mg/dL)/2).Results: The incidence of MACE increased with TyG index tertiles after 3-year follow-up. 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 TyG index was an independent predictor of MACE (95% CI 1.201-1.746; P<0.001). The optimal TyG index cut-off for predicting MACE was 9.323 (sensitivity 46.0% ; specificity 63.6%; area under the curve 0.560; P=0.001 ).Furthermore, adding 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 TyG index predicts future recurrent cardiovascular events in patients with diabetes and ACS, independently of known cardiovascular risk factors suggesting that TyG index may be a useful marker for risk stratification and prognosis in patients with diabetes and ACS.

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Triglyceride glucose and haemoglobin glycation index for predicting outcomes in diabetes patients with new-onset, stable coronary artery disease: a nested case-control study

Cited by 80 publications

References 28 publications

The haemoglobin glycation index is associated with nonalcoholic fatty liver disease in healthy subjects

The haemoglobin glycation index is associated with nonalcoholic fatty liver disease in healthy subjects

Triglyceride glucose index for predicting cardiovascular outcomes after percutaneous coronary intervention in patients with type 2 diabetes mellitus and acute coronary syndrome

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

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