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Background and aims: The aim of this study was to evaluate the glycemic parameters, lipid profiles, uric acid levels, and triglyceride-glucose (TyG) index of individuals who consume different amounts of fructose. Additionally, the relationship between the TyG index and the homeostatic model assessment for insulin resistance (HOMA-IR) values was investigated. Methods: This cross-sectional study was conducted on healthy adults aged between 18 and 55 who applied to a university hospital in Istanbul, Turkey. Demographic characteristics and food consumption were recorded using the face-to-face interview method. Participants were divided into two groups according to their fructose consumption (≤50 g/day: moderate; >50 g/day: high). The glycemic parameters, lipid profiles, and uric acid levels were measured and TyG index was calculated. Results: Fructose consumption of >50 g/day was reported by 25% of the participants. There was no relationship between lipid profile, uric acid, and fructose consumption. The fasting blood glucose (FBG), fasting insulin, HOMA-IR, and TyG index values in the moderate fructose consumption group were significantly lower than those for the high fructose consumption group (P < 0.05). The TyG index was associated with fructose consumption and HOMA-IR (P < 0.05). High fructose consumers exhibited FBG and HOMA-IR levels 1.18 (95% confidence interval [95% CI] = 1.01–1.37) and 1.42 (95% CI = 1.09–1.84) times higher than those for the moderate fructose consumers (P < 0.05). Conclusions: The results of this study confirmed that high fructose consumption negatively affects glycemic status in healthy adults. Additionally, this study revealed that there is a significant association between daily fructose consumption and TyG index.

Dong-Hyuk Jung, Byoungjin Park, Yong-Jae Lee Department of Family Medicine, Yonsei University College of Medicine, Seoul, 03722, Republic of KoreaCorrespondence: Yong-Jae Lee,Department of Family Medicine, Yonsei University College of Medicine, Gangnam Severance Hospital, 211 Eonju-ro, Gangnam-gu, Seoul, 06273, Republic of Korea,Tel +82-2-2019-2630,Fax +82-2-3463-3882,Email ukyjhome@yuhs.acDong-Hyuk Jung,Department of Family Medicine, Yonsei University College of Medicine, Yongin Severance Hospital, 363 Dongbaekjukjeondae-ro, Giheung-gu, Yongin-si, Gyeonggi-do, 16995, Republic of Korea,Tel +82-31-5189-8762,Fax +82-31-5189-8809,Email balsan2@yuhs.acPurpose: The triglyceride-glucose (TyG) index, a widely accessible measure, has been a surrogate indicator of peripheral insulin resistance, and its clinical importance continues to grow in East Asia. We hypothesized that the TyG index is relevant to subclinical white matter hypersensitivities (WMHs) of presumed vascular origin among community-dwelling Koreans.Methods: We investigated the relationship between the TyG index and WMHs on brain magnetic resonance imaging scans in 2417 Koreans over 45 years of age without a history of cancer, stroke, or ischemic heart disease. The study population was divided into four groups according to the TyG index quartiles. Using multiple logistic regression analysis, we assessed the odds ratios (ORs) and 95% confidence intervals (95% CIs) for WMHs across the TyG index quartiles.Results: The prevalence of WMHs was significantly higher in the fourth TyG index quartile, with an overall rate of 9.3%. After adjusting for potential confounding variables, the ORs of WMHs for the TyG index quartiles were 1.00, 1.47 (95% CI, 0.91– 2.40), 1.76 (95% CI, 1.05– 2.97), and 6.79 (95% CI, 3.85– 1.54), respectively.Conclusion: We found that higher TyG index values were associated with the brain’s WMHs of presumed vascular origin. Our findings suggest that the serum TyG index could be an additional valuable biomarker for assessing the risk of cerebral small vessel disease in the preclinical stage.Keywords: triglyceride-glucose index, white matter hypersensitivities, endothelial dysfunction, insulin resistance, cerebral small vessel disease

The triglyceride glucose (TyG) index was regarded as a simple surrogate marker of insulin resistance (IR). It is confirmed that IR was significantly associated with hyperuricemia, and obesity was the risk factor for IR and hyperuricemia. However, the relationship between the TyG index and hyperuricemia and the potential role of obesity in Han Chinese hypertension are not entirely elucidated. A community‐based cross‐sectional study was conducted in 4551 hypertension patients aged 40–75 years with clinical and biochemical data. The TyG index was calculated as ln [fasting triglyceride (mg/dl) × fasting plasma glucose (mg/dl)/2]. Hyperuricemia was determined as serum uric acid ≥357μmol/L (6 mg/dl) for females and ≥417μmol/L (7 mg/dl) for males. Our study suggested that the TyG index was higher in patients with hyperuricemia than in those without (8.99±0.61, 8.70±0.59, p

Aim: The triglyceride-glucose index (TyG index) is proposed as a surrogate parameter for insulin resistance (IR) and, when elevated, is related to increased cardiovascular risks. Whether the TyG index is of great value in predicting adverse prognosis for individuals diagnosed with non-ST-segment elevation acute coronary syndrome (NSTE-ACS), who received elective percutaneous coronary intervention (PCI), and without recognized diabetes remains unclear. Methods: Overall, 1,510 subjects diagnosed with NSTE-ACS, who received elective PCI, and without recognized diabetes were enrolled in the current study. All participants received a routine follow-up after discharge. The TyG index was obtained from the following equation: napierian logarithmic (ln) [fasting triglyceride (TG, mg/dL)×fasting blood glucose (FBG, mg/dL)/2]. Adverse cardiovascular events included all-cause death, nonfatal myocardial infarction (MI), nonfatal ischemic stroke, and ischemia-driven revascularization, composite of which was defined as the primary endpoint. Results: Overall, 316 (20.9%) endpoint events were documented during a 48-month follow-up. Despite adjusting for confounding variates, the TyG index remains to be a significant risk predictor for the primary endpoint, with a hazard ratio (HR) [95% confidence interval (CI)] of 2.433 (1.853-3.196) ( P ＜0.001). A significant enhancement on the predictive performance for the primary endpoint emerged when adding the TyG index into a baseline model [area under the receiver-operating characteristic (ROC) curve (AUC), 0.835 for baseline model vs. 0.853 for baseline model＋TyG index, P ＜0.001; net reclassification improvement (NRI), 0.194, P ＜0.001; integrated discrimination improvement (IDI), 0.023, P =0.007]. Conclusions: The TyG index is an independent risk predictor for adverse cardiovascular events in nondiabetic subjects diagnosed with NSTE-ACS and who received elective PCI. Further prospective studies are needed to verify these findings.

