Xue Tian1,2,3,4, Yingting Zuo1,2,3,4, Shuohua Chen5, Qian Liu6, Boni Tao7, Shouling Wu8, Anxin Wang9,10. 1. China National Clinical Research Center for Neurological Diseases, Fengtai District, Beijing Tiantan Hospital, Capital Medical University, No.119 South 4th Ring West Road, Beijing, 100070, China. 2. Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China. 3. Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China. 4. Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China. 5. Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, 57 Xinhua East Rd, Tangshan, 063000, China. 6. Graduate School, North China University of Science and Technology, Tangshan, China. 7. School of Public Health, North China University of Science and Technology, Tangshan, China. 8. Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, 57 Xinhua East Rd, Tangshan, 063000, China. drwusl@163.com. 9. China National Clinical Research Center for Neurological Diseases, Fengtai District, Beijing Tiantan Hospital, Capital Medical University, No.119 South 4th Ring West Road, Beijing, 100070, China. wanganxin@bjtth.org. 10. Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China. wanganxin@bjtth.org.
Abstract
BACKGROUND: The triglyceride-glucose (TyG) index, which is a simple surrogate marker of insulin resistance, has been suggested as a contributor of cardiovascular disease. However, evidence on the effect of long-term elevation of the TyG index exposure on myocardial infarction (MI) is limited. The current study aimed to evaluate the association of baseline and long-term elevation of the TyG index exposure with the risk of MI. METHODS: A total of 98,849 participants without MI at baseline (2006) were enrolled from the Kailuan study. The baseline TyG index was calculated as ln [fasting triglyceride (mg/dL) × fasting glucose (mg/dL)/2]. The long-term TyG index was characterized in two ways as follows. The updated mean TyG index was calculated as the mean of TyG index at all previous visits before MI occurred or the end of follow-up; alternatively, the TyG index was calculated as the number of visits with a high TyG index in 2006, 2008, and 2010, ranging from 0 (no exposure) to 3 (had high TyG index at all three study visits). Hazard ratio (HR) and 95% confidence interval (CI) was estimated using multivariable Cox proportion hazard models. RESULTS: During a median follow-up of 11.03 years, 1555 incident MI occurred. In the multivariable-adjusted model, the risk of MI increased with quartiles of the baseline and updated mean TyG index, the HR in quartile 4 versus quartile 1 was 2.08 (95% CI,1.77-2.45) and 1.58 (1.18-2.12), respectively. Individuals with a high TyG index at all three visits had a 2.04-fold higher risk (95% CI, 1.63-2.56) of MI compared with no exposure. Subgroup analyses showed that the associations were more pronounced in women than in men (Pinteraction = 0.0411). CONCLUSIONS: Elevated levels of the baseline and long-term TyG index are associated with an increased risk of MI. This finding indicates that the TyG index might be useful in identifying people at high risk of developing MI.
BACKGROUND: The triglyceride-glucose (TyG) index, which is a simple surrogate marker of insulin resistance, has been suggested as a contributor of cardiovascular disease. However, evidence on the effect of long-term elevation of the TyG index exposure on myocardial infarction (MI) is limited. The current study aimed to evaluate the association of baseline and long-term elevation of the TyG index exposure with the risk of MI. METHODS: A total of 98,849 participants without MI at baseline (2006) were enrolled from the Kailuan study. The baseline TyG index was calculated as ln [fasting triglyceride (mg/dL) × fasting glucose (mg/dL)/2]. The long-term TyG index was characterized in two ways as follows. The updated mean TyG index was calculated as the mean of TyG index at all previous visits before MI occurred or the end of follow-up; alternatively, the TyG index was calculated as the number of visits with a high TyG index in 2006, 2008, and 2010, ranging from 0 (no exposure) to 3 (had high TyG index at all three study visits). Hazard ratio (HR) and 95% confidence interval (CI) was estimated using multivariable Cox proportion hazard models. RESULTS: During a median follow-up of 11.03 years, 1555 incident MI occurred. In the multivariable-adjusted model, the risk of MI increased with quartiles of the baseline and updated mean TyG index, the HR in quartile 4 versus quartile 1 was 2.08 (95% CI,1.77-2.45) and 1.58 (1.18-2.12), respectively. Individuals with a high TyG index at all three visits had a 2.04-fold higher risk (95% CI, 1.63-2.56) of MI compared with no exposure. Subgroup analyses showed that the associations were more pronounced in women than in men (Pinteraction = 0.0411). CONCLUSIONS: Elevated levels of the baseline and long-term TyG index are associated with an increased risk of MI. This finding indicates that the TyG index might be useful in identifying people at high risk of developing MI.
Authors: Richard J Millstein; Laura L Pyle; Bryan C Bergman; Robert H Eckel; David M Maahs; Marian J Rewers; Irene E Schauer; Janet K Snell-Bergeon Journal: J Diabetes Complications Date: 2018-01-10 Impact factor: 2.852
Authors: Sang Bae Lee; Chul Woo Ahn; Byoung Kwon Lee; Shinae Kang; Ji Sun Nam; Ji Hong You; Min Jin Kim; Min Kyung Kim; Jong Suk Park Journal: Cardiovasc Diabetol Date: 2018-03-21 Impact factor: 9.951