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Epidemiology and Population Health

Association of triglyceride-glucose index and its combination with adiposity-related indices with the incidence of myocardial infarction: a cohort study from the UK Biobank

International Journal of Obesity volume 48, pages 1498–1505 (2024)Cite this article

Subjects

Abstract

Background

The triglyceride-glucose (TyG) index performs better at reflecting insulin resistance when combined with waist circumference (WC), body mass index (BMI), and waist-to-height ratio (WHtR) than when used alone. This study aimed to prospectively examine the relationships between TyG, TyG-BMI, TyG-WC, and TyG-WHtR with the incidence of myocardial infarction (MI) and its subtypes.

Methods

This cohort study included 370,390 participants from the UK Biobank. The Cox proportional hazards model and restricted cubic spline regression model were used to assess the associations of TyG, TyG-BMI, TyG-WC, and TyG-WHtR with MI, ST-elevation MI (STEMI) and non-ST-elevation MI (NSTEMI). The receiver operating characteristic (ROC) curve and the area under the curve (AUC) were employed to examine the predictive value of four indicators.

Results

The hazard ratios (HRs) and 95% confidence intervals (CIs) of MI in the highest quartiles for TyG, TyG-BMI, TyG-WC, and TyG-WHtR were 1.36 (1.28–1.44), 1.47 (1.39–1.56), 1.53 (1.43–1.64), and 1.58 (1.48–1.68) in the fully-adjusted model. Comparable findings were observed when the outcomes were reclassified as STEMI or NSTEMI. However, the associations of TyG-BMI, TyG-WC, and TyG-WHtR with the risk of STEMI were weaker than MI and NSTEMI. A linear dose-response association between TyG and the risk of MI and NSTEMI were demonstrated. TyG-BMI, TyG-WC, and TyG-WHtR all showed nonlinear patterns in their associations with the risk of MI, STEMI, and NSTEMI. TyG-WC was most effective in diagnosing MI (AUC: 0.648, 95% CI: 0.644–0.653), STEMI (AUC: 0.631, 95% CI: 0.622–0.639), and NSTEMI (AUC: 0.647, 95% CI: 0.641–0.654).

Conclusion

The TyG index was linearly associated with increased risk of MI and NSTEMI, whereas TyG-BMI, TyG-WC, and TyG-WHtR were nonlinearly associated with increased risk of MI and NSTEMI. There were distinct patterns in the relationships between these indicators with STEMI. TyG-WC provided the best diagnostic effectiveness for MI, STEMI, and NSTEMI.

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Fig. 1: A flowchart for the study population screening.
Fig. 2: Dose-response relations of TyG, TyG-BMI, TyG-WC, and TyG-WHtR with the risk of MI (A1-A4), STEMI (B1-B4), and NSTEMI (C1-C4).
Fig. 3: The receiver operating characteristic (ROC) curves for the diagnostic value of TyG, TyG-BMI, TyG-WC, and TyG-WHtR in diagnosing MI (A), STEMI (B), and NSTEMI (C).

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Data availability

The UK Biobank data are available on application through approval and oversight by the UK Biobank for reasonable requests.

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Acknowledgements

We are grateful to the UK Biobank participants. This study was carried out with the UK Biobank Resource under project 129048.

Funding

This work was supported by Sichuan Science and Technology Program (No. 24ZDYF0994) and Sichuan Cadre Health Research Project (No. Chuanganyan 2021-203).

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Author notes

  1. These authors contributed equally: Jie Zhou, Hui Huang.

Authors and Affiliations

  1. Institute of Cardiovascular Diseases & Department of Cardiology, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610072, China

    Jie Zhou, Hui Huang, Hao Huang, Jing Peng, Wenjuan Chen, Fuli Chen, Yijia Tang, Qiyong Li, Yan Xiong & Long Zhou

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Contributions

JZ, Hui Huang, and LZ analyzed the data and wrote the first draft of the manuscript. Hao Huang, JP, WC, FC, YT, and QL interpreted the data and revised the manuscript. LZ, and YX designed the study and carefully revised the manuscript. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Yan Xiong or Long Zhou.

Ethics declarations

Competing interests

Dr Long Zhou’s work has been funded by Sichuan Science and Technology Program. Dr Li’s work has been funded by Sichuan Cadre Health Research Project. The funding sources had no role in the design of the study, collection and analysis of data or decision to publish. The other authors declare no potential competing interests.

Ethics approval and consent to participate

Full ethical approval for the UK Biobank study was obtained from the North West Multi-center Research Ethics Committee (MREC) (Reference: 21/NW/0157). All procedures performed in studies involving human participants were in accordance with the 1964 Helsinki Declaration and its later amendments. Informed consent was obtained from all participants.

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Zhou, J., Huang, H., Huang, H. et al. Association of triglyceride-glucose index and its combination with adiposity-related indices with the incidence of myocardial infarction: a cohort study from the UK Biobank. Int J Obes 48, 1498–1505 (2024). https://doi.org/10.1038/s41366-024-01612-5

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