Triglyceride-Glucose Index Variability and Incident Cardiovascular Disease: A Prospective Cohort Study

Background: Recent studies have suggested that triglyceride-glucose (TyG) index is an independent predictor of cardiovascular disease (CVD). However, the impact of long-term visit-to-visit variability in TyG index on risk of CVD is not known. We aimed to investigate the longitudinal association between baseline and mean TyG index as well as TyG variability and incident CVD in a Chinese population. Methods: : We included 52,925 participants without previous history of CVD in the Kailuan study who underwent three health examinations (2006, 2008, and 2010) and were followed-up for clinical events until 2019. TyG index was calculated as Ln [fasting triglyceride (mg/dL) × fasting glucose (mg/dL)/2]. We measured the TyG variability as the SD of the residuals obtained from a linear regression on the three TyG measurements for each individual. Multivariate-adjusted Cox models were used to estimate the adjusted hazard ratio (aHR) and 95% confidence interval (CI). Results: : During a median follow-up time of 9.0 years, 2,745 developed CVD. The highest tertile (T3) of baseline and mean TyG index were each associated with higher CVD incidence as compared with the lowest tertile (T1) group: aHR, 1.35; 95% CI, 1.20-1.51; and aHR, 1.42; 95% CI, 1.27-1.60, respectively. Tertile 3 of TyG variability was associated with increased CVD incidence compared to T1 group (aHR, 1.13; 95% CI, 1.03-1.24). Individuals in the highest tertile of baseline TyG and the highest tertile of TyG variability experienced the highest incidence of CVD (aHR, 1.30; 95% CI, 1.10-1.53). Conclusion: Higher TyG level and greater TyG variability were each independently associated with a higher incidence of CVD.