Hua Jiang,1,2 Lili Li,3 Jing Liu,1 Bin Xu,1 Shuqiu Chen,1 Weidong Zhu,1 Ming Chen1 1Department of Urology, Affiliated Zhongda Hospital of Southeast University, Nanjing, 210009, People’s Republic of China; 2Department of Medical College, Southeast University, Nanjing, 210009, People’s Republic of China; 3Department of Periodontology, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, 210009, People’s Republic of ChinaCorrespondence: Ming Chen; Shuqiu ChenDepartment of Urology, Affiliated Zhongda Hospital of Southeast University, No. 87 Dingjiaqiao, Hunan Road, Gulou District, Nanjing, 210009, People’s Republic of ChinaTel/Fax +86-13913009977; Tel/Fax +86-15951815171Email mingchenseu@126.com; chenshuqiuseu@163.comBackground: Triglyceride–glucose (TyG) index has been considered as the reliable marker of insulin resistance (IR), which is one risk factor of kidney stone. This study aimed to evaluate the TyG index in the occurrence of kidney stones among the United States (US) population.Methods: Participants who received assessment were retrieved from the National Health and Nutrition Examination Survey (NHANES) between 2007 and 2018. The logistic regression analysis was conducted to assess the relationship between the TyG index and kidney stones occurrence. A 1:1 matched-pair analysis was established to optimize the bias in kidney stones by propensity score matching (PSM). The dose–response curve was performed to verify the association between the TyG index and risk of kidney stones.Results: Of the 14,158 eligible enrolled participants, 1346 (9.5%) self-reported a history of kidney stones. All participants were divided into two groups (high TyG index group and low TyG index group) based on the median TyG index. The dose–response curve exhibited a positive non-linear correlation between the TyG index and kidney stones risk. High TyG index was related to increased kidney stones occurrence in participants, with adjusted odds ratios (AOR) of 1.14 (95% confidence intervals (CI): 1.01– 1.30, P = 0.038) compared with the low TyG index subgroup before PSM. After PSM, the risk of kidney stones was 19% higher in the high TyG group compared with the low TyG group (AOR = 1.19, 95% CI: 1.02– 1.38, P = 0.026), and the dose–response curve still showed a positive association between TyG index and kidney stone risk.Conclusion: The TyG index was independently associated with kidney stones and would be a novel biomarker in predicting occurrence for clinical decision.Keywords: kidney stone, triglyceride–glucose index, insulin resistance, cross-sectional, National Health and Nutrition Examination Survey

Liangjing Lv,1,&ast; Yangmei Zhou,1,&ast; Xiangjun Chen,1 Lilin Gong,1 Jinshan Wu,1 Wenjin Luo,1 Yan Shen,1 Shichao Han,2 Jinbo Hu,1 Yue Wang,1 Qifu Li,1 Zhihong Wang1 On behalf of the Chongqing Diabetes Registry Group1Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China; 2Department of Statistics, University of California, Berkeley, CA, USA&ast;These authors contributed equally to this workCorrespondence: Zhihong WangDepartment of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Yuzhong District, Chongqing, People’s Republic of ChinaTel/Fax +86-023-89011552Email towzh713@126.comBackground: Diabetic kidney disease (DKD) lacks a simple and relatively accurate predictor. The Triglyceride–Glucose (TyG) Index is a proxy of insulin resistance, but the association between the TyG Index and DKD is less certain. We investigated if the TyG Index can predict DKD onset effectively.Materials and Methods: Cross-sectional and longitudinal analyses were undertaken. In total, 1432 type-2 diabetes mellitus (T2DM) patients were included in the cross-sectional analysis. The TyG Index (calculated by ln [fasting triglycerides (mg/dL) × fasting glucose (mg/dL)/2]) was split into three tertiles. Associations of the TyG Index with microalbuminuria and estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2 were calculated. Longitudinally, 424 patients without DKD at baseline were followed up for 21 (range, 12– 24) months. The main outcome was DKD prevalence as defined with eGFR < 60 mL/min/1.73 m2 or continuously increased urinary microalbuminuria: creatinine ratio (> 30 mg/mL) over 3 months. Cox regression was used to analyze the association between the TyG Index at baseline and DKD. Receiver operating characteristics curve (ROC) analysis was used to assess the sensitivity and specificity of the TyG Index in predicting DKD.Results: In cross-sectional analysis, patients with a higher TyG Index had a higher risk of microalbuminuria (OR = 2.342, 95% CI = 1.744– 3.144, p < 0.001), and eGFR < 60 mL/min/1.73 m2 (1.696, 95% CI =1.096– 2.625, p = 0.018). Longitudinally, 94 of 424 participants developed DKD. After confounder adjustment, patients in the high tertile of the TyG Index at baseline had a greater risk to developing DKD than those in the low tertile (HR = 1.727, 95% CI = 1.042– 2.863, p = 0.034). The area under the ROC curve was 0.69 (0.63– 0.76).Conclusion: The TyG Index is a potential predictor for DKD in T2DM patients.Clinical Trial: Clinical Trials identification number = NCT03692884.Keywords: diabetic kidney disease, triglyceride–glucose index, insulin resistance

Jing Liu,1– 3 Liying Guan,4 Meng Zhao,1,2,5 Qihang Li,2,3,5 An Song,6 Ling Gao,2,7,8 Haiyan Lin,4 Jiajun Zhao1,2,5,7 1Department of Endocrinology, Shandong Provincial Hospital, Affiliated to Shandong First Medical University, Jinan, Shandong, 250021, People’s Republic of China; 2Shandong Clinical Medical Center of Endocrinology and Metabolism, Affiliated to Shandong Provincial Hospital, Jinan, Shandong, 250021, People’s Republic of China; 3Shandong Institute of Endocrine and Metabolic Disease, Affiliated to Shandong Provincial Hospital, Jinan, Shandong, 250021, People’s Republic of China; 4Health Management Center, Shandong Provincial Hospital, Affiliated to Shandong First Medical University, Jinan, Shandong, People’s Republic of China; 5Department of Endocrinology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250021, People’s Republic of China; 6Peking Union Medical College Hospital, Affiliated to Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730, People’s Republic of China; 7Shandong Provincial Key Laboratory of Endocrinology and Lipid Metabolism, Affiliated to Shandong Provincial Hospital, Jinan, Shandong, 250021, People’s Republic of China; 8Department of Scientific Center, Shandong Provincial Hospital, Affiliated to Shandong First Medical University, Jinan, Shandong, 250021, People’s Republic of ChinaCorrespondence: Haiyan LinHealth Management Center, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 324 Jing 5 Road, Jinan, Shandong, 250021, People’s Republic of ChinaTel +86-531-68776123 (Clin.)Fax +86-531-87068707Email zxhlhy@126.comJiajun ZhaoDepartment of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 324 Jing 5 Road, Jinan, Shandong, 250021, People’s Republic of ChinaTel +86-531-68776375 (Clin.); +86-531-68776094 (Lab.)Fax +86-531-87068707Email jjzhao@sdu.edu.cnBackground: Nonalcoholic fatty liver disease (NAFLD) is increasingly becoming a major health burden. Due to the difficulty of liver biopsy, there is no reliable indicator to evaluate the outcomes of NAFLD. The triglyceride–glucose (TyG) index is a simple and convenient marker of insulin resistance for use in medical practice. Whether the TyG index is predictive of later risk of NAFLD remains unknown.Objective: To evaluate the relationship between TyG index with NAFLD progression and improvement during a median follow-up period of 21 months.Material and Methods: A total of 11,424 subjects (9327 men) diagnosed with NAFLD were included. The TyG index was calculated as follows: ln [fasting triglycerides (mg/dL) * fasting glucose (mg/dL)/2]. Multivariable Cox regression analysis was applied to analyze the data.Results: In this study, the severity of NAFLD remained the same in 38.8% of subjects, worsened in 17.4% of subjects, and improved in 43.8% of subjects. Compared with the lowest quartile of the TyG index, the adjusted HR of NAFLD progression in the highest quartile (TyG≥ 9.34) was 1.448 (1.229 to 1.706), and the adjusted HR of NAFLD improvement was 0.817 (0.723 to 0.923). Subgroup analysis found that smoking increased the correlation between the TyG index and the risk of NAFLD progression, while female, vegan diet, and weight control enhanced the correlation between the TyG index and the risk of NAFLD improvement.Conclusion: The TyG index may be a simple and helpful indicator for further risk appraisal of NAFLD in daily clinical practice.Keywords: triglyceride–glucose index, nonalcoholic fatty liver disease, outcomes

