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Multivariable-adjusted hazard ratios for AF based on restricted cubic spines among overall individuals. Each hazard ratio was computed with a TyG index level of 8.59 as the reference. The model was adjusted for age, sex, race, body mass index, smoking, drinking, low-density lipoprotein-cholesterol, high-density lipoprotein-cholesterol, use of cholesterol-lowering medication, history of diabetes, hypertension, and peripheral artery disease. The Red line represents references for HRs, and the area between the dotted line represents 95% CI. Histograms represent the frequency distribution of the baseline TyG index. AF atrial fibrillation. HR hazard ratio, CI confidence interval TyG triglyceride–glucose
Source publication
Objective
The triglyceride–glucose (TyG) index has been shown to be a new alternative measure for insulin resistance. However, no study has attempted to investigate the association of the TyG index with incident atrial fibrillation (AF) in the general population without known cardiovascular diseases.
Methods
Individuals without known cardiovascula...
Similar publications
Background The triglyceride glucose (TyG) index, a metric for estimating insulin resistance (IR), is linked with cardiovascular disease (CVD) morbidity and mortality among the population regardless of diabetic status. However, IR
prevalence and the association between the TyG index and heart failure (HF) in Americans is unclear.
Methods The Nation...
Citations
... However, several studies have indicated a positive relationship between IR and AF. In the ARIC cohort, which consisted of 11,851 participants with a mean [29]. Additionally, a retrospective observational study involving 356 patients reported a positive association between the TyG index and AF, with an OR of 2.09 (95% CI 1.41-3.10) ...
Objective
Previous studies have shown a clear link between insulin resistance (IR) and an elevated risk of atrial fibrillation (AF). However, the relationship between the estimated glucose disposal rate (eGDR), which serves as a marker for IR, and the risk of AF recurrence after radiofrequency catheter ablation (RFCA) remains uncertain. Therefore, this study aimed to examine the potential association between the eGDR and the risk of AF recurrence following RFCA.
Methods
This retrospective study was conducted at Nanchang University Affiliated Second Hospital. The study enrolled 899 patients with AF who underwent RFCA between January 2015 and January 2022. The formula used to calculate the eGDR was as follows: 19.02 − (0.22 * body mass index) − (3.26 * hypertension) − (0.61 * HbA1c). Cox proportional hazard regression models and exposure–effect curves were used to explore the correlation between the baseline eGDR and AF recurrence. The ability of the eGDR to predict AF recurrence was evaluated using the area under the receiver operating characteristic curve (AUROC).
Results
The study observed a median follow-up period of 11.63 months, during which 296 patients experienced AF recurrence. K‒M analyses revealed that the cumulative incidence AF recurrence rate was significantly greater in the group with the lowest eGDR (log-rank p < 0.01). Participants with an eGDR ≥ 8 mg/kg/min had a lower risk of AF recurrence than those with an eGDR < 4 mg/kg/min, with a hazard ratio (HR) of 0.28 [95% confidence interval (CI) 0.18, 0.42]. Additionally, restricted cubic spline analyses demonstrated a linear association between the eGDR and AF recurrence (p nonlinear = 0.70). The area under the curve (AUC) for predicting AF recurrence using the eGDR was 0.75.
Conclusions
The study revealed that a decrease in the eGDR is associated with a greater AF recurrence risk after RFCA. Hence, the eGDR could be used as a novel biomarker for assessing AF recurrence risk.
... Huang et al. found that the higher the TyG index of subjects without previous heart failure and coronary heart disease, the higher risk of developing heart failure, and the higher risk of poor left ventricular remodeling and dysfunction in a community-based cohort [3]. Furthermore, Liu et al. reported that TyG index > 9.20 was an independent risk factor for atrial fibrillation in the general population without known cardiovascular disease [25]. It is worth noting that TyG index also has clinical predictive value for coronary revascularization. ...
Background
The triglyceride glucose (TyG) index is a novel and reliable alternative marker for insulin resistance. Previous studies have shown that TyG index is closely associated with cardiovascular outcomes in cardiovascular diseases and coronary revascularization. However, the relationship between TyG index and renal outcomes of coronary revascularization is unclear. The purpose of this study was to investigate the correlation between TyG index and the risk of acute kidney injury (AKI) in patients with coronary revascularization.
