TyG index marker for predicting atherosclerosis in symptomatic CAD patients

The researchers stated that the TyG index is of higher value for identifying both carotid and coronary atherosclerotic plaques than the fasting blood glucose (FBG) or triglyceride (TG) level alone.

Hyperlipidaemia and diabetes are both risk factors for coronary artery disease (CAD), and both are associated with a high triglyceride-glucose index. The TyG index is a marker of insulin resistance (IR) and its utility in detecting and predicting cardiovascular disease has been reported. However, few studies have shown it to be a helpful marker of atherosclerosis in patients with symptomatic CAD.

Xin Qi, Nankai University Affiliated Hospital, Tianjin, China, and colleagues aimed to demonstrate that the TyG index can serve as a valuable marker for predicting carotid and coronary atherosclerosis in CAD patients, irrespective of hyperlipidemia and diabetes.

1516 patients with symptomatic CAD were included who underwent both coronary artery angiography and carotid Doppler ultrasound in the Department of Cardiology at Tianjin Union Medical Center from 2016 to 2022. The Ln formula was used to determine the TyG index.

Patients were grouped and analyzed according to the absence or presence of hyperlipidemia and diabetes. Calculation and measurement were done of carotid intima-media thickness and the Gensini score. The patients were divided into four groups according to the TyG index quartile to investigate the relationship between the TyG index and carotid or coronary artery lesions in symptomatic CAD patients.

The study revealed the following findings:

· The TyG index showed a significant positive correlation with both coronary lesions and carotid plaques in symptomatic CAD patients.

· After adjusting for age, sex, BMI, smoking, hypertension, diabetes, and the use of antidiabetic and antilipemic agents, the risk of developing coronary lesions and carotid plaques increased across the baseline TyG index.

· The highest quartile (quartile 4) was associated with a greater incidence of coronary heart disease [OR = 2.55] and carotid atherosclerotic plaque [OR = 2.31] compared with the lowest quartile of the TyG index.

· When compared to the fasting blood glucose or triglyceride level, the TyG index had a greater area under the ROC curve for predicting coronary lesions and carotid plaques.

· The subgroup analysis demonstrated the TyG index to be an equally effective predictor of coronary and carotid artery disease, regardless of diabetes and hyperlipidemia.

"There was a positive relation between the TyG index and atherosclerosis regardless of conventional influencing factors," the researchers wrote.

According to the study results, the TyG index could serve as a good marker for coronary and carotid lesion prediction in symptomatic CAD patients, regardless of hyperlipidemia and diabetes.

"There is a need for more large-scale prospective investigations to clarify the mechanisms underlying this association," the team concluded.

Reference:

Li, J., Dong, Z., Wu, H. et al. The triglyceride-glucose index is associated with atherosclerosis in patients with symptomatic coronary artery disease, regardless of diabetes mellitus and hyperlipidaemia. Cardiovasc Diabetol 22, 224 (2023). https://doi.org/10.1186/s12933-023-01919-z