Mortality from cardiovascular disease related to the mean levels of triglyceride glucose index in a population of 8.9 million adults during a follow-up of 11.7 years
K Won, H J ChangAbstract
Aims
This study aimed to examine the association between triglyceride glucose (TyG) index and mortality from cardiovascular disease (CVD) concerning clinical conditions of young age, controlled low-density lipoprotein cholesterol (LDL-C) levels, and established diabetes in the general population of adults.
Methods and Results
From the Korean National Health Insurance Service database between 2011 and 2012, 8922312 adults aged 18–99 years old who underwent routine health examinations and had no previous history of CVD or cancer were enrolled in this study. The mean levels of TyG index calculated using the formula of ln (fasting triglycerides [mg/dL] × fasting glucose [mg/ dL]/2) during a follow-up period were used in the analyses. Hazard ratio (HR) for mortality from overall CVD, ischemic heart disease (IHD), acute myocardial infarction (AMI), hemorrhagic stroke (HStr), ischemic stroke (IStr), and heart failure (HF) was analyzed using the Cox proportional regression models after adjusting for various confounders. During a mean of 11.7 years of follow-up, 83220 subjects died of CVD. In participants aged 18−44 years old, TyG index (per 1.0-unit increase) was significantly associated with adjusted HR of mortality from overall CVD (1.19, 95% confidence interval [CI] 1.09−1.30), IHD (1.46, 95% CI 1.25−1.71), AMI (1.46, 95% CI 1.19−1.78), and IStr (2.57, 95% CI 1.46−4.52) (All P <0.001) but was not associated with adjusted HR of mortality from HStr (0.97, 95% CI 0.83−1.14; P = 0.756) and HF (1.13, 95% CI 0.65−1.97; P = 0.655). Among participants with LDL-C <100 mg/dL or those with diabetes, TyG index was independently associated with the mortality from overall CVD, IHD, AMI, HStr, IStr, and HF, respectively.
Conclusion
An increase of TyG index is associated with a high risk of CVD mortality, even in adults with young age, controlled LDL-C, or established diabetes.Restricted cubic spline analysis