Characteristics Of The Study Participants' Baseline Based On TyG Index
The study analyzed the TYG index distribution among participants aged 40–85 years based on age, sex, and race/ethnicity (Table 1). The results showed that the mean age was significantly lower for participants with TYG index ≤ 8.22 (58 ± 13 years) compared to those with TYG index of 8.23-8.60 (60 ± 13 years), 8.61-9.01 (61 ± 13 years), and 9.02+ (60 ± 13 years), respectively. The proportion of males decreased from 55.9% in the TYG index category of 9.02+ to 43.0% in the category of ≤ 8.22, and the proportion of females increased from 44.1% in the TYG index category of 9.02+ to 57.0% in the category of ≤ 8.22, indicating a significant association between sex and TYG index. The study also found a significant association between race/ethnicity and TYG index, with non-Hispanic blacks having the highest proportion of participants with TYG index ≤ 8.22 (33.9%) and non-Hispanic whites having the highest proportion of participants with TYG index 9.02+ (55.7%). The association between race/ethnicity and the TYG index was statistically significant (P<0.001). Similarly, participants with less than a 9th grade education had the lowest proportion of participants with a TYG index of 9.02+ at 16.9%, while those with a college degree or above had the highest proportion at 18.6%. The association between education level and the TYG index was statistically significant (P<0.001). The majority of participants were married, with 970 (57.5%) participants falling in the ≤ 8.22 TYG index, 990 (58.5%) falling in the 8.23 - 8.60 TYG index, and 1022 (60.5%) falling in the 8.61 - 9.01 TYG index, and 1080 (64.0%) falling in the 9.02+ TYG index. There was a statistically significant association between marital status and TYG index (p = 0.010). Most participants had an income of over $20,000, with 671 (70.3%) falling in the ≤ 8.22 TYG index, 752 (69.5%) falling in the 8.23 - 8.60 TYG index, 802 (69.9%) falling in the 8.61 - 9.01 TYG index, and 892 (71.0%) falling in the 9.02+ TYG index. There was no statistically significant association between annual household income and the TYG index (p = 0.886).
Lifestyle Risk Factors and TyG Index
The vast majority of participants had a habit of alcohol consumption, with 887 (90.8%) falling in the ≤ 8.22 TYG index, 736 (90.4%) falling in the 8.23 - 8.60 TYG index, 643 (91.2%) falling in the 8.61 - 9.01 TYG index, and 517 (90.2%) falling in the 9.02+ TYG index (Table 1). There was no statistically significant association between alcohol consumption and TYG index (p = 0.930). When participants were questioned about whether they worked for 35 hours or more per week, the majority of participants responded "No," with 1526 (82.8%) falling in the ≤ 8.22 TYG index, 145 (61.2%) in the 8.23 - 8.60 TYG index, 131 (64.2%) in the 8.61 - 9.01 TYG index, and 144 (62.1%) in the 9.02+ TYG index. There was no statistically significant association between usually working 35 hours or more per week and the TYG index (p = 0.928).
Most participants were not involved in vigorous work activity, with 999 (69.2%) falling in the ≤ 8.22 TYG index, 927 (68.8%) falling in the 8.23 - 8.60 TYG index, 934 (74.1%) falling in the 8.61 - 9.01 TYG index, and 817 (70.2%) fell in the 9.02+ TYG index. There was a statistically significant association between vigorous work activity and the TYG index (p = 0.012). Most participants were not habitual of cigarette smoking, with 461 (60.4%) falling in the ≤ 8.22 TYG index, 473 (56.3%) falling in the 8.23 - 8.60 TYG index, 533 (63.0%) falling in the 8.61 - 9.01 TYG index, and 564 (62.3%) falling in the 9.02+ TYG index. There was a statistically significant association between cigarette smoking and TYG index (p = 0.027).
