The triglyceride-glucose index predicts ischemic heart disease risk in Koreans: a prospective study using National Healt
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Cardiovascular Diabetology Open Access
ORIGINAL INVESTIGATION
The triglyceride‑glucose index predicts ischemic heart disease risk in Koreans: a prospective study using National Health Insurance Service data Byoungjin Park1, Yong‑Jae Lee2,3, Hye Sun Lee4 and Dong‑Hyuk Jung1,2*
Abstract Background: Ischemic heart disease (IHD) without diabetes is considered an important challenge to human health and is associated with a poor prognosis, as well as a lack of health awareness. We prospectively investigated the rela‑ tionship between the triglyceride-glucose (TyG) index, a surrogate marker of early insulin resistance, and incident IHD risk in a large cohort of nondiabetic Korean adults using National Health Insurance Service data. Methods: We assessed 16,455 participants (8426 men and 8029 women) without diabetes using data from a health risk assessment study (HERAS) and Korea Health Insurance Review and Assessment (HIRA) data. The participants were divided into four groups according to TyG index quartiles, calculated as ln [fasting triglycerides (mg/dL) × fasting plasma glucose (mg/dL)/2]. We prospectively assessed hazard ratios (HRs) with 95% confidence intervals (CIs) for IHD using multivariate Cox proportional-hazards regression models over a 50-month period that followed the baseline survey. Results: During the follow-up period, 322 (2.0%) participants developed IHD. HRs of IHD for TyG index quartiles 2–4 were 1.61 (95% CI 1.05–2.48), 1.85 (95% CI 1.21–2.81), and 2.29 (95% CI 1.50–3.51), respectively, after adjusting for age, sex, body mass index, smoking status, alcohol intake, and physical activity. Conclusions: A higher TyG index precedes and significantly predicts future IHD among nondiabetic Koreans. Accord‑ ingly, the TyG index may be a useful measure in assessing cardiovascular risk for nondiabetic adults in the preclinical stage. Keywords: Triglyceride glucose index, Early insulin resistance, Prospective cohort study, Incident ischemic heart disease Background Ischemic heart disease (IHD) is a source of premature morbidity and mortality among middle-aged and older individuals, and it is an important challenge to human *Correspondence: [email protected] 1 Department of Family Medicine, Yonsei University College of Medicine, Yongin Severance Hospital, 363 Dongbaekjukjeondae‑ro, Giheung‑gu, Yongin‑si, Gyeonggi‑do 16995, Republic of Korea Full list of author information is available at the end of the article
health in both developing and developed countries [1]. The burden of premature IHD in an ageing population cannot be underestimated, as it is a factor that decreases quality of life and increases social burden [2]. Accordingly, assessing and identifying potential risks for IHD in the preclinical stage is worthwhile, facilitating disease prevention and slowing the progression of IHD. Accumulating evidence suggests that the triglyceride-glucose (TyG) index, a simple and widely accessible measure, is a novel and surrogate marker for early insulin
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