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.2024 May 18;23(1):173.
doi: 10.1186/s12933-024-02275-2.

Association of triglyceride glucose index and triglyceride glucose-body mass index with sudden cardiac arrest in the general population

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Association of triglyceride glucose index and triglyceride glucose-body mass index with sudden cardiac arrest in the general population

Shuijing Zhang et al. Cardiovasc Diabetol..

Abstract

Background: Insulin resistance (IR) significantly contributes to cardiovascular disease (CVD) development. Triglyceride glucose (TyG) index and triglyceride glucose-body mass index (TyG-BMI) are recognised as convenient proxies for IR. However, their relationship with sudden cardiac arrest (SCA) remains unclear.

Methods: This prospective cohort analysis included 355,242 UK Biobank participants with available TyG index and TyG-BMI data and no history of CVD. Cox proportional risk models assessed the association between the TyG index, TyG-BMI and SCA risk. Additionally, Accelerated Failure Time (AFT) models were employed to investigate the timing of SCA onset. The impact of dynamic increases in TyG index and TyG-BMI levels on SCA risk was examined using restricted cubic spline.

Results: Over a median follow-up period of 165.4 months (interquartile range 156.5-174 months), 1,622 cases of SCA were recorded. Multivariate Cox regression analysis revealed a 9% increase in SCA risk per standard deviation increase in TyG index (adjusted hazard ratio (aHR) = 1.09, 95% confidence interval (CI) 1.04-1.15) and an 14% increase per standard deviation increase in TyG-BMI (aHR 1.14, 95% CI 1.09-1.2). AFT models indicated earlier median times to SCA occurrence with increasing quintiles of TyG index and TyG-BMI compared to the lowest quintile (P for trend < 0.05). SCA risk was linearly (P = 0.54) and non-linearly (P = 0.007) correlated with gradual increases in TyG index and TyG-BMI levels, respectively. Sex-stratified analyses showed stronger associations in women.

Conclusions: Higher TyG index and TyG-BMI levels are associated with an increased SCA risk and earlier onset, particularly in women.

Keywords: Cohort study; Insulin resistance; Sudden cardiac arrest; Triglyceride glucose; Triglyceride glucose-body mass index.

© 2024. The Author(s).

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Flowchart of participant selection
Fig. 2
Fig. 2
A Kaplan–Meier survival curves for SCA events in the TyG index quintile group.B Kaplan–Meier survival curves for SCA events in the TyG-BMI quintile group. Participants with less than 2 years of follow-up were excluded.SCA sudden cardiac arrest,TyG index triglyceride glucose index,TyG-BMI triglyceride glucose index–body mass index
Fig. 3
Fig. 3
The relative importance of the variables in the model predicting the incidence of SCA, where importance is the chi-square statistic (χ2) minus the degrees of freedom (df) with respect to the predictor variable.SCA sudden cardiac arrest
Fig. 4
Fig. 4
TyG index, TyG-BMI data distribution, and their restricted cubic spline with SCA risk.SCA sudden cardiac arrest,TyG index triglyceride glucose index,TyG-BMI triglyceride glucose index–body mass index
Fig. 5
Fig. 5
A Adjusted median difference in time to occurrence of SCA in the second, third, fourth, and fifth quintile groups compared to the quintile group with the lowest TyG index.B Adjusted median difference in time to occurrence of SCA in the second, third, fourth, and fifth quintile groups compared to the quintile group with the lowest TyG-BMI. Median difference = median occurrence time in reference group (Q1)—median occurrence time in comparison group. Negative values indicate a delay in the onset of events, while positive values indicate an earlier onset. In the AFT model, adjustments were made for age, sex, race, TDI, physical activity, fasting time, diet score, drinking status, lowering lipids drugs, antihypertensives, insulin, and diabetes. Additional adjustment of body mass index was made in the TyG index model.TyG index triglyceride glucose index,TyG-BMI triglyceride glucose index-body mass index
Fig. 6
Fig. 6
Changes in risk of SCA per 1 standard deviation increase in TyG index and TyG-BMI were assessed, stratified by different clinical characteristics.SCA sudden cardiac arrest,TyG index triglyceride glucose index,TyG-BMI triglyceride glucose index–body mass index
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