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Abstract：
BACKGROUND: Triglyceride-glucose (TyG) index is an emerging surrogate indicator of insulin resistance, which has been demonstrated as a risk factor for various cardiovascular diseases including coronary syndrome, in-stent restenosis, and heart failure. However, association of TyG index with incident aortic dissection (AD) and aortic aneurysm (AA) remains to be investigated.
METHODS: This study included 420,292 participants without baseline AD/AA from the large-scale prospective UK Biobank cohort. The primary outcome was incident AD/AA, comprising AD and AA. Multivariable-adjusted Cox proportional hazards regression models and restricted cubic spline (RCS) analyses were applied to assess the relationship between TyG index and the onset of AD/AA. In addition, the association between TyG index and incident AD/AA was examined within subgroups defined by age, gender, smoking status, drinking status, diabetes, hypertension, and BMI.
RESULTS: Over a median follow-up period of 14.8 (14.1, 15.5) years, 3,481 AD/AA cases occurred. The incidence of AD/AA rose along with elevated TyG index. RCS curves showed a linear trend of TyG index with risk of incident AD/AA. TyG index was positively associated with risk of incident AD/AA after adjusting for age, gender, smoking status, drinking status, BMI, hypertension, LDL-c, and HbA1c, with adjusted HRs of 1.0 (reference), 1.20 (95% CI 1.08-1.35), 1.21 (95% CI 1.08-1.35), and 1.30 (95% CI 1.16-1.45) for TyG index quartiles 2, 3, and 4, respectively. Especially, participants in the highest TyG index quartile had highest risk of developing AA, with an adjusted HR of 1.35 (95% CI 1.20-1.52).
CONCLUSIONS: TyG index is independently associated with a higher risk of incident AD/AA, indicating the importance of using TyG index for risk assessment of AD/AA, especially for AA.
METHODS: This study included 420,292 participants without baseline AD/AA from the large-scale prospective UK Biobank cohort. The primary outcome was incident AD/AA, comprising AD and AA. Multivariable-adjusted Cox proportional hazards regression models and restricted cubic spline (RCS) analyses were applied to assess the relationship between TyG index and the onset of AD/AA. In addition, the association between TyG index and incident AD/AA was examined within subgroups defined by age, gender, smoking status, drinking status, diabetes, hypertension, and BMI.
RESULTS: Over a median follow-up period of 14.8 (14.1, 15.5) years, 3,481 AD/AA cases occurred. The incidence of AD/AA rose along with elevated TyG index. RCS curves showed a linear trend of TyG index with risk of incident AD/AA. TyG index was positively associated with risk of incident AD/AA after adjusting for age, gender, smoking status, drinking status, BMI, hypertension, LDL-c, and HbA1c, with adjusted HRs of 1.0 (reference), 1.20 (95% CI 1.08-1.35), 1.21 (95% CI 1.08-1.35), and 1.30 (95% CI 1.16-1.45) for TyG index quartiles 2, 3, and 4, respectively. Especially, participants in the highest TyG index quartile had highest risk of developing AA, with an adjusted HR of 1.35 (95% CI 1.20-1.52).
CONCLUSIONS: TyG index is independently associated with a higher risk of incident AD/AA, indicating the importance of using TyG index for risk assessment of AD/AA, especially for AA.
摘要：
背景：甘油三酯-葡萄糖（TyG）指数是胰岛素抵抗的新兴替代指标，已被证明是包括冠状动脉综合征在内的各种心血管疾病的危险因素，支架内再狭窄,和心力衰竭。然而,TyG指数与主动脉夹层（AD）和主动脉瘤（AA）的相关性仍有待研究。
方法：本研究纳入了420,292名无基线AD/AA的大规模前瞻性英国生物库队列参与者。主要结果是AD/AA，包括AD和AA。应用多变量调整的Cox比例风险回归模型和限制性三次样条（RCS）分析来评估TyG指数与AD/AA发病之间的关系。此外,在按年龄定义的亚组中检查了TyG指数与AD/AA之间的关联，性别,吸烟状况,饮酒状况,糖尿病,高血压,BMI。
结果：在14.8（14.1，15.5）年的中位随访期内，发生3,481例AD/AA病例。随着TyG指数的升高，AD/AA的发病率上升。RCS曲线显示TyG指数与AD/AA发病风险呈线性趋势。校正年龄后，TyG指数与AD/AA发病风险呈正相关，性别,吸烟状况,饮酒状况,BMI,高血压,LDL-c,和HbA1c,调整后的HR为1.0（参考），1.20（95%CI1.08-1.35），1.21（95%CI1.08-1.35），TyG指数四分位数2、3和4分别为1.30（95%CI1.16-1.45）。尤其是,TyG指数最高四分位数的参与者患AA的风险最高，调整后的HR为1.35（95%CI1.20-1.52）。
结论：TyG指数与更高的AD/AA事件风险独立相关，表明使用TyG指数进行AD/AA风险评估的重要性，尤其是AA。
方法：本研究纳入了420,292名无基线AD/AA的大规模前瞻性英国生物库队列参与者。主要结果是AD/AA，包括AD和AA。应用多变量调整的Cox比例风险回归模型和限制性三次样条（RCS）分析来评估TyG指数与AD/AA发病之间的关系。此外,在按年龄定义的亚组中检查了TyG指数与AD/AA之间的关联，性别,吸烟状况,饮酒状况,糖尿病,高血压,BMI。
结果：在14.8（14.1，15.5）年的中位随访期内，发生3,481例AD/AA病例。随着TyG指数的升高，AD/AA的发病率上升。RCS曲线显示TyG指数与AD/AA发病风险呈线性趋势。校正年龄后，TyG指数与AD/AA发病风险呈正相关，性别,吸烟状况,饮酒状况,BMI,高血压,LDL-c,和HbA1c,调整后的HR为1.0（参考），1.20（95%CI1.08-1.35），1.21（95%CI1.08-1.35），TyG指数四分位数2、3和4分别为1.30（95%CI1.16-1.45）。尤其是,TyG指数最高四分位数的参与者患AA的风险最高，调整后的HR为1.35（95%CI1.20-1.52）。
结论：TyG指数与更高的AD/AA事件风险独立相关，表明使用TyG指数进行AD/AA风险评估的重要性，尤其是AA。
