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Published in: Cardiovascular Diabetology 1/2024

Open Access 01-12-2024 | Coronary Heart Disease | Research

Relationship between triglyceride-glucose index baselines and trajectories with incident cardiovascular diseases in the elderly population

Authors: Yue Wang, Xueyu Chen, Jie Shi, Mingyi Du, Shengnan Li, Jinhong Pang, Junpeng Qiao, Yingying Zhao, Qiaoqiao Chen, Yuanyuan Guo, Yan Xi, Weiwei Chi

Published in: Cardiovascular Diabetology | Issue 1/2024

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Abstract

Background

The triglyceride-glucose (TyG) index is regarded as a sophisticated surrogate biomarker for insulin resistance, offering a refined means for evaluating cardiovascular diseases (CVDs). However, prospective cohort studies have not simultaneously conducted baseline and multi-timepoint trajectory assessments of the TyG index in relation to CVDs and their subtypes in elderly participants.

Methods

After excluding data deficiencies and conditions that could influence the research outcomes, this study ultimately incorporated a cohort of 20,185 participants, with data chronicles extending from 2016 to 2022. The TyG index was calculated as Ln [fasting triglyceride (mg/dL) × fasting glucose (mg/dL)/2]. Latent Class Trajectory Model (LCTM) was used to assess the change trends of the TyG index over multiple time points. Utilizing the Cox proportional-hazards models, we assessed the relationship between the baseline quartiles of the TyG index and various trajectories with CVDs and subtypes.

Results

During the mean follow-up time of 4.25 years, 11,099 patients experienced new CVDs in the elderly population. After stratifying by baseline TyG quartiles, the higher TyG level was associated with an increased risk of CVDs; the aHR and 95% CI for the highest quartile group were 1.28 (1.19–1.39). Five trajectory patterns were identified by the LCTM model. The low gradual increase group as the reference, the medium stable group, and the high gradual increase group exhibited an elevated risk of CVDs onset, aHR and 95%CIs were 1.17 (1.10–1.25) and 1.25 (1.15–1.35). Similar results were observed between the trajectories of the TyG index with subtypes of CVDs.

