Why the study?
Surrogate markers of insulin resistance have been linked to the occurrence and severity of coronary artery disease, but evidence remains limited.
Do surrogate markers of insulin resistance (TyG index and TG/HDL-C ratio) predict the presence and severity of coronary artery disease in patients undergoing initial coronary angiography?
Do surrogate markers of insulin resistance (TyG index and TG/HDL-C ratio) predict the presence and severity of coronary artery disease in patients undergoing initial coronary angiography?
Surrogate markers of insulin resistance, specifically the TyG index and TG/HDL-C ratio, demonstrate high positive predictive value for identifying the presence and severity of angiographically confirmed CAD.
BACKGROUND: The triglyceride-to-high-density lipoprotein cholesterol (TG/HDL-C) ratio, Metabolic Score for Insulin Resistance (METS-IR), triglyceride-glucose (TyG) index, and triglyceride-glucose body mass index (TyG-BMI) have been associated with the occurrence and severity of coronary artery disease (CAD), although evidence remains limited. METHODS: . RESULTS: A positive correlation was found between CAD and the TyG index (ρ = 0.083, p = 0.008). Patients with CAD had a significantly elevated TyG index (9.02 ± 0.62) compared to those with single-vessel disease (SVD) (8.87 ± 0.59) (p = 0.012). A strong association was observed between CAD and the TG/HDL-C ratio (ρ = 0.114, p < 0.001). Patients with multi-vessel disease exhibited a considerably higher index (4.47 ± 2.46) compared to those with SVD (3.77 ± 2.45) (p = 0.003). The TyG index cut-off was 9.22 (27.5% sensitivity, 79.3% specificity, 82.2% positive predictive value (PPV), and 23.89% negative predictive value (NPV)), while the TG/HDL-C ratio cut-off was 3.6 (44% sensitivity, 65.2% specificity, 81.5% PPV, and 25.5% NPV). CONCLUSION: Our findings indicate that the TG/HDL-C ratio, with a cut-off point of 3.6, and the TyG index, with a threshold of 9.22, are associated with the presence of CAD. (ClinicalTrials.gov registration number: NCT06237244).
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Jahangiri et al. (2025) studied this question.
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