Use Of Prescription Medications and TyG Index
The majority of participants were prescribed low-dose aspirin by a doctor, with 279 (27.2%) falling in the ≤ 8.22 TYG index, 288 (33.2%) falling in the 8.23–8.60 TYG index, 278 (37.1%) falling in the 8.61 - 9.01 TYG index, and 201 (33.9%) falling in the 9.02+ TYG index (Table 1). There was a statistically significant association between low-dose aspirin prescriptions and the TYG index (p < 0.001). The rest of the participants did not receive prescriptions for low-dose aspirin, with 748 (72.8%) in this category. Specifically, 580 (66.8%) fell in the ≤ 8.22 TYG index, 472 (62.9%) in the 8.23 - 8.60 TYG index, 392 (66.1%) in the 8.61 - 9.01 TYG index, and the remaining participants in the 9.02+ TYG index.
The majority of participants reported taking prescriptions, that is, anti-hypertensives for hypertension, with 557 (90.7%) falling in the ≤ 8.22 TYG index, 575 (89.1%) falling in the 8.23 - 8.60 TYG index, 676 (89.9%) falling in the 8.61–9.01 TYG index, and 691 (90.1%) falling in the 9.02+ TYG index. There was no statistically significant association between taking a prescription for hypertension (antihypertensive drugs) and TYG index (p = 0.831). The majority of participants reported being prescribed lipid-lowering agents for cholesterol, with 350 (34.9%) falling in the ≤ 8.22 TYG index, 413 (41.7%) falling in the 8.23–8.60 TYG index, 514 (50.4%) falling in the 8.61 - 9.01 TYG index, and 573 (55.3%) falling in the 9.02+ TYG index. There was a statistically significant association between prescriptions for cholesterol (lipid-lowering drugs) and TYG index (p < 0.001).
Baseline Characteristics and Tyg Index
The mean value for the 60-second pulse was 67 ± 11 for the ≤8.22 category, which increased to 70 ± 12 for the 9.02+ category, with a p-value of less than 0.001 (Table 1). Systolic blood pressure also showed significant differences, with mean values of 126 ± 21 for the ≤ 8.22 category, which increased to 130 ± 19 for the 9.02+ category, with a p-value of less than 0.001. Similarly, diastolic blood pressure (3rd reading) showed significant differences, with mean values of 72 ± 13 for the ≤ 8.22 category, which increased to 74 ± 13 for the 9.02+ category, with a p-value of 0.002. Body mass index (BMI) and waist circumference also showed significant differences based on the TYG index categories. The mean BMI increased from 26.8 ± 6 for the ≤ 8.22 category to 30.2 ± 5.9 for the 9.02+ category, with a p-value of less than 0.001. Similarly, the mean waist circumference increased from 93.3 ± 14.6 cm for the <= 8.22 category to 104.1 ± 13.1 cm for the 9.02+ category, with a p-value of less than 0.001.
The study also found significant differences in the lipid profile parameters. Direct HDL cholesterol levels decreased from 65 ± 17 mg/dL in the ≤ 8.22 category to 46 ± 13 mg/dL in the 9.02+ category, with a p-value of less than 0.001. Total cholesterol levels increased from 186 ± 37 mg/dL in the ≤ 8.22 category to 219 ± 48 mg/dL in the 9.02+ category, with a p-value of less than 0.001. LDL-cholesterol levels also increased from 108 ± 32 mg/dL in the ≤ 8.22 category to 127 ± 42 mg/dL in the 9.02+ category, with a p-value of less than 0.001. Similarly, apolipoprotein (B) levels increased from 88 ± 21 mg/dL in the ≤ 8.22 category to 118 ± 26 mg/dL in the 9.02+ category, with a p-value of less than 0.001. Finally, albumin levels showed significant differences based on TYG index categories, with mean values of 40 ± 3 g/L for the ≤ 8.22 category, which increased to 41 ± 3 g/L for the 9.02+ category, with a p-value of less than 0.001. However, creatinine levels in urine did not show any significant differences between the TYG index categories.
