TyG index and coronary flow reserve may help assess CV risk in women with gestational diabetes

The findings suggest the potential role of the TyG index and coronary flow reserve in assessing cardiovascular (CV) risk.

Gestational diabetes is a prevalent metabolic disorder, affecting approximately 7% of pregnancies worldwide, making it one of the most prevalent medical conditions during gestation. It is characterized by glucose tolerance during pregnancy. The TyG index, a marker of insulin resistance, and CFR, a measure of coronary microvascular function, are emerging as potential indicators of CV risk. '

Serhan Ozyildirim, Institute of Cardiology, Department of Cardiology, Istanbul University-Cerrahpasa, Istanbul, Turkey, and colleagues aimed to explore the potential association between CFR and the TyG index in patients with gestational diabetes in a cross-sectional study.

The study comprised 87 GDM patients (GDM group) and 36 healthy controls (control group). The participants underwent blood tests, clinical assessments, and echocardiographic evaluations. CFR was measured using Doppler echocardiography during rest and hyperemia induced by dipyridamole. The TyG index was calculated as ln(triglycerides × fasting glucose/2).

The researchers reported the following findings:

• There was no significant difference in age between the two groups (34.1 ± 5.3 years for GDM vs. 33.1 ± 4.9 years for the control).
• The TyG index was significantly higher in the GDM group compared to the controls (4.6 ± 0.1 versus 4.3 ± 0.4).
• CFR was significantly lower in the GDM group compared to the control group ((2.3 ± 0.4 versus 2.8 ± 0.2).
• A negative correlation between the TyG index and CFR was observed (r = -0.624).
• Linear regression revealed the TyG index as an independent predictor of reduced CFR.
• Regression analysis revealed that the TyG index independently predicted diminished CFR values.

"Our comprehensive investigation showed the TyG index as a potentially pivotal and pragmatic marker for evaluating CV risk in the specific cohort of patients diagnosed with GDM," the researchers wrote.

"In essence, our findings beckon us to envision a future where personalized healthcare strategies, informed by the TyG index, offer enhanced and tailored CV risk management for patients navigating the complexities of gestational diabetes," they concluded.

The limitations include the cross-sectional design of the study that precludes the researchers from establishing causality. The researchers suggest exercising caution in generalizing findings due to the single-centre focus and relatively modest sample size of the study.

Reference:

Ozyildirim, S., Barman, H. A., Dogan, O., Ersanli, M. K., & Dogan, S. M. (2023). The Relationship between Coronary Flow Reserve and the TyG Index in Patients with Gestational Diabetes Mellitus. Medicina, 59(10), 1811. https://doi.org/10.3390/medicina59101811