Association between triglyceride-glucose index and the risk of cardiometabolic diseases in metabolically healthy obese individuals: a prospective cohort study

Background Metabolically healthy obese (MHO) individuals meet the criteria for obesity with normal blood glucose and lipid metabolism parameters, absence of hypertension, and no concurrent cardiovascular diseases. However, the association between the triglyceride-glucose (TyG) index and the risk of cardiometabolic disease (CMD) in MHO individuals remains unclear. Methods and results This study included obese individuals who underwent health examinations at Kailuan Group from 2006 to 2010, whom without a history of hypertension, diabetes, hyperlipidemia, cardiovascular disease, as the study participants. A total of 4750 participants were included in this study. The TyG index was calculated as ln[TG (mg/dL) × FPG (mg/dL)/2] and divided into four groups based on quartiles: Q1 group (<8.18); Q2 group (8.18-8.41); Q3 group (8.42-8.62); Q4 group (≥8.63). The Cox proportional hazards model was used to assess the relationship between the TyG index and risk of CMD incidence. During a median follow-up period of 11 (IQR 10.3, 11.2) years, 826 participants experienced CMD, among whom 131 participants developed coronary heart disease, 215 participants developed stroke, and 542 participants developed diabetes. After adjusting for multiple confounding factors, compared with the Q1 group, the adjusted HRs (95% CI) for CMD in the Q2-Q4 groups were 1.33 (1.03, 1.65), 1.37 (1.04, 1.82), and 2.04 (1.56, 2.68) ( P <0.0001). A similar trend was found in the subtypes of CMD in coronary heart disease, stroke, and diabetes. Restrictive cubic spline analysis revealed a linear dose-response relationship between the TyG index and the risk of CMD. Conclusions A high TyG index increases the risk of CMD in MHO individuals. Monitoring and maintaining an appropriate TyG index may contribute to the prevention of CMD risk in MHO individuals.