Methods
A retrospective cohort study was conducted to select eligible patients with coronary revascularization admitted to ICU in the medical information mart for intensive care IV (MIMIC-IV). According to the TyG index quartile, these patients were divided into four groups (Q1-Q4). The primary endpoint was the incidence of AKI, and secondary endpoints included 28-day mortality and the rate of renal replacement therapy (RRT) use in the AKI population. Multivariate Cox regression analysis and restricted cubic splines (RCS) were used to analyze TyG index association with AKI risk. Kaplan-Meier survival analysis was performed to assess the incidence of endpoints in the four groups.
Results
In this study, 790 patients who underwent coronary revascularization surgery were included, and the incidence of AKI was 30.13%. Kaplan-Meier analysis showed that patients with a high TyG index had a significantly increased incidence of AKI (Log-rank P = 0.0045). Multivariate Cox regression analysis showed that whether TyG index was a continuous variable (HR 1.42, 95% CI 1.06–1.92, P = 0.018) or a categorical variable (Q4: HR 1.89, 95% CI 1.12–3.17, P = 0.017), and there was an independent association between TyG index and AKI in patients with coronary revascularization. The RCS curve showed a linear relationship between higher TyG index and AKI in this particular population (P = 0.078). In addition, Kaplan-Meier analysis showed a significantly increased risk of RRT application in a subset of AKI patients based on quartiles of TyG index (P = 0.029).
Conclusion
TyG index was significantly associated with increased risk of AKI and adverse renal outcomes in patients with coronary revascularization. This finding suggests that the TyG index may be useful in identifying people at high risk for AKI and poor renal outcomes in patients with coronary revascularization.
... Notably, the TyG index has proven to be a reliable tool for assessing the progression of coronary artery calcification and determining the severity of coronary artery disease [33][34][35]. It is also positively correlated with the risk of heart failure, hypertension, atrial fibrillation and myocardial infarction [36][37][38][39][40]. Similarly, BMI serves as an indicator of both obesity and IR. ...
... Sex is a crucial determinant in CVD development and progression, with growing attention on cardiovascular risk in women. Sex-specific analyses revealed a more pronounced association between IR and SCA in women, aligning with observations from previous studies indicating a stronger link between IR and adverse cardiovascular events in women [20,37,38]. Notably, consistent findings were observed across RCS and AFT models. ...
Background
Insulin resistance (IR) significantly contributes to cardiovascular disease (CVD) development. Triglyceride glucose (TyG) index and triglyceride glucose-body mass index (TyG-BMI) are recognised as convenient proxies for IR. However, their relationship with sudden cardiac arrest (SCA) remains unclear.
Methods
This prospective cohort analysis included 355,242 UK Biobank participants with available TyG index and TyG-BMI data and no history of CVD. Cox proportional risk models assessed the association between the TyG index, TyG-BMI and SCA risk. Additionally, Accelerated Failure Time (AFT) models were employed to investigate the timing of SCA onset. The impact of dynamic increases in TyG index and TyG-BMI levels on SCA risk was examined using restricted cubic spline.
Results
Over a median follow-up period of 165.4 months (interquartile range 156.5–174 months), 1,622 cases of SCA were recorded. Multivariate Cox regression analysis revealed a 9% increase in SCA risk per standard deviation increase in TyG index (adjusted hazard ratio (aHR) = 1.09, 95% confidence interval (CI) 1.04–1.15) and an 14% increase per standard deviation increase in TyG-BMI (aHR 1.14, 95% CI 1.09–1.2). AFT models indicated earlier median times to SCA occurrence with increasing quintiles of TyG index and TyG-BMI compared to the lowest quintile (P for trend < 0.05). SCA risk was linearly (P = 0.54) and non-linearly (P = 0.007) correlated with gradual increases in TyG index and TyG-BMI levels, respectively. Sex-stratified analyses showed stronger associations in women.
Conclusions
Higher TyG index and TyG-BMI levels are associated with an increased SCA risk and earlier onset, particularly in women.