Background: The triglyceride-glucose (TyG) index is a novel biomarker of insulin resistance which might plausibly influence endogenous fibrinolysis and thus early neurological outcomes in patients with acute ischemic stroke (AIS) treated with intravenous thrombolysis using recombinant tissue-plasminogen activator. Methods: We included consecutive AIS patients within 4.5 h of symptom onset undergoing intravenous thrombolysis between January 2015 and June 2022 in this multi-center retrospective observational study. Our primary outcome was early neurological deterioration (END), defined as ≥2 (END2) or ≥ 4 (END4) National Institutes of Health Stroke Scale (NIHSS) score worsening compared to the initial NIHSS score within 24 h of intravenous thrombolysis. Our secondary outcome was early neurological improvement (ENI), defined as a lower NIHSS score at discharge. TyG index was calculated using the log scale of fasting triglyceride (mg/dL) × fasting glucose (mg/dL)/2. We evaluated the association of END and ENI with TyG index using a logistic regression model. Results: A total of 676 patients with AIS were evaluated. The median age was 68 (Interquartile range, IQR (60–76) years old), and 432 (63.9%) were males. A total of 89 (13.2%) patients developed END2, 61 (9.0%) patients developed END4, and 492 (72.7%) experienced ENI. In multivariable logistic regression analysis, after adjustment for confounding factors, TyG index was significantly associated with increased risks of END2 (categorical variable, vs. lowest tertile, medium tertile odds ratio [OR] 1.05, 95% confidence interval, CI 0.54–2.02, highest tertile OR 2.94, 95%CI 1.64–5.27, overall p < 0.001) and END4 (categorical variable, vs. lowest tertile, medium tertile OR 1.21, 95%CI 0.54–2.74, highest tertile OR 3.80, 95%CI 1.85–7.79, overall p < 0.001), and a lower probability of ENI (categorical variable, vs. lowest tertile, medium tertile OR 1.00, 95%CI 0.63–1.58, highest tertile OR 0.59, 95%CI 0.38–0.93, overall p = 0.022). Conclusions: Increasing TyG index was associated with a higher risk of END and a lower probability of ENI in patients with acute ischemic stroke treated with intravenous thrombolysis.

Background: The triglyceride-glucose (TyG) index has been reported to be a simple and reliable surrogate marker of insulin resistance. The aim of this study was to investigate associations between the TyG index and echocardiographic parameters including left ventricular mass (LVM), left atrial diameter (LAD) and left ventricular ejection fraction (LVEF), and markers of peripheral artery disease, ankle-brachial index (ABI) and brachial-ankle pulse wave velocity (baPWV). Methods: A total of 823 (483 males and 340 females) patients were enrolled from 2007 to 2011 at a regional hospital in southern Taiwan. Multivariable stepwise linear regression analysis was performed to identify the factors related to echocardiographic parameters and peripheral artery disease. Results: The patients were stratified into four groups according to TyG index quartile. Multivariable stepwise linear regression analysis showed that a higher TyG index was associated with elevated observed/predicted LVM (p = 0.081), increased LAD (p = 0.004), decreased LVEF (p = 0.003) and lower ABI (p = 0.030), but not observed/predicted LVM and baPWV. Conclusions: A high TyG index was significantly associated with high LAD, low LVEF and low ABI. However, the TyG index was not significantly associated with inappropriate LVM or baPWV. The results suggest that the TyG index, as a simple indicator of insulin resistance, may reflect cardiac remodeling and dysfunction and atherosclerosis.

Background A single measurement of the triglyceride-glucose (TyG) index, a simple and reliable surrogate marker of insulin resistance, is associated with ischemic stroke. However, evidence for an effect of a long-term elevation in TyG index on ischemic stroke is limited. Therefore, we evaluated the relationship between cumulative TyG index exposure and the risk of ischemic stroke. Methods A total of 54,098 participants in the Kailuan study who had not experienced ischemic stroke underwent three measurements of fasting blood glucose and triglycerides during 2006–2007, 2008–2009, and 2010–2011. Cumulative exposure to TyG index was calculated as the weighted sum of the mean TyG index value for each time interval (value × time). Participants were placed into four groups according to the quartile of the weighted mean: Q1 group, Results There were 2083 incident ischemic stroke events over the 9 years of follow-up. The risk of ischemic stroke increased with the quartile of cumulative TyG index. After adjustment for multiple potential confounders, participants in groups Q4, Q3, and Q2 had significantly higher risks of ischemic stroke, with HRs (95% CIs) of 1.30 (1.12–1.52), 1.26 (1.09–1.45), and 1.09 (0.94–1.27), respectively (Ptrend Conclusions High cumulative TyG index is associated with a higher risk of ischemic stroke. This finding implies that monitoring and the maintenance of an appropriate TyG index may be useful for the prevention of ischemic stroke.

Insulin resistance (IR) is a major contributor to the pathogenesis of nonalcoholic fatty liver disease (NAFLD). The triglyceride-glucose (TyG) index has recently gained popularity for the assessment of IR and NAFLD due to its ease of acquisition and calculation. Therefore, we conducted this systematic review and meta-analysis to summarize the existing studies in the literature and provide a quantitative assessment of the significance of the TyG index in predicting the incidence of NAFLD. A comprehensive literature search in PubMed, EMBASE, and Web of Science databases from inception until 25 March 2022 was conducted. Published observational studies that evaluated the association between TyG index and NAFLD among the adult population and reported the hazard ratio (HR) or odds ratio (OR) for this association after multivariate analysis were included. The random-effects model was used as the primary statistical analysis model in the estimation of pooled ORs and HRs with the corresponding confidence intervals (CIs). A total of 17 observational studies, including 121,975 participants, were included. For studies analyzing the TyG index as a categorical variable, both pooled OR (6.00, CI 4.12–8.74) and HR (1.70, CI 1.28–2.27) were significant for the association between TyG index and incident NAFLD. For studies analyzing the TyG index as a continuous variable, pooled OR (2.25, CI 1.66–3.04) showed similar results. Consistent results were obtained in subgroup analyses according to the study design, sample size, ethnicity, and diabetic status. In conclusion, our meta-analysis demonstrates that a higher TyG index is associated with higher odds of NAFLD. TyG index may serve as an independent predictive tool to screen patients at high risk of NAFLD in clinical practice, especially in primary care settings. Patients with a high TyG index should be referred for a liver ultrasound and start intense lifestyle modifications. However, further large-scale prospective cohort studies are necessary to validate our findings.