Conclusion

Participants with high levels of baseline TyG index and medium stable or high gradual increase trajectories were associated with an elevated risk of developing CVDs in elderly populations.
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Literature
1.
go back to reference Zhao D, Liu J, Wang M, Zhang X, Zhou M. Epidemiology of cardiovascular disease in China: current features and implications. Nat Rev Cardiol. 2019;16(4):203–12.CrossRefPubMed Zhao D, Liu J, Wang M, Zhang X, Zhou M. Epidemiology of cardiovascular disease in China: current features and implications. Nat Rev Cardiol. 2019;16(4):203–12.CrossRefPubMed
2.
go back to reference Kaminsky LA, German C, Imboden M, Ozemek C, Peterman JE, Brubaker PH. The importance of healthy lifestyle behaviors in the prevention of cardiovascular disease. Prog Cardiovasc Dis. 2022;70:8–15.CrossRefPubMed Kaminsky LA, German C, Imboden M, Ozemek C, Peterman JE, Brubaker PH. The importance of healthy lifestyle behaviors in the prevention of cardiovascular disease. Prog Cardiovasc Dis. 2022;70:8–15.CrossRefPubMed
3.
4.
go back to reference Crupi AN, Haase J, Brandhorst S, Longo VD. Periodic and intermittent fasting in diabetes and cardiovascular disease. Curr Diab Rep. 2020;20(12):83.CrossRefPubMed Crupi AN, Haase J, Brandhorst S, Longo VD. Periodic and intermittent fasting in diabetes and cardiovascular disease. Curr Diab Rep. 2020;20(12):83.CrossRefPubMed
5.
go back to reference US Preventive Services Task Force, Bibbins-Domingo K, Grossman DC, Curry SJ, Davidson KW, Epling JW Jr, Garcia FAR, Gillman MW, Kemper AR, Krist AH, et al. statin use for the primary prevention of cardiovascular disease in adults: US preventive services task force recommendation statement. JAMA. 2016;316(19):1997–2007.CrossRef US Preventive Services Task Force, Bibbins-Domingo K, Grossman DC, Curry SJ, Davidson KW, Epling JW Jr, Garcia FAR, Gillman MW, Kemper AR, Krist AH, et al. statin use for the primary prevention of cardiovascular disease in adults: US preventive services task force recommendation statement. JAMA. 2016;316(19):1997–2007.CrossRef
6.
go back to reference Stewart R. Cardiovascular disease and frailty: what are the mechanistic links? Clin Chem. 2019;65(1):80–6.CrossRefPubMed Stewart R. Cardiovascular disease and frailty: what are the mechanistic links? Clin Chem. 2019;65(1):80–6.CrossRefPubMed
7.
go back to reference Semb AG, Ikdahl E, Wibetoe G, Crowson C, Rollefstad S. Atherosclerotic cardiovascular disease prevention in rheumatoid arthritis. Nat Rev Rheumatol. 2020;16(7):361–79.CrossRefPubMed Semb AG, Ikdahl E, Wibetoe G, Crowson C, Rollefstad S. Atherosclerotic cardiovascular disease prevention in rheumatoid arthritis. Nat Rev Rheumatol. 2020;16(7):361–79.CrossRefPubMed
8.
go back to reference Liu Y, Yu X, Zhang W, Zhang X, Wang M, Ji F. Mechanistic insight into premature atherosclerosis and cardiovascular complications in systemic lupus erythematosus. J Autoimmun. 2022;132: 102863.CrossRefPubMed Liu Y, Yu X, Zhang W, Zhang X, Wang M, Ji F. Mechanistic insight into premature atherosclerosis and cardiovascular complications in systemic lupus erythematosus. J Autoimmun. 2022;132: 102863.CrossRefPubMed
10.
go back to reference D’Agostino RB Sr, Vasan RS, Pencina MJ, Wolf PA, Cobain M, Massaro JM, Kannel WB. General cardiovascular risk profile for use in primary care: the Framingham Heart Study. Circulation. 2008;117(6):743–53.CrossRefPubMed D’Agostino RB Sr, Vasan RS, Pencina MJ, Wolf PA, Cobain M, Massaro JM, Kannel WB. General cardiovascular risk profile for use in primary care: the Framingham Heart Study. Circulation. 2008;117(6):743–53.CrossRefPubMed
11.
go back to reference Muzurovic E, Mikhailidis DP, Mantzoros C. Non-alcoholic fatty liver disease, insulin resistance, metabolic syndrome and their association with vascular risk. Metabolism. 2021;119: 154770.CrossRefPubMed Muzurovic E, Mikhailidis DP, Mantzoros C. Non-alcoholic fatty liver disease, insulin resistance, metabolic syndrome and their association with vascular risk. Metabolism. 2021;119: 154770.CrossRefPubMed