... Researchers have discovered in their studies on the risk factors for atrial fibrillation that patients with this condition tend to have higher TyG index levels. Moreover, a meta-analysis has shown that individuals with heart failure also exhibit elevated TyG index levels compared to healthy individuals [28][29][30]. Consequently, the TyG index is increasingly recognized as an indispensable tool for assessing cardiovascular risk, demonstrating its efficacy in prognosticating CHD, heart failure, arrhythmias, and associated clinical outcomes. As research progresses, the TyG index is anticipated to ascend as a paramount biomarker in the cardiovascular health landscape, guiding the development of nuanced, patient-centered treatment modalities across the globe. ...
Background
Insulin resistance (IR) can lead to cellular metabolic disorders, activation of oxidative stress, and endothelial dysfunction, contributing to in-stent restenosis (ISR). The triglyceride-glucose index (TyG index), a new indicator reflecting IR, is extensively researched in the cardiovascular field. This study, through a meta-analysis, aimed to utilize a larger combined sample size and thereby enhance the overall test efficacy to explore the TyG index-ISR relationship.
Methods
A thorough search was conducted in the PubMed, EMBASE, Web of Science, and Cochrane Library databases to find original papers and their references published between 1990 and January 2024. This search included both prospective and retrospective studies detailing the correlation between the TyG index and ISR in individuals with coronary heart disease (CHD).
Outcomes
The five included articles comprised 3,912 participants, and the odds ratio (OR) extracted from each study was combined using the Inverse Variance method. Results showed that, in the context of CHD patients, each incremental unit in the TyG index, when treated as a continuous variable, corresponded to a 42% elevation in ISR risk (95% CI 1.26–1.59, I²=13%, p < 0.005). When analyzing the TyG index categorically, the results revealed a higher ISR risk in the highest TyG index group compared to the lowest group (OR: 1.69, 95% CI 1.32–2.17, I²=0). Additionally, in patients with chronic coronary syndrome (CCS), each unit increase in the TyG index, the risk of ISR in patients increased by 37% (95% CI 1.19–1.57, I²=0%, p < 0.005). This correlation was also observable in acute coronary syndrome (ACS) patients (OR:1.48, 95% CI 1.19–1.85, I²=0, p < 0.005).
Conclusions
The TyG index, an economical and precise surrogate for IR, is significantly linked with ISR. Furthermore, this correlation is unaffected by the type of coronary heart disease.
... Then, a further 89 studies were excluded by title/ abstract screening, and another 25 were excluded during the full-text assessment for reasons mentioned in Fig. 1. At the end of the screening, nine studies fully met the inclusion criteria and were included in the analysis [28][29][30][31][32][33][34][35][36]. Studies were conducted mostly in China [28,29,[32][33][34][35][36], followed by the United States [30] and Sweden [31]. ...
... At the end of the screening, nine studies fully met the inclusion criteria and were included in the analysis [28][29][30][31][32][33][34][35][36]. Studies were conducted mostly in China [28,29,[32][33][34][35][36], followed by the United States [30] and Sweden [31]. The design of the included studies were prospective cohort [30,31,33,34], retrospective cohort [28,29], case-control [35,36], and cross-sectional [32]. ...
... Studies were conducted mostly in China [28,29,[32][33][34][35][36], followed by the United States [30] and Sweden [31]. The design of the included studies were prospective cohort [30,31,33,34], retrospective cohort [28,29], case-control [35,36], and cross-sectional [32]. In these studies, 886 patients with AF were compared against 5285 without AF, with a mean age of 63.46 ± 10.47 years and 56.81 ± 10.54 years, respectively. ...
Background
An essential relationship between insulin resistance (IR) and atrial fibrillation (AF) has been demonstrated. Among the methods used to assess IR, the triglyceride-glucose (TyG) index is the more straightforward, dimensionless, and low-cost tool. However, the possible usage of this index in clinical practice to predict and diagnose AF has yet to be determined and consolidated.
Objective and rationale
Herein, we performed a systematic review and meta-analysis to assess the association between the TyG index and AF.