Purpose: Pseudoexfoliation (PEX) syndrome is an age-related disease characterized by the accumulation of extracellular material in many ocular structures, skin and internal organs. Recent studies have shown that the Triglyceride-Glucose (TyG) index has clinical importance for the evaluation of vascular damage. The purpose of this study was to determine the relationship between PEX syndrome and TyG index, and to detect the risk in terms of vascular diseases. Methods: In the present study, 50 patients with PEX syndrome who were admitted to the ophthalmology outpatient clinic were evaluated along with 50 others who made up the control group. The Triglyceride-Glucose index was calculated with fasting plasma glucose and triglyceride values. Results: The mean age was 68.2 ± 1.2 years and 61.0% of the patients were male. There was no statistically significant difference between the two groups in terms of blood sugar and lipid profile (except triglyceride) (p > 0.05). The TyG index value was 8.9 ± 0.5 in the PEX group and 8.6 ± 0.6 in the control group. This difference was statistically significant (p = 0.003). In univariate regression analysis, TyG index (OR = 2.81; CI: 1.37–5.75; p = 0.005) was found to be correlated with PEX. In multivariate logistic regression analysis, this correlation remained statistically significant when adjusted for age and sex (OR = 2.89; CI: 1.35–6.18; p = 0.006). Conclusion: Results showed that the TyG index was high in patients diagnosed with PEX. The risk of vascular diseases can be determined by examining the TyG index in patients with PEX, and this predetermination would have significant consequences for public health. © 2022, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

BackgroundTo investigate the association between insulin resistance (IR), quantified by triglyceride glycemic index (TyG index), cardiovascular mortality (CVM), and all-cause mortality (ACM) in hypertension patients.MethodsWe included 8,554 patients with hypertension aged ≥18 years old from the 1999–2014 National Health and Nutrition Examination Surveys (NHANES). The status of CVM and ACM of participants were followed through December 31, 2015. Cox proportional hazards models and Kaplan-Meier survival curves were used to evaluate the relationship between TyG index, CVM, and ACM.ResultsDuring a median of 82 months follow-up, 1,882 mortality cases had occurred, 434 of which were due to cardiovascular disease. The patients with hypertension with TyG ≥ 10 were older, had a higher chance of being smokers, were obese, had higher blood pressure, and had risk or had cardiovascular disease. In Cox proportional hazards models, compared with the patients with TyG P < 0.05).ConclusionsWe demonstrated that the association between ACM and TyG index in elderly patients with hypertension aged ≥60 years was non-linear. However, TyG index was only more than 9.52, hence, the risk for CVM would increase among the whole hypertension group.

Background: Vitamin D deficiency (VDD) increases the risk for type 2 diabetes mellitus (T2DM), which might be related to insulin resistance (IR). We aimed to explore the association between the triglyceride-glucose (TyG) index, a reliable indicator of IR, and VDD in patients with T2DM. Methods: There were 1034 participants with T2DM enrolled in the Second Xiangya Hospital of Central South University. The TyG index was calculated as ln (fasting triglyceride (TG, mg/dL) × fasting blood glucose (mg/dL)/2). VDD was defined as 25-hydroxyvitamin D [25(OH)D] level

Background: Insulin resistance (IR) represents a critical regulator in the development and progress of coronary artery disease (CAD). Triglyceride-glucose (TyG) index, a novel surrogate biomarker of IR, has been implicated in several cardiovascular diseases. Accordingly, we conduct a meta-analysis to elucidate the relationship between TyG index and adverse cardiovascular events in patients with CAD.Methods: To identify the studies examining the predictive capacity of the TyG index for adverse cardiovascular events in the setting of CAD, we performed a comprehensive literature retrieval of Scopus, PubMed, EMBASE, and Web of Science, from the inception of databases to October 5, 2021. We pooled the adjusted hazard ratio (HR) along with 95% CI using a random-effects model. The primary outcome was a composite of major adverse cardiovascular events (MACEs), including all-cause death, cardiovascular death (CV death), myocardial infarction (MI), stroke, hospitalization for unstable angina or heart failure, and revascularization. The secondary outcomes were all-cause death, CV death, MI, stroke, and revascularization. Additionally, we conducted subgroup analyses stratified by diabetes status, age, body mass index (BMI), low-density lipoprotein cholesterol (LDL-C), category of TyG index, sample size, follow-up duration, and study design.Results: About 12 studies involving 28,795 patients with CAD were finally taken into the quantitative analysis. Our findings showed that there was a 2.14-fold higher risk of MACEs among CAD populations in the highest TyG group compared with those in the lowest TyG group (HR: 2.14, 95% CI: 1.69–2.71, P < 0.001). A greater risk of MACEs was observed in participants with higher BMI than those with lower BMI (P = 0.03 for interaction). In the analysis of secondary outcomes, we also observed a markedly increased risk of MI, stroke, and revascularization in the highest TyG group compared with the lowest TyG group. No evidence of a significant association between TyG index and CV mortality or all-cause mortality in patients with CAD was identified.Conclusions: The elevated TyG index is a promising predictive factor of adverse cardiovascular events in patients with CAD.Systematic Review Registration:https://www.crd.york.ac.uk/PROSPERO, identifier: CRD42021228521.

Background: To examine the effect of the triglyceride-glucose (TyG) index on longitudinal cognitive decline in a healthy middle-aged-to-elderly population. Methods: We conducted a population-based longitudinal study. A total of 1774 participants without cognitive impairment were enrolled in the 4-year follow-up. They were divided into four groups according to the quartile of the TyG index. Multivariable-adjusted Cox proportional hazard models were performed to examine the association between the TyG index and cognitive decline. Discrimination tests were used to evaluate the incremental predictive value of the TyG index beyond conventional risk factors. Results: During the follow-up, compared with those in the bottom quartile group, participants in the top TyG quartile group presented a 51% increase in the risk of cognitive decline (OR 1.51 (95% CI: 1.06–2.14)). As shown by discrimination tests, adding the TyG index into the conventional model resulted in a slight improvement in predicting the risk of cognitive decline (NRI 16.00% (p = 0.004)). Conclusion: This study demonstrated that increasing values of the TyG index were positively associated with the risk of cognitive decline. Monitoring the TyG index may help in the early identification of individuals at high risk of cognitive deterioration.

