Why the study?
The association between the triglyceride glucose index and CVD mortality with respect to young age, controlled LDL-C levels, and established diabetes in the general adult population required investigation.
An elevated triglyceride glucose (TyG) index is independently associated with a higher risk of cardiovascular disease mortality over 11.7 years, even in young adults (18–44 years), individuals with controlled LDL-C (<100 mg/dL), or those with established diabetes.
TyG index elevation was associated with higher CVD mortality in young adults; leaves open its value for risk stratification in prospective studies.
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.
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Won et al. (2026) studied this question.
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