January 3, 2024Cardiovascular DiabetologyOpen Access

Relationship between triglyceride-glucose index baselines and trajectories with incident cardiovascular diseases in the elderly population

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Why the study?

Prospective cohort studies had not simultaneously evaluated baseline and multi-timepoint trajectory assessments of the triglyceride-glucose index regarding incident cardiovascular diseases and their subtypes in elderly participants.

Does a higher baseline and increasing trajectory of the triglyceride-glucose (TyG) index increase the risk of incident cardiovascular diseases in the elderly population?

Structured PICO

Does a higher baseline and increasing trajectory of the triglyceride-glucose (TyG) index increase the risk of incident cardiovascular diseases in the elderly population?

Population

20,185 elderly participants (aged 60 and above), mean age 76.9 years, 41.7% male, from Shandong Province, China (Cheeloo LEAD cohort).

Intervention

High baseline triglyceride-glucose (TyG) index (highest quartile) and medium stable or high gradual increase trajectories of TyG index

Comparator

Low baseline TyG index (lowest quartile) and low gradual increase trajectory

Outcome

Incident (new-onset) cardiovascular diseases (CVDs), including coronary heart disease, cerebrovascular disease, peripheral arterial disease, rheumatic heart disease, deep vein thrombosis and pulmonary embolismhard clinical

High baseline levels and increasing trajectories of the triglyceride-glucose index are associated with an elevated risk of developing cardiovascular diseases in the elderly, suggesting its utility as an early warning biomarker.

Implication

May aid elderly CVD risk stratification via TyG trajectories; extends prior associations but leaves causal effects open.

Abstract

BACKGROUND: The triglyceride-glucose (TyG) index is regarded as a sophisticated surrogate biomarker for insulin resistance, offering a refined means for evaluating cardiovascular diseases (CVDs). However, prospective cohort studies have not simultaneously conducted baseline and multi-timepoint trajectory assessments of the TyG index in relation to CVDs and their subtypes in elderly participants. METHODS: After excluding data deficiencies and conditions that could influence the research outcomes, this study ultimately incorporated a cohort of 20,185 participants, with data chronicles extending from 2016 to 2022. The TyG index was calculated as Ln [fasting triglyceride (mg/dL) × fasting glucose (mg/dL)/2]. Latent Class Trajectory Model (LCTM) was used to assess the change trends of the TyG index over multiple time points. Utilizing the Cox proportional-hazards models, we assessed the relationship between the baseline quartiles of the TyG index and various trajectories with CVDs and subtypes. RESULTS: During the mean follow-up time of 4.25 years, 11,099 patients experienced new CVDs in the elderly population. After stratifying by baseline TyG quartiles, the higher TyG level was associated with an increased risk of CVDs; the aHR and 95% CI for the highest quartile group were 1.28 (1.19-1.39). Five trajectory patterns were identified by the LCTM model. The low gradual increase group as the reference, the medium stable group, and the high gradual increase group exhibited an elevated risk of CVDs onset, aHR and 95%CIs were 1.17 (1.10-1.25) and 1.25 (1.15-1.35). Similar results were observed between the trajectories of the TyG index with subtypes of CVDs. CONCLUSION: Participants with high levels of baseline TyG index and medium stable or high gradual increase trajectories were associated with an elevated risk of developing CVDs in elderly populations.