AimsWe aimed to assess the association between triglyceride–glucose (TyG) index and kidney stones in US adults.MethodsData were obtained from the 2007–2014 National Health and Nutrition Examination Survey (NHANES). Participants aged ≥18 years who were not pregnant and provided complete data about TyG index and kidney stones were included in the analysis. Weighted multivariable regression analysis and subgroup analysis were preformed to estimate the independent relationship between TyG index and nephrolithiasis and recurrence.ResultsA total of 20,972 participants were included with the mean TyG index of 8.71 ± 0.72. The prevalence rates of nephrolithiasis and recurrence were 9.30% and 3.17% overall and increased with the higher TyG index tertiles (Nephrolithiasis: Tertile 1, 6.98%; Tertile 2, 9.15%; Tertile 3, 11.98%, p < 0.01; Recurrence: Tertile 1, 1.84%; Tertile 2, 3.27%; Tertile 3, 4.50%, p < 0.01). Each unit increase in TyG index was associated with 12% and 26% higher odds of nephrolithiasis [odds ratio (OR) = 1.12; 95% CI: 1.02–1.22; p = 0.02] and recurrence (OR = 1.26; 95% CI: 1.08–1.46; p < 0.01). Interaction tests indicated no significant effect of gender, age, body mass index, hypertension, and diabetes on this association between TyG index and kidney stones.ConclusionsHigher TyG index was associated with an increased likelihood of nephrolithiasis and recurrence. Considering TyG index is a reliable indicator of insulin resistance (IR). Treatment and management of IR at a younger age may improve or alleviate the occurrence and recurrence of kidney stones.

Lili Li,1– 3 Lu Li,1– 3 Yi Zhou,1– 3 Xu Chen,1– 3 Yan Xu1– 3 1Department of Periodontology, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, People’s Republic of China; 2Jiangsu Province Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, Jiangsu Province, People’s Republic of China; 3Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, Jiangsu Province, People’s Republic of ChinaCorrespondence: Yan XuDepartment of Periodontology, The Affiliated Stomatological Hospital of Nanjing Medical University, No. 136, Hanzhong Road, Gulou District, Nanjing, Jiangsu Province, 210029, People’s Republic of ChinaTel/Fax +86 25-69593041Email yanxu@njmu.edu.cnBackground: The purpose of this study was to investigate the TyG index in the occurrence of periodontitis among the United States (US) population.Methods: We analyzed clinical data from 4813 participants in the National Health and Nutrition Examination Survey (NHANES) from 2009 to 2014. the TyG index was calculated as ln [fasting triglycerides (mg/dL) × fasting glucose (mg/dL)/2]. Dose–response curves, univariate and multivariate logistic analyses were used to analyze the adjusted odds ratio (aOR) and 95% confidence interval (CI) between TyG index and periodontitis. In addition, we performed 1:1 propensity score matching (PSM) for periodontitis and no periodontitis participants to further explore the relationship between TyG and periodontitis.Results: A total of 4813 participants were included in our study, of which 1353 (28.1%) reported periodontitis and 3460 (71.9%) no periodontitis. The dose–response curves showed a non-linear positive association between TyG and periodontitis, with the risk of periodontitis increased with increasing TyG. In addition, similar results were still observed after subgroup analysis and PSM analysis. After adjusting for confounding variables, multivariate logistic analysis showed that TyG was associated with an increased risk of periodontitis (aOR =1.153; 95% CI 1.006– 1.322, p=0.034).Conclusion: Elevated TyG index was significantly associated with a high risk of periodontitis, and people with a high TyG index should be aware of the risk of periodontitis progression in order to establish lifestyle changes at an early stage.Keywords: periodontitis, triglyceride-glucose index, NHANES, propensity score matching

Background To date, there have no study comparing the associations between TyG index and HOMA-IR on the risk of incident albuminuria. Accordingly, the objective of the present study is to use discordance analysis to evaluate the diverse associations between TyG index and HOMA-IR on the risk of incident albuminuria. Methods A community-based prospective cohort study was performed with 2446 Chinese adults. We categorized participants into 4 concordance or discordance groups. Discordance was defined as a TyG index equal to or greater than the upper quartile and HOMA-IR less than the upper quartile, or vice versa. Results During a median follow-up period of 3.9 years, 203 of 2446 participants developed incident albuminuria (8.3%). In the multivariable logistic analyses, the high TyG index tertile group was associated with a 1.71-fold (95% confidence interval (CI) 1.07–2.72) higher risk of incident albuminuria, comparing with the low tertile group. Participants in TyG (+) & HOMA-IR (−) group had a greater risk of incident albuminuria compared with those in TyG (−) & HOMA-IR (−) group after multivariate adjustment. Subgroup analyses showed that low HOMA-IR and discordantly high TyG index was closely related to a highest risk of incident albuminuria in cardiovascular metabolic disorder subjects. Conclusions Participants with a discordantly high TyG index had a significantly greater risk of incident albuminuria, especially in metabolic dysfunction subjects. The TyG index might be a better predictor of early stage of chronic kidney disease than HOMA-IR for subjects with metabolic abnormality.

Background Triglyceride glucose-body mass index (TyG-BMI) is a recently developed alternative indicator to identify insulin resistance. However, few studies have investigated the association between the TyG-BMI and nonalcoholic fatty liver disease (NAFLD). Therefore, this study aimed to study the relationship between NAFLD and the TyG-BMI in the general population and its predictive value. Methods A cross-sectional study was conducted on 14,251 general subjects who took part in a comprehensive health examination. The anthropological characteristics and many risk factors for NAFLD were measured. Results After fully adjusting for confounding variables, a stable positive correlation was found between NAFLD and the TyG-BMI (OR: 3.90 per SD increase; 95% CI: 3.54 to 4.29; P-trendP Conclusions This epidemiological study is the first on the association between the TyG-BMI and NAFLD risk in the general population. In this large data set from the general population, the TyG-BMI showed an independent positive correlation with NAFLD. The discovery of the threshold effect and saturation effect between them provides a new idea to prevent and treat NAFLD.

