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      Use of the triglyceride-glucose index (TyG) in cardiovascular disease patients

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          Abstract

          Da Silva et al. showed that the triglyceride-glucose (TyG) index was positively associated with a higher prevalence of symptomatic coronary artery disease (CAD). TyG has been used in healthy individuals as a marker of insulin resistance. The use of this index as a marker of atherosclerosis in cardiovascular disease (CVD) patients might be influenced by diabetes and the hyperlipidemic state that led to CVD. Certain considerations might be necessary before we conclude that the TyG index can be used as a marker of atherosclerosis in CVD patients. These factors can highlight the role of fasting blood glucose and triglyceride levels that are used in the TyG formula. Comparing the fasting blood glucose and/or triglyceride levels with the TyG index in these patients to show how much value the TyG index can add to clinical practice seems to be necessary. Conclusions of such studies might be biased by these facts. Stratification by CAD disease category cannot help achieve an understanding of the role of TyG in CVD. Correlations do not imply causation, so the use of the TyG index as an index in CAD patients is questionable.

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          High triglyceride–glucose index is associated with poor prognosis in patients with acute ST-elevation myocardial infarction after percutaneous coronary intervention

          Erfei Luo, Dong Wang, Gaoliang Yan … (2019)
          Background Insulin resistance (IR) is considered a pivotal risk factor for cardiometabolic diseases, and the triglyceride–glucose index (TyG index) has emerged as a reliable surrogate marker of IR. Although several recent studies have shown the association of the TyG index with vascular disease, no studies have further investigated the role of the TyG index in acute ST-elevation myocardial infarction (STEMI). The objective of the present study was to evaluate the potential role of the TyG index as a predictor of prognosis in STEMI patients after percutaneous coronary intervention (PCI). Methods The study included 1092 STEMI patients who underwent PCI. The patients were divided into 4 quartiles according to TyG index levels. Clinical characteristics, fasting plasma glucose (FPG), triglycerides (TGs), other biochemical parameters, and the incidence of major adverse cardiovascular and cerebral events (MACCEs) during the follow-up period were recorded. The TyG index was calculated using the following formula: ln[fasting TGs (mg/dL) × FPG (mg/dL)/2]. Results The incidence of MACCEs and all-cause mortality within 30 days, 6 months and 1 year after PCI were higher among STEMI patients with TyG index levels in the highest quartile. The TyG index was significantly associated with an increased risk of MACCEs in STEMI patients within 1 year after PCI, independent of confounding factors, with a value of 1.529 (95% CI 1.001–2.061; P = 0.003) for those in the highest quartile. The area under the curve (AUC) of the TyG index predicting the occurrence of MACCEs in STEMI patients after PCI was 0.685 (95% CI 0.610–0.761; P = 0.001). The results also revealed that Killip class > 1, anaemia, albumin, uric acid, number of stents and left ventricular ejection fraction (LVEF) were independent predictors of MACCEs in STEMI patients after PCI (all P < 0.05). Conclusions This study indicated an association between higher TyG index levels and increased risk of MACCEs in STEMI patients for the first time, and the TyG index might be a valid predictor of clinical outcomes in STEMI patients undergoing PCI. Trial Registration ChiCTR1900024577.
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            Association between macro- and microvascular damage and the triglyceride glucose index in community-dwelling elderly individuals: the Northern Shanghai Study

            Song Zhao, Shikai Yu, Chen Tung Chi … (2019)
            Background It has been reported that the triglyceride-glucose (TyG) index may serve as a simple and credible surrogate marker of insulin resistance (IR). However, its association with macrovascular and microvascular damage is unclear. Accordingly, the objective of the present study is to investigate the association of macrovascular and microvascular damage with the TyG index. Methods A total of 2830 elderly participants from the Northern Shanghai Study (NSS) were enrolled. The TyG index was calculated as ln[fasting triglycerides (mg/dL) × fasting glucose (mg/dL)/2]. Parameters of vascular damage, including carotid-femoral pulse wave velocity (cf-PWV), brachial-ankle pulse wave velocity (ba-PWV), ankle–brachial index (ABI), carotid intima–media thickness (CMT), carotid plaque, estimated glomerular filtration rate (eGFR) and the urine albumin-to-creatinine ratio (UACR), were measured and calculated. Results In univariate logistic regression, an increased TyG index was associated with a higher risk of cf-PWV > 10 m/s, ba-PWV > 1800 cm/s, ABI   10 m/s (OR = 1.86, 95% confidence interval [95% CI] 1.37–2.53, P for trend    1800 cm/s (OR = 1.39, [95% CI] 1.05–1.84, P for trend = 0.02), MAU (OR = 1.61, [95% CI] 1.22–2.13, P for trend  < 0.001) and CKD (OR = 1.67, [95% CI] 1.10–1.50, P for trend = 0.02) after adjustment for age, sex, BMI, waist circumference, smoking habit, hypertension, family history of premature CVD, diabetes, HDL-C, LDL-C, insulin therapy and statin therapy. However, no significant relationship was observed between the TyG index and lower extremity atherosclerosis, carotid hypertrophy or carotid plaque. Conclusion An elevated TyG index was significantly associated with a higher risk of arterial stiffness and nephric microvascular damage. This conclusion lends support to the clinical significance of the TyG index for the assessment of vascular damage. Electronic supplementary material The online version of this article (10.1186/s12933-019-0898-x) contains supplementary material, which is available to authorized users.
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              Triglyceride-glucose index is associated with symptomatic coronary artery disease in patients in secondary care