12.
go back to reference Wang T, Li M, Zeng T, Hu R, Xu Y, Xu M, Zhao Z, Chen Y, Wang S, Lin H, et al. Association between insulin resistance and cardiovascular disease risk varies according to glucose tolerance status: a nationwide prospective cohort study. Diabetes Care. 2022;45(8):1863–72.CrossRefPubMedPubMedCentral Wang T, Li M, Zeng T, Hu R, Xu Y, Xu M, Zhao Z, Chen Y, Wang S, Lin H, et al. Association between insulin resistance and cardiovascular disease risk varies according to glucose tolerance status: a nationwide prospective cohort study. Diabetes Care. 2022;45(8):1863–72.CrossRefPubMedPubMedCentral
13.
go back to reference Louie JZ, Shiffman D, McPhaul MJ, Melander O. Insulin resistance probability score and incident cardiovascular disease. J Intern Med. 2023;294(4):531–5.CrossRefPubMed Louie JZ, Shiffman D, McPhaul MJ, Melander O. Insulin resistance probability score and incident cardiovascular disease. J Intern Med. 2023;294(4):531–5.CrossRefPubMed
14.
go back to reference Tao LC, Xu JN, Wang TT, Hua F, Li JJ. Triglyceride-glucose index as a marker in cardiovascular diseases: landscape and limitations. Cardiovasc Diabetol. 2022;21(1):68.CrossRefPubMedPubMedCentral Tao LC, Xu JN, Wang TT, Hua F, Li JJ. Triglyceride-glucose index as a marker in cardiovascular diseases: landscape and limitations. Cardiovasc Diabetol. 2022;21(1):68.CrossRefPubMedPubMedCentral
15.
go back to reference Liu L, Wu Z, Zhuang Y, Zhang Y, Cui H, Lu F, Peng J, Yang J. Association of triglyceride-glucose index and traditional risk factors with cardiovascular disease among non-diabetic population: a 10-year prospective cohort study. Cardiovasc Diabetol. 2022;21(1):256.CrossRefPubMedPubMedCentral Liu L, Wu Z, Zhuang Y, Zhang Y, Cui H, Lu F, Peng J, Yang J. Association of triglyceride-glucose index and traditional risk factors with cardiovascular disease among non-diabetic population: a 10-year prospective cohort study. Cardiovasc Diabetol. 2022;21(1):256.CrossRefPubMedPubMedCentral
16.
go back to reference Alizargar J, Bai CH, Hsieh NC, Wu SV. Use of the triglyceride-glucose index (TyG) in cardiovascular disease patients. Cardiovasc Diabetol. 2020;19(1):8.CrossRefPubMedPubMedCentral Alizargar J, Bai CH, Hsieh NC, Wu SV. Use of the triglyceride-glucose index (TyG) in cardiovascular disease patients. Cardiovasc Diabetol. 2020;19(1):8.CrossRefPubMedPubMedCentral
17.
go back to reference Ding X, Wang X, Wu J, Zhang M, Cui M. Triglyceride-glucose index and the incidence of atherosclerotic cardiovascular diseases: a meta-analysis of cohort studies. Cardiovasc Diabetol. 2021;20(1):76.CrossRefPubMedPubMedCentral Ding X, Wang X, Wu J, Zhang M, Cui M. Triglyceride-glucose index and the incidence of atherosclerotic cardiovascular diseases: a meta-analysis of cohort studies. Cardiovasc Diabetol. 2021;20(1):76.CrossRefPubMedPubMedCentral
18.
go back to reference Huang R, Wang Z, Chen J, Bao X, Xu N, Guo S, Gu R, Wang W, Wei Z, Wang L. Prognostic value of triglyceride glucose (TyG) index in patients with acute decompensated heart failure. Cardiovasc Diabetol. 2022;21(1):88.CrossRefPubMedPubMedCentral Huang R, Wang Z, Chen J, Bao X, Xu N, Guo S, Gu R, Wang W, Wei Z, Wang L. Prognostic value of triglyceride glucose (TyG) index in patients with acute decompensated heart failure. Cardiovasc Diabetol. 2022;21(1):88.CrossRefPubMedPubMedCentral
19.
go back to reference Camara M, Giner RM, Gonzalez-Fandos E, Lopez-Garcia E, Manes J, Portillo MP, Rafecas M, Dominguez L, Martinez JA. Food-based dietary guidelines around the world: a comparative analysis to update AESAN scientific committee dietary recommendations. Nutrients. 2021;13(9):3131.CrossRefPubMedPubMedCentral Camara M, Giner RM, Gonzalez-Fandos E, Lopez-Garcia E, Manes J, Portillo MP, Rafecas M, Dominguez L, Martinez JA. Food-based dietary guidelines around the world: a comparative analysis to update AESAN scientific committee dietary recommendations. Nutrients. 2021;13(9):3131.CrossRefPubMedPubMedCentral