Background It remains unclear whether triglyceride-glucose (TyG) index, a surrogate marker of insulin resistance, is prospectively associated with incident peripheral arterial disease (PAD). Methods We included 12,320 Atherosclerosis Risk in Communities Study participants (aged 54.3 ± 5.7 years) free of a history of PAD at baseline (visit 1: 1987–1989). The TyG index was determined using ln (fasting triglycerides [mg/dL] × fasting glucose [mg/dL]/2), and measured at 5 visits between 1987 and 2013. Incident PAD was defined as the first hospitalization with PAD diagnosis or a new onset of measured ABI Results Over a median follow-up of 23 years, 1300 participants developed PAD. After adjustment for traditional PAD risk factors, each 1-SD (0.58) increase in TyG index was associated with an 11.9% higher risk of incident PAD [hazard ratio, 1.119 (95% CI, 1.049–1.195)]. Results were similar when individuals were categorized by TyG index quartiles [hazard ratio, 1.239 (95% CI, 1.028–1.492); comparing extreme quartiles]. Four distinct trajectories of stable TyG indexes at various levels along the follow-up duration were identified [low (22.2%), moderate (43.2%), high (27.5%), and very high (7.1%) trajectory groups]. Compared with those with a TyG index trajectory at a low level, those participants with TyG index trajectories at high and very high levels had an even greater risk of future incident PAD [odds ratio (95%CI): 1.404 (1.132–1.740) and 1.742 (1.294–2.344), respectively] after multivariate adjustments for traditional PAD risk factors. Conclusions Higher TyG index is independently associated with an increased risk of incident PAD. Long-term trajectories of TyG index help identify individuals at a higher risk of PAD who deserve specific preventive and therapeutic approaches. Trial registration: Clinical trial registration number: The ARIC trial was registered at clinicaltrials.gov as NCT00005131.

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 2 = 89%, 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 2 = 0%, P Conclusions A higher TyG index may be independently associated with a higher incidence of ASCVDs, CAD, and stroke in people without ASCVDs at baseline.

BackgroundTriglyceride-glucose (TyG) index was recently suggested to be a reliable surrogate marker of insulin resistance. We aim to investigate the associations between baseline and long-term TyG index with subsequent stroke and its subtypes in a community-based cohort.MethodsA total of 97,653 participants free of history of stroke in the Kailuan Study were included. TyG index was calculated as ln (fasting triglyceride [mg/dL] × fasting glucose [mg/dL]/2). Baseline TyG index was measured during 2006–2007. Updated cumulative average TyG index used all available TyG index from baseline to the outcome events of interest or the end of follow up. The outcome was the first occurrence of stroke, including ischemic stroke, intracerebral hemorrhage and subarachnoid hemorrhage. The associations of TyG index with outcomes were explored with Cox regression.ResultsDuring a median of 11.02 years of follow-up, 5122 participants developed stroke of whom 4277 were ischemic stroke, 880 intracerebral hemorrhage, and 144 subarachnoid hemorrhage. After adjusting for confounding variables, compared with participants in the lowest quartile of baseline TyG index, those in the third and fourth quartile were associated with an increased risk of stroke (adjusted hazard ratio [HR] 1.22, 95% confidence interval [CI] 1.12–1.33, and adjusted HR 1.32, 95% CI 1.21–1.44, respectively,Pfor trend ConclusionsElevated levels of both baseline and long-term updated cumulative average TyG index can independently predict stroke and ischemic stroke but not intracerebral hemorrhage in the general population during an 11-year follow-up.

Background: The causal evidence of the triglyceride–glucose (TyG) index, as well as the joint exposure of higher glucose and triglyceride on the risk of cardio-cerebrovascular diseases (CVD), was lacking.Methods: A comprehensive factorial Mendelian randomization (MR) was performed in the UK Biobank cohort involving 273,368 individuals with European ancestry to assess and quantify these effects. The factorial MR, MR-PRESSO, MR-Egger, meta-regression, sensitivity analysis, positive control, and external verification were utilized. Outcomes include major outcomes [overall CVD, ischemic heart diseases (IHD), and cerebrovascular diseases (CED)] and minor outcomes [angina pectoris (AP), acute myocardial infarction (AMI), chronic IHD (CIHD), heart failure (HF), hemorrhagic stroke (HS), and ischemic stroke (IS)].Results: The TyG index significantly increased the risk of overall CVD [OR (95% CI): 1.20 (1.14–1.25)], IHD [OR (95% CI): 1.22 (1.15–1.29)], CED [OR (95% CI): 1.14 (1.05–1.23)], AP [OR (95% CI): 1.29 (1.20–1.39)], AMI [OR (95% CI): 1.27 (1.16–1.39)], CIHD [OR (95% CI): 1.21 (1.13–1.29)], and IS [OR (95% CI): 1.22 (1.06–1.40)]. Joint exposure to genetically higher GLU and TG was significantly associated with a higher risk of overall CVD [OR (95% CI): 1.17 (1.12–1.23)] and IHD [OR (95% CI): 1.22 (1.16–1.29)], but not with CED. The effect of GLU and TG was independent of each other genetically and presented dose–response effects in bivariate meta-regression analysis.Conclusions: Lifelong genetic exposure to higher GLU and TG was jointly associated with higher cardiac metabolic risk while the TyG index additionally associated with several cerebrovascular diseases. The TyG index could serve as a more sensitive pre-diagnostic indicator for CVD while the joint GLU and TG could offer a quantitative risk for cardiac metabolic outcomes.

Objective: The triglyceride-glucose (TyG) index is a reliable surrogate of insulin resistance and a marker for ischemic stroke (IS) incident. Whether the TyG index predicts stroke outcome remains uncertain. This study investigated the prognostic value of the TyG index in critically ill stroke patients.Methods: This was a retrospective observational study that included stroke patients, and all data were extracted from the eICU Collaborative Research Database. The TyG index was calculated as the ln [fasting glucose level (mg/dL) × triglyceride level (mg/dL)/2]. Outcomes included the hospital and intensive care unit (ICU) death. Multivariate logistic regression was used to determine independent risk factors. The smoothing curves and forest plots were illustrated.Results: A total of 4,570 eligible subjects were enrolled. The mean level of TyG index was 9.1 ± 0.7. The hospital and ICU mortality rate were 10.3 and 5.0%, respectively. TyG index as a continuous variable was associated hospital mortality in univariate analysis (OR 1.723, 95% CI 1.524–1.948, P < 0.001), adjusted model 1 (OR 1.861, 95% CI 1637–2.116, P < 0.001), and adjusted model 2 (OR 2.543, 95% CI 1.588–4.073, P < 0.001). TyG was also associated ICU mortality in univariate analysis (OR 2.146, 95% CI 1.826–2.523, P < 0.001), adjusted model 1 (OR 2.183, 95% CI 1.847–2.580, P < 0.001), and adjusted model 2 (OR 2.672, 95% CI 1.376–5.188, P < 0.001). The smoothing curves observed a continuous linear association after adjusting all covariates both in hospital and ICU mortality. Subgroup analysis demonstrated TyG index was associated with increased risk of hospital and ICU death in critically ill IS (P < 0.05), but not in hemorrhage stroke (P > 0.05).Conclusion: The TyG index is a potential predictor for hospital and ICU mortality in critically ill stroke patients, especially in IS patients.