              Alessandra Peres da Silva, Ana Paula Silva Caldas, Helen Hermsdorff … (2019)
              Background The triglyceride-glucose index (TyG index) is a tool for insulin resistance evaluation, however, little is known about its association with coronary artery disease (CAD), which is the major cardiovascular death cause, and what factors may be associated with TyG index. Objective To evaluate the association between the TyG index and the prevalence of CAD phases, as well as cardiovascular risk factors. Methods The baseline data of patients in secondary care in cardiology from Brazilian Cardioprotective Nutritional Program Trial (BALANCE Program Trial) were analyzed. Anthropometric, clinical, socio-demographic and food consumption data were collected by trained professionals. The TyG index was calculated by the formula: Ln (fasting triglycerides (mg/dl) × fasting blood glucose (mg/dl)/2) and regression models were used to evaluate the associations. Results We evaluated 2330 patients, which the majority was male (58.1%) and elderly (62.1%). The prevalence of symptomatic CAD was 1.16 times higher in patients classified in the last tertile of the TyG index (9.9 ± 0.5) compared to those in the first tertile (8.3 ± 0.3). Cardiometabolic risk factors were associated with TyG index, with the highlight for higher carbohydrate and lower lipid consumption in relation to recommendations that reduced the chance of being in the last TyG index tertile. Conclusion The TyG index was positively associated with a higher prevalence of symptomatic CAD, with metabolic and behavioral risk factors, and could be used as a marker for atherosclerosis. Trial registration ClinicalTrials.gov identifier: NCT01620398. Registered 15 June, 2012 Electronic supplementary material The online version of this article (10.1186/s12933-019-0893-2) contains supplementary material, which is available to authorized users.
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                Author and article information

                Contributors
                Javad Alizargar:
                ORCID: http://orcid.org/0000-0003-2966-1315
                jaz.tmu@gmail.com
                Chyi-Huey Bai: baich@tmu.edu.tw
                Nan-Chen Hsieh: nchsieh@ntunhs.edu.tw
                Shu-Fang Vivienne Wu: shufang@ntunhs.edu.tw
                Journal
                Journal ID (nlm-ta): Cardiovasc Diabetol
                Journal ID (iso-abbrev): Cardiovasc Diabetol
                Title: Cardiovascular Diabetology
                Publisher: BioMed Central (London )
                ISSN (Electronic): 1475-2840
                Publication date (Electronic): 15 January 2020
                Publication date PMC-release: 15 January 2020
                Publication date Collection: 2020
                Volume: 19
                Electronic Location Identifier: 8
                Affiliations
                [1 ]ISNI 0000 0004 0573 0416, GRID grid.412146.4, Research Center for Healthcare Industry Innovation, , National Taipei University of Nursing and Health Sciences, ; Taipei, 112 Taiwan
                [2 ]ISNI 0000 0000 9337 0481, GRID grid.412896.0, School of Public Health, College of Public Health, , Taipei Medical University, ; 250 Wu-Hsing Street, Taipei, 11031 Taiwan
                [3 ]ISNI 0000 0004 0573 0416, GRID grid.412146.4, Department of Information Management, , National Taipei University of Nursing and Health Sciences, ; Taipei, 112 Taiwan
                [4 ]ISNI 0000 0004 0573 0416, GRID grid.412146.4, College of Nursing, School of Nursing, , National Taipei University of Nursing and Health Sciences, ; Taipei, 112 Taiwan
                Author information
                http://orcid.org/0000-0003-2966-1315
                Article
                Publisher ID: 982
                DOI: 10.1186/s12933-019-0982-2
                PMC ID: 6963998
                PubMed ID: 31941513
                SO-VID: 7879d2d8-f26d-4b43-b3d1-e6d63e6d4bb4
                Copyright © © The Author(s) 2020
                License:

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                Date received : 22 November 2019
                Date accepted : 26 December 2019
                Categories
                Subject: Commentary
                Custom metadata
                issue-copyright-statement © The Author(s) 2020

                ScienceOpen disciplines: Endocrinology & Diabetes
                Keywords: cardiovascular diseases,coronary artery disease,risk factors,secondary care,triglyceride-glucose index
                Data availability:
                ScienceOpen disciplines: Endocrinology & Diabetes
                Keywords: cardiovascular diseases, coronary artery disease, risk factors, secondary care, triglyceride-glucose index

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