High triglyceride-glucose index in young adulthood is associated with incident cardiovascular disease and mortality in later life: insight from the CARDIA study

Abstract Background This study aimed to investigate the associations between the triglyceride-glucose (TyG) index in young adulthood with incident cardiovascular disease (CVD) and mortality. Methods We included 4,754 participants from the Coronary Artery Risk Development in Young Adults study at bas...

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Main Authors: Xinghao Xu, Rihua Huang, Yifen Lin, Yue Guo, Zhenyu Xiong, Xiangbin Zhong, Xiaomin Ye, Miaohong Li, Xiaodong Zhuang, Xinxue Liao
Format: Article
Language:English
Published: BMC 2022-08-01
Series:Cardiovascular Diabetology
Subjects:
Online Access:https://doi.org/10.1186/s12933-022-01593-7
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author Xinghao Xu
Rihua Huang
Yifen Lin
Yue Guo
Zhenyu Xiong
Xiangbin Zhong
Xiaomin Ye
Miaohong Li
Xiaodong Zhuang
Xinxue Liao
author_facet Xinghao Xu
Rihua Huang
Yifen Lin
Yue Guo
Zhenyu Xiong
Xiangbin Zhong
Xiaomin Ye
Miaohong Li
Xiaodong Zhuang
Xinxue Liao
author_sort Xinghao Xu
collection DOAJ
description Abstract Background This study aimed to investigate the associations between the triglyceride-glucose (TyG) index in young adulthood with incident cardiovascular disease (CVD) and mortality. Methods We included 4,754 participants from the Coronary Artery Risk Development in Young Adults study at baseline. The TyG index was calculated as ln (fasting TG [mg/dl] × fasting glucose [mg/dl]/2), and the TyG index trajectories were identified by using the latent class growth mixture model. We evaluated the association between the baseline and trajectories of the TyG index with incident CVD events and all-cause mortality using Cox proportional hazards regression analysis. The added value of the TyG index included in pooled cohort equations for CVD prediction was also analyzed. Results Among 4754 participants (mean age 24.72 years, 45.8% male, 51.2% black), there were 158 incident CVD events and 246 all-cause mortality during a median 25 years follow-up. After adjusting for multiple confounding variables, each one-unit increase in the TyG index was associated with a 96% higher CVD risk (hazard ratio [HR] 1.96, 95% confidence interval [CI] 1.44–2.66) and a 85% higher all-cause mortality risk (HR 1.85, 95% CI 1.45–2.36). Three distinct trajectories of the TyG index along the follow-up duration were identified: low (44.0%), moderate (45.5%), and high (10.5%). Compared with those participants in the low TyG index trajectory group, those in the high TyG index trajectory group had a greater risk of CVD events (HR 2.35, 95% CI 1.34–4.12) and all-cause mortality (HR 3.04, 95% CI 1.83–5.07). The addition of baseline TyG index to pooled cohort equations for CVD improved the C-statistics (P < 0.001), integrated discrimination improvement value (P < 0.001), and category-free net reclassification improvement value (P = 0.003). Conclusions Higher baseline TyG index levels and higher long-term trajectory of TyG index during young adulthood were significantly associated with an increased risk of incident CVD events and all-cause mortality in later life.