Methods
Databases (PubMed, Embase, Scopus, and Web of Science) were systematically searched for studies evaluating the TyG index in AF. The inclusion criteria were observational studies investigating AF and TyG index correlation in individuals older than 18 years, while preclinical studies and those without the relevant data were excluded. Random effect meta-analyses comparing TyG levels between AF and non-AF cases, AF recurrence after radiofrequency ablation, and post-procedural AF were performed using standardized mean differences (SMD) with their matching 95% confidence intervals (CIs).
Results
Our screening identified nine studies to be analyzed, including 6,171 participants including 886 with AF. The meta-analysis demonstrated that the TyG index resulted higher in patients with AF than non-AF counterparts (SMD 1.23, 95% CI 0.71 to 1.75, I² 98%, P < 0.001). Subgroup analysis showed the same results for post-procedure AF (SMD 0.99, 95% CI 0.78 to 1.20, I² 10%, P < 0.001) and post-ablation AF (SMD 1.25, 95% CI 1.07 to 1.43, I² 46%, P < 0.001), while no difference was found in population-based cohorts (SMD 1.45, 95% CI − 0.41 to 3.31, I² 100%, P = 0.13). Publication year (P = 0.036) and sample size (P = 0.003) showed significant associations with the effect size, using multivariable meta-regression.
Conclusion
The TyG index is an easy-to-measure surrogate marker of IR in patients with AF. Further clinical studies are warranted to demonstrate its ability for routine clinical use and as a screening tool.
... TyG index, as a validated marker for assessing IR, had been reported to be strongly associated with AF and to be an independent risk factor for the onset and development of AF in hospitalized patients [24]. Liu et al. found a U-shaped association between TyG index and the incidence of AF in the general population by studying a cohort after 24 years of follow-up [25]. Numerous studies have demonstrated the usefulness and effectiveness of the TyG-BMI index for assessing IR [26,27]. ...
Background
The TyG-BMI index, which is a reliable indicator of insulin resistance (IR), has been found to have a significant correlation with the occurrence of cardiovascular events. However, there still lacks study on the TyG-BMI index and prognosis in patients with atrial fibrillation (AF). The objective of the present study was to evaluate the relationship between TyG-BMI index at admission to ICU and all-cause mortality in critically ill patients with AF.
Methods
The patient’s data were extracted from Medical Information Mart for Intensive Care IV(MIMIC-IV) database. All patients were divided into four groups according to TyG-BMI index. Outcomes include primary and secondary endpoints, with the primary endpoint being the 30-day and 365-day all-cause mortality and the secondary endpoint being the 90-day and 180-day all-cause mortality. TyG-BMI index was quartile and Kaplan-Meier curve was used to compare the outcome of each group. Cox proportional-hazards regression model and restricted cubic splines (RCS) were conducted to assess the relationship between TyG-BMI index and outcomes.
Results
Out of a total of 2509 participants, the average age was 73.26 ± 11.87 years, with 1555 (62.0%) being males. Patients with lower level of TyG-BMI had higher risk of 30-day, 90-day, 180-day and 365-day all-cause mortality, according to the Kaplan-Meier curves (log-rank P < 0.001). In addition, cox proportional-hazards regression analysis revealed that the risk of 30-day, 90-day, 180-day and 365-day all-cause mortality was significantly higher in the lowest quartile of TyG-BMI. Meanwhile, the RCS analysis indicated that L-typed relationships between TyG-BMI index and all-cause mortality, with inflection points at 223.60 for 30-day and 255.02 for 365-day all-cause mortality, respectively. Compared to patients with TyG-BMI levels below the inflection points, those with higher levels had a 1.8% lower risk for 30-day all-cause mortality (hazard ratio [HR] 0.982, 95% confidence interval [CI] 0.9676–0.988) and 1.1% lower risk for 365-day all-cause mortality (HR 0.989, 95% CI 0.986–0.991).
Conclusion
In critically ill patients with AF, a lower TyG-BMI level is significantly associated with a higher risk of 30-day, 90-day, 180-day and 365-day all-cause mortality. TyG-BMI index could be used as a valid indicator for grading and treating patients with AF in the ICU.