Background Recent studies have suggested the triglyceride-glucose index (TyG index) may serve as a suitable substitute for insulin resistance. However, evidence for the relationship between TyG index and risk of diabetes remains limited. This study sought to explore the association of baseline TyG index with risk of developing diabetes in Chinese adults. Methods This retrospective cohort study was conducted using data from the health screening program in China. A total of 201,298 non-diabetic individuals were included. TyG index was calculated as Ln [fasting plasma glucose (mg/dL) × fasting triglyceride level (mg/dL) / 2]. Diabetes was defined as fasting plasma glucose ≥126 mg/dL and/or self-reported diabetes. Cox proportion-hazard model was employed to evaluate the independent impact of baseline TyG index on future diabetes risk. Sensitivity and subgroup analyses were implemented to verify the reliability of results. Notably, data were downloaded from the DATADRYAD website, and used only for secondary analyses. Results During an average follow-up of 3.12 years, among 201,298 individuals aged ≥20 years, 3389 subjects developed diabetes. After adjusting for potential confounders, elevated TyG index were independently correlated with greater risk of incident diabetes (hazard ratio (HR), 3.34; 95% confidence interval (CI), 3.11–3.60). Compared with the lowest quartile (Q1), increasing TyG index (Q2, Q3, and Q4) was related to increased HR estimates of incident diabetes [HR (95% CI), 1.83 (1.49–2.26); 3.29 (2.70–4.01), and 6.26 (5.15–7.60), respectively]. Moreover, a nonlinear relationship was observed between TyG index and risk of diabetes and the slope of the curve increased accompanying the rise of TyG index. Subgroup analysis revealed the positive association was stronger among subjects with age 2 and 2, or systolic blood pressure Conclusions Elevated TyG index is independently correlated with increased risk of incident diabetes in Chinese adults, indicating it may represent a reliable predictor of diabetes in high-risk populations.

Background The triglyceride-glucose index (TyG) is a reliable predictor of non-alcoholic fatty liver disease (NAFLD). Its association with the severity of hepatic steatosis and liver fibrosis in NAFLD is poorly understood. This study evaluated the relationship between these factors in NAFLD. Methods A total of 4784 participants who underwent ultrasonography were enrolled. Anthropometric and biochemical measurements were assessed. Participants with NAFLD were diagnosed by ultrasound. The degree of hepatic steatosis and liver stiffness was evaluated with transient elastography. Results The TyG index was significantly correlated with the severity of hepatic steatosis and the presence of liver fibrosis in patients with NAFLD. TyG quartile values correlated with increasing prevalence of NAFLD (Q1 30.9%, Q2 53.3%, Q3 71.7%, and Q4 86.4%, P P Conclusion The TyG index is positively related to the severity of hepatic steatosis and the presence of liver fibrosis in NAFLD. The index also performed better than HOMA-IR.

Aims/Introduction The triglyceride–glucose (TyG) index has been proposed as a reliable and simple marker of insulin resistance. We investigated the association between TyG index and diabetic nephropathy (DN) in patients with type 2 diabetes. Materials and Methods A consecutive case series of 682 adult patients with type 2 diabetes hospitalized in the Department of Endocrinology at the Tongji Hospital (Wuhan, Hubei, China) from January 2007 to December 2009 was included in this cross‐sectional analysis. Receiver operating characteristics curve analysis, correlation analysis and multiple logistic regression analysis were carried out. Results A total of 232 (34.0%) participants were identified with DN. Compared with the non‐DN group, the DN group had longer disease duration, and higher bodyweight, systolic blood pressure, diastolic blood pressure, glycated hemoglobin, triglycerides, total cholesterol, serum uric acid, 24 h‐urinary albumin, TyG index and homeostasis model assessment 2 estimates for insulin resistance (HOMA2‐IR; P 9.66 showed a higher area under the receiver operating characteristic curve of 0.67 (P = 0.002) than HOMA2‐IR (area under the curve 0.61, P = 0.029) on receiver operating characteristic curve analysis for DN identification. Additionally, the TyG index positively correlated with the levels of metabolic indicators (bodyweight, glycated hemoglobin, triglycerides, total cholesterol, serum uric acid, fasting glucose and HOMA2‐IR) and natural logarithmic 24 h‐urinary albumin (P, The triglyceride–glucose index provides an affordable and easily interpreted biomarker for monitoring the degree of insulin resistance, and was independently associated with diabetic nephropathy in patients with type 2 diabetes. It was a better marker than homeostasis model assessment for insulin resistance for identification of diabetic nephropathy in type 2 diabetes patients.

Background The relationship between triglyceride-glucose index (TyG index) and the prevalence and prognosis of cardiovascular disease has been confirmed by former studies. However, it remains uncertain whether TyG index has a prognostic impact in patients with type 2 diabetes mellitus (T2DM) and non-ST-segment elevation acute coronary syndrome (NSTE-ACS) undergoing percutaneous coronary intervention (PCI). Methods The study retrospectively enrolled 798 patients (mean age: 60.9 ± 8.3 years; 68.3% men) with T2DM and NSTE-ACS who underwent PCI at Beijing Anzhen Hospital from January to December 2015. TyG index was calculated as previously reported: ln [fasting TGs (mg/dL) * FBG (mg/dL)/2]. The primary endpoint was a composite of adverse events as follows: all-cause death, non-fatal myocardial infarction (MI) and ischemia-driven revascularization. Results TyG index was significantly higher in patients with a primary endpoint event compared with those without. Multivariate Cox proportional hazards analysis showed that 1-unit increase of TyG index was independently associated with higher risk of primary endpoint, independent of other risk factors [hazard ratio (HR) 3.208 per 1-unit increase, 95% confidence interval (CI) 2.400–4.289, P Conclusions Increased TyG index is a significant predictor of adverse prognosis in patients with T2DM and NSTE-ACS undergoing PCI. Further studies need to be performed to determine whether interventions for TyG index have a positive impact on improving clinical prognosis.

Background The triglyceride-glucose index (TyG index) has been regarded as a reliable alternative marker of insulin resistance and an independent predictor of cardiovascular outcomes. Whether the TyG index predicts adverse cardiovascular events in patients with diabetes and acute coronary syndrome (ACS) remains uncertain. The aim of this study was to investigate the prognostic value of the TyG index in patients with diabetes and ACS. Methods A total of 2531 consecutive patients with diabetes who underwent coronary angiography for ACS were enrolled in this study. Patients were divided into tertiles according to their TyG index. The primary outcomes included the occurrence of major adverse cardiovascular events (MACEs), defined as all-cause death, non-fatal myocardial infarction and non-fatal stroke. The TyG index was calculated as the ln (fasting triglyceride level [mg/dL] × fasting glucose level [mg/dL]/2). Results The incidence of MACE increased with TyG index tertiles at a 3-year follow-up. The Kaplan–Meier curves showed significant differences in event-free survival rates among TyG index tertiles (P = 0.005). Multivariate Cox hazards regression analysis revealed that the TyG index was an independent predictor of MACE (95% CI 1.201–1.746; P Conclusions The TyG index predicts future MACE in patients with diabetes and ACS independently of known cardiovascular risk factors, suggesting that the TyG index may be a useful marker for risk stratification and prognosis in patients with diabetes and ACS.