Association Between Cardiovascular Diseases and TyG Index
The prevalence of being identified with high blood pressure increased with higher TYG index categories (Table 1). Among those with TYG index scores of 8.22 or less, 36.5% reported being identified with high BP by a doctor, whereas among those with TYG index scores of 9.02 or higher, 45.5% reported being diagnosed with high blood pressure by a doctor. This relationship was also statistically significant (p < 0.001). No significant relationship was observed between TYG index categories and congestive heart failure (CHF). However, the prevalence of coronary heart disease (CHD) increases with higher TYG index categories. Among those with TYG index scores of 8.22 or less, 3.0% reported diagnosed CHD, whereas among those with TYG index scores of 9.02 or higher, 6.7% reported CHD. This relationship was statistically significant (p < 0.001).
The prevalence of stroke also showed a significant relationship with TYG index categories. Among those with TYG index scores of 8.22 or less, 3.6% reported stroke, while among those with TYG index scores of 9.02 or higher, 4.5% reported being told that they had a stroke by a doctor (p = 0.001). Similarly, the prevalence of being diagnosed with heart attack increased with higher TYG index categories. Among those with TYG index scores ≤ 8.22 or less, 3.1% reported a diagnosis of heart attack by a doctor, while among those with TYG index scores of 9.02 or higher, 7.2% reported being diagnosed with heart attack by a doctor. This relationship was statistically significant (p < 0.001). Finally, there was no significant relationship between TYG index categories and the presence of angina. However, the prevalence of definitive angina tended to be higher in those with higher TYG index scores. Among those with TYG index scores of 8.22 or less, 6.5% reported definitive angina, while among those with TYG index scores of 9.02 or higher, 8.0% reported definitive angina (p = 0.065).
Variable
|
Categories
|
TYG Index
|
<= 8.22
|
8.23 - 8.60
|
8.61 - 9.01
|
9.02+
|
P-value
|
N (%)
Mean ± SD
|
N (%)
Mean ± SD
|
N (%)
Mean ± SD
|
N (%)
Mean ± SD
|
Age
|
58 ± 13
|
60 ± 13
|
61 ± 13
|
60 ± 13
|
< 0.001
|
Gender
|
Male
|
726 (43.0%)
|
804 (47.5%)
|
843 (49.9%)
|
945 (55.9%)
|
< 0.001
|
Female
|
964 (57.0%)
|
887 (52.5%)
|
848 (50.1%)
|
745 (44.1%)
|
Race/Ethnicity
|
Mexican American
|
145 (8.6%)
|
218 (12.9%)
|
248 (14.7%)
|
330 (19.5%)
|
< 0.001
|
Other Hispanic
|
87 (5.1%)
|
108 (6.4%)
|
138 (8.2%)
|
99 (5.9%)
|
Non-Hispanic White
|
716 (42.4%)
|
792 (46.8%)
|
869 (51.4%)
|
942 (55.7%)
|
Non-Hispanic Black
|
573 (33.9%)
|
413 (24.4%)
|
265 (15.7%)
|
154 (9.1%)
|
Other Race - Including Multi-Racial
|
169 (10.0%)
|
160 (9.5%)
|
171 (10.1%)
|
165 (9.8%)
|
Education Level
|
