Abstract：
OBJECTIVE: Triglyceride-glucose (TyG) index, a surrogate measure of insulin resistance, is associated with hypertension mediated organ damage (HMOD) and cardiovascular disease. This study investigated the association between TyG index and major adverse cardiovascular events (MACE) and its interaction with traditional risk factors and HMOD.
RESULTS: Healthy subjects recruited from the general population were thoroughly examined and followed for MACE using nation-wide registries. Cox proportional hazard models were used to calculate the association between TyG index and MACE occurrence. Models were adjusted for Systematic Coronary Risk Evaluation (SCORE) risk factors, pulse wave velocity, left ventricular mass index, carotid atherosclerotic plaque status, and microalbuminuria. Continuous net reclassification and Harrell\'s Concordance index (C-index) were used to assess the added prognostic value of TyG index. During a follow-up period of mean 15.4 ± 4.7 years, MACE were observed in 332 (17%) of 1970 included participants. TyG index was associated with MACE; HR = 1.44 [95%CI:1.30-1.59] per standard deviation. After adjustment for traditional cardiovascular (CV) risk factors, HR was 1.16 [95%CI:1.03-1.31]. The association between TyG index and MACE remained significant after further adjustment for each HMOD component. However, this finding was evident only in subjects aged 41 or 51 years (HR = 1.39; 95%CI:1.15-1.69). Including TyG index in a risk model based on traditional CV risk factors improved C-index with 0.005 (P = 0.042).
CONCLUSIONS: In this population-based study of healthy middle-aged subjects, TyG index was associated with MACE independently of traditional CV risk factors and HMOD. TyG index may have a potential role in future risk prediction systems.
RESULTS: Healthy subjects recruited from the general population were thoroughly examined and followed for MACE using nation-wide registries. Cox proportional hazard models were used to calculate the association between TyG index and MACE occurrence. Models were adjusted for Systematic Coronary Risk Evaluation (SCORE) risk factors, pulse wave velocity, left ventricular mass index, carotid atherosclerotic plaque status, and microalbuminuria. Continuous net reclassification and Harrell\'s Concordance index (C-index) were used to assess the added prognostic value of TyG index. During a follow-up period of mean 15.4 ± 4.7 years, MACE were observed in 332 (17%) of 1970 included participants. TyG index was associated with MACE; HR = 1.44 [95%CI:1.30-1.59] per standard deviation. After adjustment for traditional cardiovascular (CV) risk factors, HR was 1.16 [95%CI:1.03-1.31]. The association between TyG index and MACE remained significant after further adjustment for each HMOD component. However, this finding was evident only in subjects aged 41 or 51 years (HR = 1.39; 95%CI:1.15-1.69). Including TyG index in a risk model based on traditional CV risk factors improved C-index with 0.005 (P = 0.042).
CONCLUSIONS: In this population-based study of healthy middle-aged subjects, TyG index was associated with MACE independently of traditional CV risk factors and HMOD. TyG index may have a potential role in future risk prediction systems.
摘要：
目标：甘油三酯-葡萄糖（TyG）指数，胰岛素抵抗的替代指标，与高血压介导的器官损伤（HMOD）和心血管疾病有关。这项研究调查了TyG指数与主要不良心血管事件（MACE）之间的关系及其与传统危险因素和HMOD的相互作用。
结果：从普通人群中招募的健康受试者进行了全面检查，并使用全国范围的注册表进行了MACE随访。Cox比例风险模型用于计算TyG指数与MACE发生之间的关联。针对系统冠状动脉风险评估（SCORE）危险因素调整模型，脉搏波速度,左心室质量指数,颈动脉粥样硬化斑块状态，和微量白蛋白尿。连续净分类和Harrell一致性指数（C指数）用于评估TyG指数的附加预后价值。在平均15.4±4.7年的随访期间，在1970年的332名（17％）参与者中观察到MACE。TyG指数与MACE相关;每标准偏差HR=1.44[95CI:1.30-1.59]。在调整传统心血管(CV)危险因素后，HR为1.16[95CI:1.03-1.31]。在进一步调整每个HMOD成分后，TyG指数和MACE之间的关联仍然显着。然而,这一发现仅在41岁或51岁的受试者中明显(HR=1.39;95CI:1.15-1.69).在基于传统CV危险因素的风险模型中加入TyG指数使C指数提高了0.005(P=0.042)。
结论：在这项基于人群的健康中年受试者研究中，TyG指数与MACE相关，与传统CV危险因素和HMOD无关。TyG指数可能在未来风险预测系统中发挥潜在作用。
结果：从普通人群中招募的健康受试者进行了全面检查，并使用全国范围的注册表进行了MACE随访。Cox比例风险模型用于计算TyG指数与MACE发生之间的关联。针对系统冠状动脉风险评估（SCORE）危险因素调整模型，脉搏波速度,左心室质量指数,颈动脉粥样硬化斑块状态，和微量白蛋白尿。连续净分类和Harrell一致性指数（C指数）用于评估TyG指数的附加预后价值。在平均15.4±4.7年的随访期间，在1970年的332名（17％）参与者中观察到MACE。TyG指数与MACE相关;每标准偏差HR=1.44[95CI:1.30-1.59]。在调整传统心血管(CV)危险因素后，HR为1.16[95CI:1.03-1.31]。在进一步调整每个HMOD成分后，TyG指数和MACE之间的关联仍然显着。然而,这一发现仅在41岁或51岁的受试者中明显(HR=1.39;95CI:1.15-1.69).在基于传统CV危险因素的风险模型中加入TyG指数使C指数提高了0.005(P=0.042)。
结论：在这项基于人群的健康中年受试者研究中，TyG指数与MACE相关，与传统CV危险因素和HMOD无关。TyG指数可能在未来风险预测系统中发挥潜在作用。