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spelling doaj.art-48226c3af03e47f595c6154e69dddcee2022-12-22T02:45:51ZengBMCCardiovascular Diabetology1475-28402022-08-0121111210.1186/s12933-022-01593-7High triglyceride-glucose index in young adulthood is associated with incident cardiovascular disease and mortality in later life: insight from the CARDIA studyXinghao Xu0Rihua Huang1Yifen Lin2Yue Guo3Zhenyu Xiong4Xiangbin Zhong5Xiaomin Ye6Miaohong Li7Xiaodong Zhuang8Xinxue Liao9Department of Cardiology, First Affiliated Hospital of Sun Yat-Sen UniversityDepartment of Cardiology, First Affiliated Hospital of Sun Yat-Sen UniversityDepartment of Cardiology, First Affiliated Hospital of Sun Yat-Sen UniversityDepartment of Cardiology, First Affiliated Hospital of Sun Yat-Sen UniversityDepartment of Cardiology, First Affiliated Hospital of Sun Yat-Sen UniversityDepartment of Cardiology, First Affiliated Hospital of Sun Yat-Sen UniversityDepartment of Cardiology, First Affiliated Hospital of Sun Yat-Sen UniversityDepartment of Cardiology, First Affiliated Hospital of Sun Yat-Sen UniversityDepartment of Cardiology, First Affiliated Hospital of Sun Yat-Sen UniversityDepartment of Cardiology, First Affiliated Hospital of Sun Yat-Sen UniversityAbstract Background This study aimed to investigate the associations between the triglyceride-glucose (TyG) index in young adulthood with incident cardiovascular disease (CVD) and mortality. Methods We included 4,754 participants from the Coronary Artery Risk Development in Young Adults study at baseline. The TyG index was calculated as ln (fasting TG [mg/dl] × fasting glucose [mg/dl]/2), and the TyG index trajectories were identified by using the latent class growth mixture model. We evaluated the association between the baseline and trajectories of the TyG index with incident CVD events and all-cause mortality using Cox proportional hazards regression analysis. The added value of the TyG index included in pooled cohort equations for CVD prediction was also analyzed. Results Among 4754 participants (mean age 24.72 years, 45.8% male, 51.2% black), there were 158 incident CVD events and 246 all-cause mortality during a median 25 years follow-up. After adjusting for multiple confounding variables, each one-unit increase in the TyG index was associated with a 96% higher CVD risk (hazard ratio [HR] 1.96, 95% confidence interval [CI] 1.44–2.66) and a 85% higher all-cause mortality risk (HR 1.85, 95% CI 1.45–2.36). Three distinct trajectories of the TyG index along the follow-up duration were identified: low (44.0%), moderate (45.5%), and high (10.5%). Compared with those participants in the low TyG index trajectory group, those in the high TyG index trajectory group had a greater risk of CVD events (HR 2.35, 95% CI 1.34–4.12) and all-cause mortality (HR 3.04, 95% CI 1.83–5.07). The addition of baseline TyG index to pooled cohort equations for CVD improved the C-statistics (P < 0.001), integrated discrimination improvement value (P < 0.001), and category-free net reclassification improvement value (P = 0.003). Conclusions Higher baseline TyG index levels and higher long-term trajectory of TyG index during young adulthood were significantly associated with an increased risk of incident CVD events and all-cause mortality in later life.https://doi.org/10.1186/s12933-022-01593-7Triglyceride-glucose indexCardiovascular diseaseMortality
spellingShingle Xinghao Xu
Rihua Huang
Yifen Lin
Yue Guo
Zhenyu Xiong
Xiangbin Zhong
Xiaomin Ye
Miaohong Li
Xiaodong Zhuang
Xinxue Liao
High triglyceride-glucose index in young adulthood is associated with incident cardiovascular disease and mortality in later life: insight from the CARDIA study
Cardiovascular Diabetology
Triglyceride-glucose index
Cardiovascular disease
Mortality
title High triglyceride-glucose index in young adulthood is associated with incident cardiovascular disease and mortality in later life: insight from the CARDIA study
title_full High triglyceride-glucose index in young adulthood is associated with incident cardiovascular disease and mortality in later life: insight from the CARDIA study
title_fullStr High triglyceride-glucose index in young adulthood is associated with incident cardiovascular disease and mortality in later life: insight from the CARDIA study
title_full_unstemmed High triglyceride-glucose index in young adulthood is associated with incident cardiovascular disease and mortality in later life: insight from the CARDIA study
title_short High triglyceride-glucose index in young adulthood is associated with incident cardiovascular disease and mortality in later life: insight from the CARDIA study
title_sort high triglyceride glucose index in young adulthood is associated with incident cardiovascular disease and mortality in later life insight from the cardia study
topic Triglyceride-glucose index
Cardiovascular disease
Mortality
url https://doi.org/10.1186/s12933-022-01593-7
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