TyG Index Strongly Predicts Subclinical Myocardial Injury, Especially in Diabetes: Study

A new study published in the journal of Cardiovascular Diabetology showed that for the first time, a U-shaped correlation was found between the incidence of subclinical myocardial damage and the triglyceride–glucose (TyG) index. The relationship between the TyG index and subclinical myocardial damage may be significantly altered by diabetes.

Early cardiac damage that takes place before overt cardiovascular illness manifests clinically is referred to as subclinical myocardial injury. Through metabolic and inflammatory mechanisms, the TyG index, a straightforward surrogate measure of insulin resistance, has been progressively associated with myocardial damage. Diabetes can alter this relationship by increasing oxidative stress, endothelial dysfunction, and lipotoxicity.

Diabetes is characterized by persistent hyperglycemia and dyslipidemia. Early risk assessment and focused cardiovascular preventive techniques can be enhanced by investigating how diabetes modifies the association between the TyG index and subclinical myocardial damage. want to examine the impact of diabetes and the relationship between the TyG index and the occurrence of elevated high-sensitivity cardiac troponin T (hs-cTnT) in people without established CVD.

The Atherosclerosis Risk in Communities (ARIC) cohort was used to enroll people without a history of cardiovascular disease. The formula for calculating the baseline TyG index was ln [fasting triglycerides (mg/dL) × fasting glucose (mg/dL)/2]. Both cross-sectional and prospective cohort designs were used to evaluate the relationship between the baseline TyG index and subclinical myocardial damage [high-sensitivity cardiac troponin T (hs-cTnT≥14 ng/L)].

The cross-sectional study included 11,478 people (mean age, 56.78 years; 42.44% male), whereas the prospective cohort study included 8801 participants (mean age, 56.57 years; 41.36% male). The TyG index and baseline hs-cTnT level were positively correlated in both linear (r = 0.13, p < 0.001) and logistic regression analyses (adjusted odds ratio [aOR] = 1.33, p < 0.001).

This correlation was consistent in diabetic participants (aOR = 1.64, p = 0.020) but not significant in non-diabetic participants (aOR = 0.89, p = 0.374). A U-shaped correlation between the TyG index and the incidence of hs-cTnT elevation was seen among all individuals during a six-year follow-up.

Additional subgroup analyses revealed a J-shaped (aOR = 2.09, p < 0.001) and an L-shaped (aOR = 0.72, p = 0.006) relationship between the TyG index and the occurrence of hs-cTnT increase in individuals with and without diabetes, respectively.

Overall, a U-shaped correlation was found between the TyG index and the frequency of subclinical myocardial damage. Subsequent subgroup analyses revealed a J-shaped and an L-shaped relationship between subclinical myocardial damage and the TyG index in individuals with and without diabetes, respectively.

Source:

Abudukeremu, A., Lv, J., Liu, W., Lu, F., Huang, T., Zhang, J., Liu, Y., Zhang, Y., Liu, X., & Yu, P. (2025). Diabetes modifies the association between the triglyceride-glucose index and subclinical myocardial injury: A prospective cohort study. Cardiovascular Diabetology, 24(1), 443. https://doi.org/10.1186/s12933-025-02979-z