20.
go back to reference Che B, Zhong C, Zhang R, Pu L, Zhao T, Zhang Y, Han L. Triglyceride-glucose index and triglyceride to high-density lipoprotein cholesterol ratio as potential cardiovascular disease risk factors: an analysis of UK biobank data. Cardiovasc Diabetol. 2023;22(1):34.CrossRefPubMedPubMedCentral Che B, Zhong C, Zhang R, Pu L, Zhao T, Zhang Y, Han L. Triglyceride-glucose index and triglyceride to high-density lipoprotein cholesterol ratio as potential cardiovascular disease risk factors: an analysis of UK biobank data. Cardiovasc Diabetol. 2023;22(1):34.CrossRefPubMedPubMedCentral
21.
go back to reference Sanchez-Inigo L, Navarro-Gonzalez D, Fernandez-Montero A, Pastrana-Delgado J, Martinez JA. The TyG index may predict the development of cardiovascular events. Eur J Clin Invest. 2016;46(2):189–97.CrossRefPubMed Sanchez-Inigo L, Navarro-Gonzalez D, Fernandez-Montero A, Pastrana-Delgado J, Martinez JA. The TyG index may predict the development of cardiovascular events. Eur J Clin Invest. 2016;46(2):189–97.CrossRefPubMed
22.
go back to reference Liu X, Tan Z, Huang Y, Zhao H, Liu M, Yu P, Ma J, Zhao Y, Zhu W, Wang J. Relationship between the triglyceride-glucose index and risk of cardiovascular diseases and mortality in the general population: a systematic review and meta-analysis. Cardiovasc Diabetol. 2022;21(1):124.CrossRefPubMedPubMedCentral Liu X, Tan Z, Huang Y, Zhao H, Liu M, Yu P, Ma J, Zhao Y, Zhu W, Wang J. Relationship between the triglyceride-glucose index and risk of cardiovascular diseases and mortality in the general population: a systematic review and meta-analysis. Cardiovasc Diabetol. 2022;21(1):124.CrossRefPubMedPubMedCentral
23.
go back to reference Tian Y, Sun J, Qiu M, Lu Y, Qian X, Sun W, Kong X. Association between the triglyceride-glucose index and albuminuria in hypertensive individuals. Clin Exp Hypertens. 2023;45(1):2150204.CrossRefPubMed Tian Y, Sun J, Qiu M, Lu Y, Qian X, Sun W, Kong X. Association between the triglyceride-glucose index and albuminuria in hypertensive individuals. Clin Exp Hypertens. 2023;45(1):2150204.CrossRefPubMed
24.
go back to reference Wang A, Tian X, Zuo Y, Chen S, Meng X, Wu S, Wang Y. Change in triglyceride-glucose index predicts the risk of cardiovascular disease in the general population: a prospective cohort study. Cardiovasc Diabetol. 2021;20(1):113.CrossRefPubMedPubMedCentral Wang A, Tian X, Zuo Y, Chen S, Meng X, Wu S, Wang Y. Change in triglyceride-glucose index predicts the risk of cardiovascular disease in the general population: a prospective cohort study. Cardiovasc Diabetol. 2021;20(1):113.CrossRefPubMedPubMedCentral
25.
go back to reference Yu H, Tao L, Li YG, Yang L, Liu D, Wang Y, Hao X, He H, Che Y, Wang P, et al. Association between triglyceride-glucose index trajectories and carotid atherosclerosis progression. Cardiovasc Diabetol. 2023;22(1):130.CrossRefPubMedPubMedCentral Yu H, Tao L, Li YG, Yang L, Liu D, Wang Y, Hao X, He H, Che Y, Wang P, et al. Association between triglyceride-glucose index trajectories and carotid atherosclerosis progression. Cardiovasc Diabetol. 2023;22(1):130.CrossRefPubMedPubMedCentral
26.
go back to reference Huang Z, Ding X, Yue Q, Wang X, Chen Z, Cai Z, Li W, Cai Z, Chen G, Lan Y, et al. Triglyceride-glucose index trajectory and stroke incidence in patients with hypertension: a prospective cohort study. Cardiovasc Diabetol. 2022;21(1):141.CrossRefPubMedPubMedCentral Huang Z, Ding X, Yue Q, Wang X, Chen Z, Cai Z, Li W, Cai Z, Chen G, Lan Y, et al. Triglyceride-glucose index trajectory and stroke incidence in patients with hypertension: a prospective cohort study. Cardiovasc Diabetol. 2022;21(1):141.CrossRefPubMedPubMedCentral
27.
