Incremental prognostic value of triglyceride glucose index additional to coronary artery calcium score in asymptomatic low-risk population

Shinjeong Song, Su Yeon Choi, Hyo Eun Park, Hae Won Han, Sung Hak Park, Jidong Sung, Hae Ok Jung, Ji Min Sung, Hyuk Jae Chang

Research output: Contribution to journalArticlepeer-review

Abstract

Background: The triglyceride glucose (TyG) index has been suggested as a reliable surrogate marker of insulin resistance which is a substantial risk factor for atherosclerotic cardiovascular disease (ASCVD). Several recent studies have shown the relationship between the TyG index and cardiovascular disease; however, the role of the TyG index in coronary artery calcification (CAC) progression has not been extensively assessed especially in low-risk population. Methods: We enrolled 5775 Korean adults who had at least two CAC evaluations. We determined the TyG index using ln (fasting triglycerides [mg/dL] x fasting glucose [mg/dL]/2). The CAC progression was defined as either incident CAC in a CAC-free population at baseline or an increase of ≥ 2.5 units between the square roots of the baseline and follow-up coronary artery calcium scores (CACSs) of subjects with detectable CAC at baseline. Results: CAC progression was seen in 1,382 subjects (23.9%) during mean 3.5 years follow-up. Based on the TyG index, subjects were stratified into four groups. Follow-up CACS and incidence of CAC progression were markedly elevated with rising TyG index quartiles (group I [lowest]:17.6% vs. group II:22.2% vs. group III:24.6% vs. group IV [highest]: 31.3%, p < 0.001). In multivariate logistic regression analysis, the TyG index was independent predictor of CAC progression (odds ratio: 1.57; 95% confidence interval: 1.33 to 1.81; p < 0.001) especially in baseline CACS ≤ 100 group. Conclusion: The TyG index is an independent predictor of CAC progression in low-risk population. It adds incremental risk stratification over established factors including baseline CACS.

Original languageEnglish
Article number193
JournalCardiovascular Diabetology
Volume21
Issue number1
DOIs
StatePublished - Dec 2022
Externally publishedYes

Keywords

  • Atherosclerotic cardiovascular disease
  • Coronary artery calcification
  • Triglyceride glucose index

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