... p < 0.001). In a similar vein, the TyG index has been utilized to prognosticate non-alcoholic fatty liver disease (NAFLD) [47], ischemic stroke [48], atrial fibrillation [49], carotid atherosclerosis [50], as well as the onset of diseases within the realm of oncology [51] and chronic kidney disease (CKD) [52]. The present study aimed to investigate the association between the TyG index and the conventional etiology of cardiovascular disease. ...
Background
The TyG index, a prominent metric for assessing insulin resistance, has gained traction as a prognostic tool for cardiovascular disease. Nevertheless, the understanding of the prognostic significance of the extent of coronary artery stenosis in individuals afflicted with H-type hypertension remains limited.
Methods
A retrospective study was conducted at Wuhan Third Hospital, including a cohort of 320 inpatients who were diagnosed with hypertension in combination with coronary artery disease. The study period spanned from January 1, 2021, to February 1, 2023. The study cohort was stratified based on the severity of stenosis into three distinct groups: low stenosis, medium stenosis, and high stenosis, as determined by the Gensini score derived from coronary angiography findings. The present study aimed to investigate the association between the severity of coronary stenosis and the number of lesion branches, utilizing the TyG index as a testing indicator. The predictive ability of TyG for coronary lesion severity was assessed using logistic regression analysis.
Results
The results of our study indicate a positive correlation between elevated levels of TyG and an increased susceptibility to severe stenosis in individuals diagnosed with H-type hypertension. Upon careful consideration of potential confounding variables, it has been observed that the TyG index exhibits a robust association with the likelihood of severe stenosis in individuals with H-type hypertension (odds ratio [OR] = 4000, 95% confidence interval CI 2.411–6.635, p = 0.0001), as well as the prevalence of multivessel disease (OR = 1.862, 95% CI 1.036–3.348, p < 0.0001). The TyG index demonstrated superior predictive ability for severe coronary stenosis in patients with H-type hypertension compared to those without H-type hypertension (area under the curve [AUC] = 0.888, 95% confidence interval CI 0.838–0.939, p < 0.0001, versus AUC = 0.615, 95% CI 0.494–0.737, p < 0.05).
Conclusion
The TyG index is an independent risk factor for the degree of coronary stenosis and a better predictor in patients with H-type hypertension combined with coronary artery disease.
... Over recent years, TyG index has gained attention due to its potential in predicting clinical outcomes like atrial fibrillation, cardiovascular disease (CVD), and stroke [5][6][7]. Although the association between poor prognosis and a high TyG index has been reported in most contemporary studies [8], there remains a notable discrepancy in the literature. ...
Background
The association between triglyceride–glucose (TyG) index and poor prognosis remains controversial. Whether renal function status affects the ability of the TyG index to predict poor prognosis has not yet been elucidated and merits further studies.
Methods
This retrospective cohort study included 22,031 participants from communities in the U.S. By juxtaposing the TyG categories with the estimated glomerular filtration rate (eGFR, either < 60 mL/min/1.73m ² or ≥ 60 mL/min/1.73m ² ), participants were categorized into four distinct groups: (1) TyG_L/eGFR_H; (2) TyG_H/eGFR_H; (3) TyG_L/eGFR_L; and (4) TyG_H/eGFR_L. The endpoint was the all-cause mortality rate. Standard Kaplan–Meier plots were constructed and multifactor Cox regression analyses were carried out and restricted cubic spline regression analysis was utilized to assess the association between death and the TyG index for different renal function statuses.
Results
No statistical differences were found in the TyG groups in participants with normal renal function after adjustment for all covariates ( P = 0.070). However, in the high TyG index group with renal insufficiency, the risk of all-cause mortality rates was reduced by 18%. (HR, 0.82; CI, 0.69–0.98). The TyG index (high vs. low) and renal function (eGFR < 60 vs. eGFR ≥ 60) had statistically significant interactions with death (P < 0.001). When all covariates were adjusted, the risk of mortality for the TyG_L combined with eGFR_L group was 56% higher than that for the TyG_L combined with eGFR_H group (HR, 1.56; CI, 1.33–1.82). In the renal insufficiency population, a nonlinear relationship was observed between mortality and the TyG index, albeit with a differing pattern ( P for nonlinearity < 0.001).
