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Published in: Cardiovascular Diabetology 1/2019

Open Access 01-12-2019 | Care | Original investigation

Triglyceride-glucose index is associated with symptomatic coronary artery disease in patients in secondary care

Authors: Alessandra da Silva, Ana Paula Silva Caldas, Helen Hermana Miranda Hermsdorff, Ângela Cristine Bersch-Ferreira, Camila Ragne Torreglosa, Bernardete Weber, Josefina Bressan

Published in: Cardiovascular Diabetology | Issue 1/2019

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Abstract

Background

The triglyceride-glucose index (TyG index) is a tool for insulin resistance evaluation, however, little is known about its association with coronary artery disease (CAD), which is the major cardiovascular death cause, and what factors may be associated with TyG index.

Objective

To evaluate the association between the TyG index and the prevalence of CAD phases, as well as cardiovascular risk factors.

Methods

The baseline data of patients in secondary care in cardiology from Brazilian Cardioprotective Nutritional Program Trial (BALANCE Program Trial) were analyzed. Anthropometric, clinical, socio-demographic and food consumption data were collected by trained professionals. The TyG index was calculated by the formula: Ln (fasting triglycerides (mg/dl) × fasting blood glucose (mg/dl)/2) and regression models were used to evaluate the associations.

Results

We evaluated 2330 patients, which the majority was male (58.1%) and elderly (62.1%). The prevalence of symptomatic CAD was 1.16 times higher in patients classified in the last tertile of the TyG index (9.9 ± 0.5) compared to those in the first tertile (8.3 ± 0.3). Cardiometabolic risk factors were associated with TyG index, with the highlight for higher carbohydrate and lower lipid consumption in relation to recommendations that reduced the chance of being in the last TyG index tertile.