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

Background and ObjectivesTriglyceride-glucose (TyG) is an emerging vital indicator of insulin resistance and is associated with increased risk of T2DM and cardiovascular events. We aimed to explore the TyG index and contrast-induced acute kidney injury (CI-AKI) in patients with type 2 diabetes who underwent coronary angiology.MethodsThis study enrolled 928 patients with suspected coronary artery disease who underwent coronary angiology or percutaneous coronary intervention in Zhongda hospital. Patient data were divided into quartiles according to the TyG index: group 1: TyG ≤ 8.62; group 2: 8.629.45. CI-AKI was diagnosed according to the KIDIGO criteria. Demographic data, hematological parameters, coronary angiology data, and medications were all recorded. We calculated the TyG index using the following formula: ln [fasting TG (mg/dL)×FPG (mg/dL)/2].ResultsPatients who developed CI-AKI exhibited significantly higher TyG index levels compared to patients who did not develop CI-AKI. The incidence of CI-AKI sharply increased with increasing TyG. Univariate and multivariate analysis identified TyG as an independent risk factor for CI-AKI. The AUC of the ROC curve was as high as 0.728 when the value of TyG was 8.88. The corresponding sensitivity was as high as 94.9%. Adding the variable TyG to the model for predicting CI-AKI risk further increased the predictive value of the model from 80.4% to 82%.ConclusionsHigh TyG is closely associated with increased incidence of CI-AKI, demonstrating that TyG is an independent risk factor for CI-AKI. TyG has potentially predictive value for CI-AKI and may play a crucial role in risk stratification in clinical practice.

The triglyceride–glucose (TyG) index has been correlated with insulin resistance. We aim to investigate the role of the TyG index on cardiovascular (CV) events in type 2 diabetes mellitus and compare the roles of fasting glucose, hemoglobin A1c, and the TyG index in predicting CV events. This retrospective study enrolled 3524 patients with type 2 diabetes from the Kaohsiung Medical University Research Database in 2009 in this longitudinal study and followed them until 2015. The TyG index was calculated as log (fasting triglyceride level (mg/dL) × fasting glucose level (mg/dL)/2). CV events included myocardial infarction, unstable angina, stroke, hospitalization for coronary artery disease, peripheral artery disease, and CV-related death. The association between variables and CV events was assessed using a multivariable stepwise Cox proportional hazard analysis. Two hundred and fifteen CV events (6.1%) were recorded during a follow-up period of 5.93 years. The multivariable stepwise analysis showed that high fasting glucose (HR, 1.007; p < 0.001) and a high TyG index (HR, 1.521; p = 0.004) but not hemoglobin A1c or triglycerides were associated with a higher rate of CV events. Adding fasting glucose and the TyG index to the basic model improved the predictive ability of progression to a CV event (p < 0.001 and p = 0.018, respectively), over that of hemoglobin A1c (p = 0.084) and triglyceride (p = 0.221). Fasting glucose and the TyG index are useful parameters and stronger predictive factors than hemoglobin A1c and triglyceride for CV events and may offer an additional prognostic benefit in patients with type 2 diabetes.

The triglyceride glucose (TyG) index, a product of triglyceride and fasting glucose, is a reliable marker for insulin resistance. We aimed to investigate the association between the TyG-related markers and coronary artery calcification (CAC) progression. We enrolled 1145 asymptomatic participants who underwent repeated CAC score measurements during routine health examinations. Homeostasis model assessment of insulin resistance (HOMA-IR), TyG index, TyG-BMI (body mass index), and TyG-WC (waist circumference) were calculated. Progression of CAC was defined as (1) incident CAC in a CAC-free population, or an (2) increase of &ge, 2.5 units between the baseline and final square root of the CAC scores in participants with detectable CAC. According to the quartiles of parameters, we stratified the subjects into four groups. The prevalence of progression increased with the TyG-WC quartile (15.0%, 24.1%, 31.0%, and 32.2% for each of the groups, p &lt, 0.001). The multivariate-adjusted odds ratio (95% confidence interval) for CAC score progression was 1.66 (1.01&ndash, 2.77) when the highest and lowest TyG-WC index quartiles were compared. Furthermore, the predictability of TyG-WC for CAC progression was better than the other indices in terms of the area under the curve. The TyG-WC index predicted CAC progression better than other indices and could be a potential marker of future coronary atherosclerosis.

Diabetes mellitus is an important chronic disease causing economic and social burden. Insulin resistance is a determinant of diabetes, and regular eating patterns are an important factor in blood sugar control. This study investigated the association between breakfast frequency and the risk of increased insulin resistance in Koreans. Data for 12,856 participants without diabetes in the 2016&ndash, 2018 Korea National Health and Nutrition Examination Survey were analyzed. Insulin resistance was assessed using the triglyceride-glucose (TyG) index, while the median TyG index value was used to define higher (&ge, 8.5) vs. lower (&lt, 8.5) insulin resistance. Association between breakfast frequency and risk of increased insulin resistance was investigated using multiple logistic regression. Compared with those who had regular breakfast 5&ndash, 7 times per week, the odds ratios (95% confidence intervals) of individuals who did not eat breakfast were the highest at 1.42 (95% CI = 1.24&ndash, 1.64, p &le, 0.0001). Those who had breakfast 1&ndash, 4 times per week had an odds ratio of 1.17 (95% CI = 1.03&ndash, 1.32, p = 0.0153). We found that a lower weekly breakfast consumption was associated with a higher risk of insulin resistance in Koreans. Promoting the benefits of breakfast can be an important message to improve the health of the population.

Keywords: triglyceride-glucose index, microangiopathy, macroangiopathy, type 2 diabetes mellitus

The triglyceride&ndash, glucose (TyG) index has been correlated with insulin resistance. We aim to investigate the role of the TyG index on cardiovascular (CV) events in type 2 diabetes mellitus and compare the roles of fasting glucose, hemoglobin A1c, and the TyG index in predicting CV events. This retrospective study enrolled 3524 patients with type 2 diabetes from the Kaohsiung Medical University Research Database in 2009 in this longitudinal study and followed them until 2015. The TyG index was calculated as log (fasting triglyceride level (mg/dL) &times, fasting glucose level (mg/dL)/2). CV events included myocardial infarction, unstable angina, stroke, hospitalization for coronary artery disease, peripheral artery disease, and CV-related death. The association between variables and CV events was assessed using a multivariable stepwise Cox proportional hazard analysis. Two hundred and fifteen CV events (6.1%) were recorded during a follow-up period of 5.93 years. The multivariable stepwise analysis showed that high fasting glucose (HR, 1.007, p &lt, 0.001) and a high TyG index (HR, 1.521, p = 0.004) but not hemoglobin A1c or triglycerides were associated with a higher rate of CV events. Adding fasting glucose and the TyG index to the basic model improved the predictive ability of progression to a CV event (p &lt, 0.001 and p = 0.018, respectively), over that of hemoglobin A1c (p = 0.084) and triglyceride (p = 0.221). Fasting glucose and the TyG index are useful parameters and stronger predictive factors than hemoglobin A1c and triglyceride for CV events and may offer an additional prognostic benefit in patients with type 2 diabetes.