Liu MJ, Pei JY, Zeng C, Xing Y, Zhang YF, Tang PQ, Deng SM, Hu XQ. Triglyceride-glucose related indices as predictors for major adverse cardiovascular events and overall mortality in type-2 diabetes mellitus patients. World J Diabetes 2025; 16(3): 101488 [DOI: 10.4239/wjd.v16.i3.101488]
Corresponding Author of This Article
Xin-Qun Hu, MD, Chief Physician, Professor, Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, No. 139 Renmin Middle Road, Changsha 410011, Hunan Province, China. huxinqun@csu.edu.cn
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Mao-Jun Liu, Jun-Yu Pei, Cheng Zeng, Ying Xing, Yi-Feng Zhang, Pei-Qi Tang, Si-Min Deng, Xin-Qun Hu, Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan Province, China
Author contributions: Hu XQ and Liu MJ designed the study; Hu XQ, Liu MJ and Pei JY prepared the manuscript; Zeng C, Xin Y, Zhang YF, Tang PQ and Deng SM revised the draft; All authors read and approved the final manuscript.
Institutional review board statement: The study was exempt from ethical review and approval, as no additional institutional review board approval was necessary for the secondary analysis.
Informed consent statement: The data for our study are derived from the Action to Control Cardiovascular Risk in Diabetes (ACCORD). All participants completed informed consent forms before participating in the study.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The original data are available from the NHLBI BioLINCC. Some or all of the data sets generated and/or analyzed in the current study are not publicly available, but may be obtained from the corresponding author upon reasonable request at huxinqun@csu.edu.cn.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xin-Qun Hu, MD, Chief Physician, Professor, Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, No. 139 Renmin Middle Road, Changsha 410011, Hunan Province, China. huxinqun@csu.edu.cn
Received: September 16, 2024 Revised: November 5, 2024 Accepted: December 26, 2024 Published online: March 15, 2025 Processing time: 127 Days and 2.6 Hours
Abstract
BACKGROUND
Recent studies have indicated that triglyceride glucose (TyG)-waist height ratio (WHtR) and TyG-waist circumference (TyG-WC) are effective indicators for evaluating insulin resistance. However, research on the association in TyG-WHtR, TyG-WC, and the risk and prognosis of major adverse cardiovascular events (MACEs) in type 2 diabetes mellitus (T2DM) cases are limited.
AIM
To clarify the relation in TyG-WHtR, TyG-WC, and the risk of MACEs and overall mortality in T2DM patients.
METHODS
Information for this investigation was obtained from Action to Control Cardiovascular Risk in Diabetes (ACCORD)/ACCORD Follow-On (ACCORDION) study database. The Cox regression model was applied to assess the relation among TyG-WHtR, TyG-WC and future MACEs risk and overall mortality in T2DM cases. The RCS analysis was utilized to explore the nonlinear correlation. Subgroup and interaction analyses were conducted to prove the robustness. The receiver operating characteristic curves were applied to analysis the additional predicting value of TyG-WHtR and TyG-WC.
RESULTS
After full adjustment for confounding variables, the highest baseline TyG-WHtR cohort respectively exhibited a 1.353-fold and 1.420-fold higher risk for MACEs and overall mortality, than the lowest quartile group. Similarly, the highest baseline TyG-WC cohort showed a 1.314-fold and 1.480-fold higher risk for MACEs and overall mortality, respectively. Each 1 SD increase in TyG-WHtR was significantly related to an 11.7% increase in MACEs and a 14.9% enhance in overall mortality. Each 1 SD increase in TyG-WC corresponded to an 11.5% in MACEs and a 16.6% increase in overall mortality. Including these two indexes in conventional models significantly improved the predictive power for MACEs and overall mortality.
CONCLUSION
TyG-WHtR and TyG-WC were promising predictors of MACEs and overall mortality risk in T2DM cases.
Core Tip: This study demonstrates that triglyceride-glucose-related indices, namely the triglyceride glucose (TyG)-waist height ratio (WHtR) and TyG-waist circumference (TyG-WC), are significant predictors of major adverse cardiovascular events (MACEs) and overall mortality in patients with type 2 diabetes mellitus (T2DM). Including TyG-WHtR and TyG-WC in conventional cardiovascular risk models significantly improves predictive accuracy for MACEs and mortality. These indices could be valuable for early cardiovascular risk stratification and targeted intervention in T2DM management.
