Comparison of the correlation between triglyceride‐glucose index and homeostasis model assessment of insulin resistance with subclinical left ventricular dysfunction

Aims/Introduction We aimed to explore the association of the triglyceride‐glucose (TyG) index and homeostasis model assessment of insulin resistance (HOMA‐IR) with subclinical left ventricular function in the general population. Materials and Methods A total of 2,850 participants with left ventricular ejection fraction ≥50% were recruited from 2017 to 2019 in Danyang. Speckle‐tracking echocardiography (Philips CX50) was used to measure global longitudinal strain (GLS). Subclinical left ventricular systolic dysfunction (LVSD) was defined as GLS < 18%. Results In univariate analyses, higher TyG index and HOMA‐‐IR were significantly associated with reduced GLS, lower E/A ratio and e', and higher E/e' ratio ( P < 0.001). After adjustment for confounders, HOMA‐IR remained significantly associated with lower GLS ( P = 0.002), whereas the TyG index showed stronger correlations with E/e' ratio ( P < 0.01). The inclusion of log‐transformed HOMA‐IR significantly improved model fit in analyses incorporating GLS and TyG index ( P = 0.004) but not in those with E/e' ratio and TyG index ( P = 0.65). Conversely, the TyG index enhanced model performance for the E/e'–HOMA‐IR association ( P < 0.001) but not for GLS–HOMA‐IR relationships ( P = 1). In addition, participants in the highest versus lowest HOMA‐IR quartile demonstrated significantly increased odds ratio of subclinical LVSD (OR = 2.22, 95% CI: 1.26–3.92; P = 0.006), while the TyG index showed no significant association with its prevalence ( P = 0.98). Conclusions In a community‐based population, elevated HOMA‐IR demonstrated a robust association with subclinical LVSD, whereas the TyG index exhibited a more pronounced correlation with early diastolic dysfunction.