Triglyceride Glucose Index is Independently Associated with Aorta Intima-Media Thickness in Patients without Clinical Manifestations of Cardiovascular Disease Running Head: Triglyceride Glucose Index and Intima-Media Thickness

Abstract

Background and Aims: Subclinical atherosclerosis begins to develop in the thoracic aorta early in life. Insulin resistance is a well-established risk factor for the development of atherosclerosis. The triglyceride-glucose (TyG) index is a reliable marker of insulin resistance regardless of glucose tolerance or obesity. We aimed to investigate the relationship between the TyG index and aortic intima-media thickness (IMT) in patients without diabetes mellitus and cardiovascular disease undergoing transesophageal echocardiography due to suspected structural heart disease.Methods: One hundred twenty-two patients enrolled in the study between January 2021 and June 2021. Triglyceride-glucose index was calculated using fasting laboratory parameters, major cardiovascular risk factors and IMT of the thoracic aorta were recorded. Patients were divided into two groups according to their median IMT; patients with an IMT equal to or less than 1.42 mm were low IMT group, and higher than 1.42 mm were high IMT group.Results: Triglyceride-glucose index were higher in the high IMT group (8.69 ± 0.59 vs. 8.37 ± 0.53, p= 0.003). Triglyceride-glucose index was correlated with IMT (r=0.259, p=0.005) and in binary logistic regression analysis age and TyG was independently associated with having high IMT (β = 0.091, exp(B)=1.095 95%CI = 1.041 – 1.152, p<0.001 and β=1.726, exp(B)= 5.621 95%CI= 1.139- 27.728, p=0.034, respectively)Conclusion: We found an independent relationship between TyG and IMT of the thoracic aorta, an early marker of subclinical atherosclerosis in patients without atherosclerotic cardiovascular disease. Therefore, the TyG index can be used to identify high-risk subjects among healthy subjects.