Conclusion

The TyG index was positively associated with a higher prevalence of symptomatic CAD, with metabolic and behavioral risk factors, and could be used as a marker for atherosclerosis.
Trial registration ClinicalTrials.gov identifier: NCT01620398. Registered 15 June, 2012
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Literature
1.
go back to reference Ribeiro ALP, Duncan BB, Brant LCC, Lotufo PA, Mill JG, Barreto SM. Cardiovascular health in Brazil trends and perspectives. Circulation. 2016;133:422–33.CrossRef Ribeiro ALP, Duncan BB, Brant LCC, Lotufo PA, Mill JG, Barreto SM. Cardiovascular health in Brazil trends and perspectives. Circulation. 2016;133:422–33.CrossRef
2.
go back to reference Schmidt MI, Duncan BB, e Silva GA, Menezes AM, Monteiro CA, Barreto SM, et al. Chronic non-communicable diseases in Brazil: burden and current challenges. Lancet. 2011;377:1949–61.CrossRef Schmidt MI, Duncan BB, e Silva GA, Menezes AM, Monteiro CA, Barreto SM, et al. Chronic non-communicable diseases in Brazil: burden and current challenges. Lancet. 2011;377:1949–61.CrossRef
7.
go back to reference Yahagi K, Kolodgie FD, Lutter C, Mori H, Romero ME, Finn AV, et al. Pathology of human coronary and carotid artery atherosclerosis and vascular calcification in diabetes mellitus. Arterioscler Thromb Vasc Biol. 2016;37:191–204.CrossRef Yahagi K, Kolodgie FD, Lutter C, Mori H, Romero ME, Finn AV, et al. Pathology of human coronary and carotid artery atherosclerosis and vascular calcification in diabetes mellitus. Arterioscler Thromb Vasc Biol. 2016;37:191–204.CrossRef
10.
go back to reference Bornfeldt KE, Tabas I. Insulin resistance, hyperglycemia, and atherosclerosis. Cell Metab. 2011;14:575–85.CrossRef Bornfeldt KE, Tabas I. Insulin resistance, hyperglycemia, and atherosclerosis. Cell Metab. 2011;14:575–85.CrossRef
11.
go back to reference Simental-Mendía LE, Rodríguez-Morán M, Guerrero-Romero F. The product of fasting glucose and triglycerides as surrogate for identifying insulin resistance in apparently healthy subjects. Metab Syndr Relat Disord. 2008;6:299–304.CrossRef Simental-Mendía LE, Rodríguez-Morán M, Guerrero-Romero F. The product of fasting glucose and triglycerides as surrogate for identifying insulin resistance in apparently healthy subjects. Metab Syndr Relat Disord. 2008;6:299–304.CrossRef
12.
go back to reference Jian S, Su-Mei N, Xue C, Jie Z, Xue-sen W. Association and interaction between triglyceride–glucose index and obesity on risk of hypertension in middle-aged and elderly adults. Clin Exp Hypertens. 2017;39:732–9.CrossRef Jian S, Su-Mei N, Xue C, Jie Z, Xue-sen W. Association and interaction between triglyceride–glucose index and obesity on risk of hypertension in middle-aged and elderly adults. Clin Exp Hypertens. 2017;39:732–9.CrossRef
14.
go back to reference Lambrinoudaki I, Kazani MV, Armeni E, Georgiopoulos G, Tampakis K, Rizos D, et al. The TyG index as a marker of subclinical atherosclerosis and arterial stiffness in lean and overweight postmenopausal women. Hear Lung Circ. 2018;27:716–24.CrossRef Lambrinoudaki I, Kazani MV, Armeni E, Georgiopoulos G, Tampakis K, Rizos D, et al. The TyG index as a marker of subclinical atherosclerosis and arterial stiffness in lean and overweight postmenopausal women. Hear Lung Circ. 2018;27:716–24.CrossRef
16.
go back to reference Sánchez-Íñigo L, Navarro-González D, Fernández-Montero A, Pastrana-Delgado J, Martínez JA. The TyG index may predict the development of cardiovascular events. Eur J Clin Invest. 2016;46:189–97.CrossRef Sánchez-Íñigo L, Navarro-González D, Fernández-Montero A, Pastrana-Delgado J, Martínez JA. The TyG index may predict the development of cardiovascular events. Eur J Clin Invest. 2016;46:189–97.CrossRef
19.
go back to reference Irace C, Carallo C, Scavelli FB, De Franceschi MS, Esposito T, Tripolino C, et al. Markers of insulin resistance and carotid atherosclerosis. A comparison of the homeostasis model assessment and triglyceride glucose index. Int J Clin Pract. 2013;67:665–72.CrossRef Irace C, Carallo C, Scavelli FB, De Franceschi MS, Esposito T, Tripolino C, et al. Markers of insulin resistance and carotid atherosclerosis. A comparison of the homeostasis model assessment and triglyceride glucose index. Int J Clin Pract. 2013;67:665–72.CrossRef
21.
go back to reference Weber B, Bersch-Ferreira ÂC, Torreglosa CR, Ross-Fernandes MB, Da Silva JT, Galante AP, et al. The Brazilian Cardioprotective Nutritional Program to reduce events and risk factors in secondary prevention for cardiovascular disease: study protocol (The BALANCE Program Trial). Am Heart J. 2016;171:73–81.e2.CrossRef Weber B, Bersch-Ferreira ÂC, Torreglosa CR, Ross-Fernandes MB, Da Silva JT, Galante AP, et al. The Brazilian Cardioprotective Nutritional Program to reduce events and risk factors in secondary prevention for cardiovascular disease: study protocol (The BALANCE Program Trial). Am Heart J. 2016;171:73–81.e2.CrossRef
22.
go back to reference World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;310:2191–4.CrossRef World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;310:2191–4.CrossRef
25.
28.
go back to reference Won K-B, Kim YS, Lee BK, Heo R, Han D, Lee JH, et al. The relationship of insulin resistance estimated by triglyceride glucose index and coronary plaque characteristics. Medicine. 2018;97:e10726.CrossRef Won K-B, Kim YS, Lee BK, Heo R, Han D, Lee JH, et al. The relationship of insulin resistance estimated by triglyceride glucose index and coronary plaque characteristics. Medicine. 2018;97:e10726.CrossRef
