Triglyceride glucose index superior to modified TyG indices for predicting cardiovascular diseases: Study

The researchers found that TyG and TyG-waist-to-height ratio (WHtR) are significantly associated with new-onset CVDs, and the TyG outperformed the modified TyG indices to identify individuals at risk of an incident cardiovascular event.

The findings, published in Cardiovascular Diabetology, support the superiority of the TyG index over the modified TyG indices using obesity-related parameters for risk stratification and predicting future cardiovascular disease (CVD).

Cardiovascular diseases, including heart disease and stroke, are leading causes of mortality worldwide, with risk factors such as obesity, diabetes, and dyslipidemia playing significant roles. Traditional risk assessment tools rely on factors like cholesterol levels and blood pressure measurements. However, emerging evidence suggests that novel biomarkers, such as the TyG index, may offer additional insights into cardiovascular risk.

The triglyceride and glucose (TyG) index, a surrogate marker of insulin resistance, has been validated as a predictor of CVD. However, the effects remain unknown of TyG-related indices combined with obesity markers on CVD. Therefore, Zhonghang Xu, China-Japan Union Hospital of Jilin University, Jilin University, Jilin, China, and colleagues aimed to investigate the associations between the TyG index and modified TyG indices with new-onset cardiovascular disease and the time-dependent predictive capacity using a nationally representative cohort.

For this purpose, the researchers conducted a retrospective observational cohort study using China Health and Retirement Longitudinal Study (CHARLS) data of 7 115 participants. The TyG index was calculated as Ln [fasting triglyceride (mg/dL) × fasting glucose (mg/dL)/2].

The modified TyG indices were developed by combining TyG with waist circumference (WC), body mass index (BMI), and waist-to‐height ratio (WHtR). Adjusted Cox proportional hazards regression was used to analyze the association and predictive capacity based on hazard ratio (HR) and Harrell’s C‐index.

Based on the study, the researchers reported the following findings:

· Over a 7-year follow‐up period, 2136 participants developed cardiovascular disease, including 1633 cases of coronary heart disease and 719 cases of stroke.

· Compared with the lowest tertile group, the adjusted HR for new-onset cardiovascular disease in the highest tertile for TyG, TyG-BMI, TyG-WHtR, and TyG-WC were 1.215, 1.073, 1.112, and 1.078, respectively.

· The C‐indices of the TyG index for cardiovascular disease onset were higher than other modified TyG indices.

· Similar results were observed for coronary heart disease and stroke.

In conclusion, the study highlights the potential of the triglyceride glucose index and its modified versions as valuable tools for predicting cardiovascular disease risk in middle-aged and older Chinese adults. By refining risk assessment strategies, these indices could ultimately contribute to more effective prevention and management of cardiovascular diseases, reducing the burden of these conditions on public health.

Reference:

Cui, C., Qi, Y., Song, J. et al. Comparison of triglyceride glucose index and modified triglyceride glucose indices in prediction of cardiovascular diseases in middle aged and older Chinese adults. Cardiovasc Diabetol 23, 185 (2024). https://doi.org/10.1186/s12933-024-02278-z