Conclusions
While it has been known that TyG index was a prognosis marker of CVD, this research highlights that higher TyG index was associated with higher all-cause mortality rates for all participants. Furthermore, renal function status significantly moderates the effect of the TyG index on all-cause mortality in community-dwelling adults.
... Similarly, Park et al. pointed out that the TyG index served as an independent indicator for the presence of coronary heart disease (CHD), particularly mixed coronary artery plaques or non-calcified [31]. Another cohort study conducted by Liu et al. showed that a TyG index exceeding 9.20 was significantly linked to an increased susceptibility to AF in Americans without known cardiovascular diseases [32]. ...
Background
Insulin resistance (IR) can be effectively assessed using the dependable surrogate biomarker triglyceride-glucose (TyG) index. In various critical care contexts, like contrast-induced acute kidney injury (AKI), an elevated TyG index has demonstrated a robust correlation with the incidence of AKI. Nonetheless, the potential of the TyG index to predict AKI in critically ill patients with heart failure (HF) remains uncertain.
Methods
A cohort of participants was non-consecutively selected from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database and divided into quartiles based on their TyG index values. The incidence of AKI was the primary outcome. The secondary endpoint was in-hospital mortality within both the whole study population and the subset of AKI patients. The use of the renal replacement therapy (RRT) which represented the progression of AKI severity was also included as a secondary endpoint representing renal outcome. A restricted cubic splines model and Cox proportional hazards models were utilized to evaluate the association of TyG index with the risk of AKI in patients with HF in a critical condition. Kaplan-Meier survival analysis was employed to estimate primary and secondary endpoint disparities across groups differentiated by their TyG index.
Results
This study included a total of 1,393 patients, with 59% being male. The incidence of AKI was 82.8%. Cox proportional hazards analyses revealed a significant association between TyG index and the incidence of AKI in critically ill patients with HF. The restricted cubic splines model illustrated the linear relationship between higher TyG index and increased risk of AKI in this specific patient population. Furthermore, the Kaplan-Meier survival analyses unveiled statistically significant differences in the use of RRT across the subset of AKI patients based on the quartiles of the TyG index.
Conclusions
The results highlight the TyG index as a robust and independent predictor of the incidence of AKI and poor renal outcome in patients with HF in a critical condition. However, further confirmation of causality necessitates larger prospective studies.
... Current studies have discovered an established association between the TyG index and several diseases, including hypertension [4], carotid atherosclerosis [5], stroke [6], CVD [7], and coronary artery stenosis [8]. However, in Americans, studies on the prevalence and associated cardiovascular risk of the TyG index are limited [9,10]. ...
Background The triglyceride glucose (TyG) index, a metric for estimating insulin resistance (IR), is linked with cardiovascular disease (CVD) morbidity and mortality among the population regardless of diabetic status. However, IR
prevalence and the association between the TyG index and heart failure (HF) in Americans is unclear.
Methods The Nation Health and Nutrition Examination Survey (NHANES) (2009–2018) dataset was used. IR was
defined by homeostatic model assessment of insulin resistance (HOMA-IR) > 2.0 and 1.5. The TyG index was calculated
as Ln [fasting triglycerides (mg/dL)×fasting glucose (mg/dL)/2]. A weighted logistic regression was applied to evaluate the association between the TyG index and the prevalence of HF.
Results This study comprised 12,388 people, including 322 (2.6%) individuals with HF. The average prevalence of
IR was found to be 13.9% and 22.7% for cutoff values greater than 2.0 and 1.5, respectively. HOMA-IR and the TyG
index showed a moderate correlation (r=0.30). There is a significant positive association between the TyG index and
HF prevalence (per 1-unit increment; adjusted OR [aOR]: 1.34; 95% confidence interval [CI]: 1.02–1.76). Patients with
higher TyG values were associated with a prevalence of HF (OR:1.41; 95% CI: 1.01,1.95) (quartiles 4 vs 1–3). The TyG
index is associated with a higher prevalence of dyslipidemia, coronary heart disease, and hypertension but not a
stroke (cerebrovascular disease).
Conclusions Our results show that IR does not considerably increase from 2008 to 2018 in American adults. A moderate correlation is noted between HOMA-IR and the TyG index. TyG index is associated with the prevalence of HF, as
were other cardiovascular diseases
