Triglyceride-glucose index and the incidence of atherosclerotic cardiovascular diseases: a meta-analysis of cohort studies

Cardiovasc Diabetol. 2021 Apr 3;20(1):76. doi: 10.1186/s12933-021-01268-9.

Abstract

Background: Insulin resistance has been demonstrated to be involved in the pathogenesis of atherosclerotic cardiovascular diseases (ASCVDs). This study evaluated the association between the triglyceride-glucose (TyG) index, a novel surrogate indicator of insulin resistance, and the incidence of ASCVDs in people without ASCVDs at baseline by performing a meta-analysis.

Methods: Cohort studies reporting the multivariate-adjusted association between the TyG index and the incidence of ASCVDs were obtained by searching the PubMed and Embase databases. A random-effects model incorporating intra-study heterogeneity was applied to combine the results.

Results: Eight cohort studies comprising 5,731,294 participants were included in this meta-analysis. The results showed that compared to those with the lowest TyG index category, participants with the highest TyG index category were independently associated with a higher risk of ASCVDs [hazard ratio (HR): 1.61, 95% confidence interval (CI) 1.29-2.01, I2 = 80%, P < 0.001]. This finding was consistent with the meta-analysis results with the TyG index analyzed as a continuous variable (HR per 1-unit increment of the TyG index: 1.39, 95% CI 1.18-1.64, I2 = 89%, P < 0.001). Subgroup analyses suggested that the age, sex, and diabetic status did not significantly affect the association (for subgroup analyses, all P > 0.05). Moreover, participants with the highest TyG index category were independently associated with a higher risk of coronary artery disease [(CAD), HR: 1.95, 95% CI 1.47-2.58, I2 = 92%, P < 0.001] and stroke (HR: 1.26, 95% CI 1.23-1.29, I2 = 0%, P < 0.001).

Conclusions: A higher TyG index may be independently associated with a higher incidence of ASCVDs, CAD, and stroke in people without ASCVDs at baseline.

Keywords: Atherosclerotic cardiovascular diseases; Coronary artery disease; Insulin resistance; Meta-analysis; Triglyceride-glucose index.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Aged
  • Atherosclerosis / blood*
  • Atherosclerosis / diagnosis
  • Atherosclerosis / epidemiology*
  • Biomarkers / blood
  • Blood Glucose / metabolism*
  • Coronary Artery Disease / blood
  • Coronary Artery Disease / epidemiology
  • Female
  • Humans
  • Incidence
  • Insulin Resistance*
  • Male
  • Middle Aged
  • Risk Assessment
  • Risk Factors
  • Stroke / blood
  • Stroke / epidemiology
  • Time Factors
  • Triglycerides / blood*

Substances

  • Biomarkers
  • Blood Glucose
  • Triglycerides