go back to reference Cipolletta E, Tata LJ, Nakafero G, Avery AJ, Mamas MA, Abhishek A. Association between gout flare and subsequent cardiovascular events among patients with gout. JAMA. 2022;328(5):440–50.CrossRefPubMedPubMedCentral Cipolletta E, Tata LJ, Nakafero G, Avery AJ, Mamas MA, Abhishek A. Association between gout flare and subsequent cardiovascular events among patients with gout. JAMA. 2022;328(5):440–50.CrossRefPubMedPubMedCentral
28.
go back to reference Kitada M, Ogura Y, Monno I, Koya D. Supplementation with red wine extract increases insulin sensitivity and peripheral blood mononuclear Sirt1 expression in nondiabetic humans. Nutrients. 2020;12(10):3108.CrossRefPubMedPubMedCentral Kitada M, Ogura Y, Monno I, Koya D. Supplementation with red wine extract increases insulin sensitivity and peripheral blood mononuclear Sirt1 expression in nondiabetic humans. Nutrients. 2020;12(10):3108.CrossRefPubMedPubMedCentral
29.
go back to reference Barzilai N, Ferrucci L. Insulin resistance and aging: a cause or a protective response? J Gerontol A Biol Sci Med Sci. 2012;67(12):1329–31.CrossRefPubMed Barzilai N, Ferrucci L. Insulin resistance and aging: a cause or a protective response? J Gerontol A Biol Sci Med Sci. 2012;67(12):1329–31.CrossRefPubMed
30.
go back to reference Girousse A, Tavernier G, Valle C, Moro C, Mejhert N, Dinel AL, Houssier M, Roussel B, Besse-Patin A, Combes M, et al. Partial inhibition of adipose tissue lipolysis improves glucose metabolism and insulin sensitivity without alteration of fat mass. PLoS Biol. 2013;11(2): e1001485.CrossRefPubMedPubMedCentral Girousse A, Tavernier G, Valle C, Moro C, Mejhert N, Dinel AL, Houssier M, Roussel B, Besse-Patin A, Combes M, et al. Partial inhibition of adipose tissue lipolysis improves glucose metabolism and insulin sensitivity without alteration of fat mass. PLoS Biol. 2013;11(2): e1001485.CrossRefPubMedPubMedCentral
31.
go back to reference Hill MA, Yang Y, Zhang L, Sun Z, Jia G, Parrish AR, Sowers JR. Insulin resistance, cardiovascular stiffening and cardiovascular disease. Metabolism. 2021;119: 154766.CrossRefPubMed Hill MA, Yang Y, Zhang L, Sun Z, Jia G, Parrish AR, Sowers JR. Insulin resistance, cardiovascular stiffening and cardiovascular disease. Metabolism. 2021;119: 154766.CrossRefPubMed
32.
go back to reference Laakso M, Kuusisto J. Insulin resistance and hyperglycaemia in cardiovascular disease development. Nat Rev Endocrinol. 2014;10(5):293–302.CrossRefPubMed Laakso M, Kuusisto J. Insulin resistance and hyperglycaemia in cardiovascular disease development. Nat Rev Endocrinol. 2014;10(5):293–302.CrossRefPubMed
33.
go back to reference Ormazabal V, Nair S, Elfeky O, Aguayo C, Salomon C, Zuniga FA. Association between insulin resistance and the development of cardiovascular disease. Cardiovasc Diabetol. 2018;17(1):122.CrossRefPubMedPubMedCentral Ormazabal V, Nair S, Elfeky O, Aguayo C, Salomon C, Zuniga FA. Association between insulin resistance and the development of cardiovascular disease. Cardiovasc Diabetol. 2018;17(1):122.CrossRefPubMedPubMedCentral
35.
go back to reference You M, Liu Y, Wang B, Li L, Zhang H, He H, Zhou Q, Cao T, Wang L, Zhao Z, et al. Asprosin induces vascular endothelial-to-mesenchymal transition in diabetic lower extremity peripheral artery disease. Cardiovasc Diabetol. 2022;21(1):25.CrossRefPubMedPubMedCentral You M, Liu Y, Wang B, Li L, Zhang H, He H, Zhou Q, Cao T, Wang L, Zhao Z, et al. Asprosin induces vascular endothelial-to-mesenchymal transition in diabetic lower extremity peripheral artery disease. Cardiovasc Diabetol. 2022;21(1):25.CrossRefPubMedPubMedCentral
Metadata
Title
Relationship between triglyceride-glucose index baselines and trajectories with incident cardiovascular diseases in the elderly population
Authors
Yue Wang
Xueyu Chen
Jie Shi
Mingyi Du
Shengnan Li
Jinhong Pang
Junpeng Qiao
Yingying Zhao
Qiaoqiao Chen
Yuanyuan Guo
Yan Xi
Weiwei Chi
Publication date
01-12-2024
Publisher
BioMed Central
Published in
Cardiovascular Diabetology / Issue 1/2024
Electronic ISSN: 1475-2840
DOI
https://doi.org/10.1186/s12933-023-02100-2

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