30.
go back to reference Sánchez-Íñigo L, Navarro-González D, Pastrana-Delgado J, Fernández-Montero A, Martínez JA. Association of triglycerides and new lipid markers with the incidence of hypertension in a Spanish cohort. J Hypertens. 2016;34:1257–65.CrossRef Sánchez-Íñigo L, Navarro-González D, Pastrana-Delgado J, Fernández-Montero A, Martínez JA. Association of triglycerides and new lipid markers with the incidence of hypertension in a Spanish cohort. J Hypertens. 2016;34:1257–65.CrossRef
32.
go back to reference Jin J-L, Cao Y-X, Wu L-G, You X-D, Guo Y-L, Wu N-Q, et al. Triglyceride glucose index for predicting cardiovascular outcomes in patients with coronary artery disease. J Thorac Dis. 2018;10:6137–46.CrossRef Jin J-L, Cao Y-X, Wu L-G, You X-D, Guo Y-L, Wu N-Q, et al. Triglyceride glucose index for predicting cardiovascular outcomes in patients with coronary artery disease. J Thorac Dis. 2018;10:6137–46.CrossRef
33.
go back to reference Salazar J, Bermúdez V, Olivar LC, Torres W, Palmar J, Añez R, et al. Insulin resistance indices and coronary risk in adults from Maracaibo city, Venezuela: a cross sectional study. F1000Research. 2018;7:44.CrossRef Salazar J, Bermúdez V, Olivar LC, Torres W, Palmar J, Añez R, et al. Insulin resistance indices and coronary risk in adults from Maracaibo city, Venezuela: a cross sectional study. F1000Research. 2018;7:44.CrossRef
38.
go back to reference Hooper L, Martin N, Abdelhamid A, G DS. Reduction in saturated fat intake for cardiovascular disease (Review). Summary of findings for the main comparison. 2015. Hooper L, Martin N, Abdelhamid A, G DS. Reduction in saturated fat intake for cardiovascular disease (Review). Summary of findings for the main comparison. 2015.
40.
go back to reference Billingsley H, Carbone S, Lavie C. Dietary fats and chronic noncommunicable diseases. Nutrients. 2018;10:1385.CrossRef Billingsley H, Carbone S, Lavie C. Dietary fats and chronic noncommunicable diseases. Nutrients. 2018;10:1385.CrossRef
41.
go back to reference Siri-Tarino PW, Sun Q, Hu FB, Krauss RM. Saturated fat, carbohydrate, and cardiovascular disease. Am J Clin Nutr. 2010;91:502–9.CrossRef Siri-Tarino PW, Sun Q, Hu FB, Krauss RM. Saturated fat, carbohydrate, and cardiovascular disease. Am J Clin Nutr. 2010;91:502–9.CrossRef
42.
go back to reference Dehghan M, Mente A, Zhang X, Swaminathan S, Li W, Mohan V, et al. Associations of fats and carbohydrate intake with cardiovascular disease and mortality in 18 countries from five continents (PURE): a prospective cohort study. Lancet. 2017;390:2050–62.CrossRef Dehghan M, Mente A, Zhang X, Swaminathan S, Li W, Mohan V, et al. Associations of fats and carbohydrate intake with cardiovascular disease and mortality in 18 countries from five continents (PURE): a prospective cohort study. Lancet. 2017;390:2050–62.CrossRef
43.
go back to reference Rippe JM, Angelopoulos TJ. Sugars, obesity, and cardiovascular disease: results from recent randomized control trials. Eur J Nutr. 2016;55:45–53.CrossRef Rippe JM, Angelopoulos TJ. Sugars, obesity, and cardiovascular disease: results from recent randomized control trials. Eur J Nutr. 2016;55:45–53.CrossRef
44.
go back to reference López-Jaramillo P, Otero J, Camacho PA, Baldeón M, Fornasini M. Reevaluating nutrition as a risk factor for cardio-metabolic diseases. Colomb Medica. 2018;49:175–81.CrossRef López-Jaramillo P, Otero J, Camacho PA, Baldeón M, Fornasini M. Reevaluating nutrition as a risk factor for cardio-metabolic diseases. Colomb Medica. 2018;49:175–81.CrossRef
45.
go back to reference Aune D, Keum N, Giovannucci E, Fadnes LT, Boffetta P, Greenwood DC, et al. Whole grain consumption and risk of cardiovascular disease, cancer, and all cause and cause specific mortality: systematic review and dose-response meta-analysis of prospective studies. BMJ. 2016;353:i2716.CrossRef Aune D, Keum N, Giovannucci E, Fadnes LT, Boffetta P, Greenwood DC, et al. Whole grain consumption and risk of cardiovascular disease, cancer, and all cause and cause specific mortality: systematic review and dose-response meta-analysis of prospective studies. BMJ. 2016;353:i2716.CrossRef
46.
go back to reference Kirwan JP, Malin SK, Scelsi AR, Kullman EL, Navaneethan SD, Pagadala MR, et al. A whole-grain diet reduces cardiovascular risk factors in overweight and obese adults: a randomized controlled trial. J Nutr. 2016;146:2244–51.CrossRef Kirwan JP, Malin SK, Scelsi AR, Kullman EL, Navaneethan SD, Pagadala MR, et al. A whole-grain diet reduces cardiovascular risk factors in overweight and obese adults: a randomized controlled trial. J Nutr. 2016;146:2244–51.CrossRef
Metadata
Title
Triglyceride-glucose index is associated with symptomatic coronary artery disease in patients in secondary care
Authors
Alessandra da Silva
Ana Paula Silva Caldas
Helen Hermana Miranda Hermsdorff
Ângela Cristine Bersch-Ferreira
Camila Ragne Torreglosa
Bernardete Weber
Josefina Bressan
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Cardiovascular Diabetology / Issue 1/2019
Electronic ISSN: 1475-2840
DOI
https://doi.org/10.1186/s12933-019-0893-2

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