Triglyceride-Glucose Index and Cardiovascular Risk Assessment

The triglyceride-glucose (TyG) index is an emerging, cost-effective surrogate marker of insulin resistance calculated from fasting triglyceride and glucose concentrations. Insulin resistance underlies a spectrum of cardiometabolic disturbances, including dyslipidaemia, endothelial dysfunction and chronic low-grade inflammation, all of which contribute to atherosclerotic plaque formation and cardiovascular events. The TyG index has garnered attention owing to its simplicity and strong association with established risk factors such as obesity, hypertension and dysglycaemia. Epidemiological evidence indicates that elevated TyG index values correlate with both subclinical vascular damage—measured by arterial stiffness, carotid intima–media thickness and coronary calcification—and hard cardiovascular outcomes, including myocardial infarction, stroke and all-cause mortality. Threshold values have been proposed to optimise risk stratification, though these vary by population. The index’s broad applicability across diverse ethnicities and its predictive value beyond traditional lipid ratios underscore its potential utility in routine cardiovascular risk assessment and in guiding preventive interventions.

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Triglyceride-Glucose Index and Cardiovascular Risk Assessment publication trend

The graph below shows the total number of articles in triglyceride-glucose index and cardiovascular risk assessment across all publications each year (not limited to Nature Index journals).

Technical terms

Triglyceride-Glucose (TyG) Index: A logarithmic calculation combining fasting triglyceride and glucose levels that serves as a surrogate marker of insulin resistance.

Insulin Resistance: A metabolic state in which target tissues exhibit diminished responsiveness to insulin, leading to impaired glucose uptake, dysregulated lipid metabolism and pro-inflammatory signalling.

Atherosclerotic Cardiovascular Disease (ASCVD): A spectrum of conditions—such as coronary artery disease and stroke—arising from the accumulation of lipid-rich plaques within arterial walls, compromising blood flow and promoting thrombotic events.

Homeostasis Model Assessment of Insulin Resistance (HOMA-IR): A method to estimate insulin resistance using fasting glucose and insulin concentrations, often used as a comparator to validate the TyG index.

References

1. The triglyceride-glucose index is a predictor for cardiovascular and all-cause mortality in CVD patients with diabetes or pre-diabetes: evidence from NHANES 2001–2018. Cardiovascular Diabetology (2023).
2. Triglyceride-glucose index as a marker in cardiovascular diseases: landscape and limitations. Cardiovascular Diabetology (2022).
3. Diagnostic Accuracy of the Triglyceride and Glucose Index for Insulin Resistance: A Systematic Review. International Journal of Endocrinology (2020).
4. Clinical usefulness of lipid ratios, visceral adiposity indicators, and the triglycerides and glucose index as risk markers of insulin resistance. Cardiovascular Diabetology (2014).
5. Association between triglyceride glucose index and arterial stiffness in Korean adults. Cardiovascular Diabetology (2018).
6. Triglyceride–glucose index and the incidence of atherosclerotic cardiovascular diseases: a meta-analysis of cohort studies. Cardiovascular Diabetology (2021).
7. The triglyceride glucose index is a simple and low-cost marker associated with atherosclerotic cardiovascular disease: a population-based study. BMC Medicine (2020).
8. Relationship between the triglyceride glucose index and coronary artery calcification in Korean adults. Cardiovascular Diabetology (2017).