Less Than 9th Grade
|
134 (7.9%)
|
168 (9.9%)
|
231 (13.7%)
|
286 (16.9%)
|
< 0.001
|
9-11th Grade (Includes 12th grade with no diploma)
|
196 (11.6%)
|
210 (12.4%)
|
247 (14.7%)
|
212 (12.6%)
|
High School Grad/GED or Equivalent
|
369 (21.9%)
|
443 (26.2%)
|
388 (23.0%)
|
425 (25.2%)
|
Some College or AA degree
|
522 (31.0%)
|
493 (29.2%)
|
443 (26.3%)
|
451 (26.7%)
|
College Graduate or above
|
465 (27.6%)
|
376 (22.2%)
|
375 (22.3%)
|
314 (18.6%)
|
Marital Status
|
Married
|
970 (57.5%)
|
990 (58.5%)
|
1022 (60.5%)
|
1080 (64.0%)
|
0.010
|
Widowed
|
319 (18.9%)
|
314 (18.6%)
|
308 (18.2%)
|
260 (15.4%)
|
Divorced
|
219 (13.0%)
|
210 (12.4%)
|
187 (11.1%)
|
167 (9.9%)
|
Separated
|
34 (2.0%)
|
37 (2.2%)
|
48 (2.8%)
|
32 (1.9%)
|
Never married
|
90 (5.3%)
|
88 (5.2%)
|
70 (4.1%)
|
89 (5.3%)
|
Living with partner
|
56 (3.3%)
|
52 (3.1%)
|
53 (3.1%)
|
59 (3.5%)
|
Annual Household Income
|
Under $20,000
|
284 (29.7%)
|
330 (30.5%)
|
345 (30.1%)
|
365 (29.0%)
|
0.886
|
Over $20,000
|
671 (70.3%)
|
752 (69.5%)
|
802 (69.9%)
|
892 (71.0%)
|
Ever had a drink of any kind of alcohol
|
Yes
|
887 (90.8%)
|
736 (90.4%)
|
643 (91.2%)
|
517 (90.2%)
|
0.930
|
No
|
90 (9.2%)
|
78 (9.6%)
|
62 (8.8%)
|
56 (9.8%)
|
Usually work 35 or more hours per week
|
Yes
|
90 (37.2%)
|
92 (38.8%)
|
73 (35.8%)
|
88 (37.9%)
|
0.928
|
No
|
15262.8%)
|
145 (61.2%)
|
131 (64.2%)
|
144 (62.1%)
|
Vigorous work activity
|
Yes
|
445 (30.8%)
|
421 (31.2%)
|
327 (25.9%)
|
346 (29.8%)
|
0.012
|
No
|
999 (69.2%)
|
927 (68.8%)
|
934 (74.1%)
|
817 (70.2%)
|
Do you now smoke cigarettes
|
Every day
|
247 (32.4%)
|
319 (38.0%)
|
272 (32.2%)
|
294 (32.5%)
|
0.027
|
Some days
|
55 (7.2%)
|
48 (5.7%)
|
41 (4.8%)
|
47 (5.2%)
|
Not at all
|
461 (60.4%)
|
473 (56.3%)
|
533 (63.0%)
|
564 (62.3%)
|
Dr told to take daily low-dose aspirin?
|
Yes
|
279 (27.2%)
|
288 (33.2%)
|
278 (37.1%)
|
201 (33.9%)
|
< 0.001
|
No
|
748 (72.8%)
|
580 (66.8%)
|
472 (62.9%)
|
392 (66.1%)
|
Taking prescription for hypertension (Antihypertensive drugs)
|
Yes
|
557 (90.7%)
|
575 (89.1%)
|
676 (89.9%)
|
691 (90.1%)
|
0.831
|
No
|
57 (9.3%)
|
70 (10.9%)
|
76 (10.1%)
|
76 (9.9%)
|
Told to take prescript for cholesterol (Lowering cholesterol drugs)
|
Yes
|
350 (34.9%)
|
413 (41.7%)
|
514 (50.4%)
|
573 (55.3%)
|
< 0.001
|
No
|
654 (65.1%)
|
577 (58.3%)
|
506 (49.6%)
|
463 (44.7%)
|
60 sec. pulse (30 sec. pulse * 2):
|
67 ± 11
|
68 ± 12
|
69 ± 12
|
70 ± 12
|
< 0.001
|
Systolic: Blood pressure (3rd rdg) mm Hg
|
126 ± 21
|
128 ± 21
|
129 ± 20
|
130 ± 19
|
< 0.001
|
Diastolic: Blood pressure (3rd rdg) mm Hg
|
72 ± 13
|
73 ± 13
|
73 ± 14
|
74 ± 13
|
0.002
|
Systolic: Blood pressure (4th rdg) mm Hg
|
132 ± 26
|
131 ± 22
|
134 ± 22
|
133 ± 18
|
0.535
|
Diastolic: Blood pressure (4th rdg) mm Hg
|
74 ± 15
|
72 ± 16
|
71 ± 16
|
72 ± 19
|
0.291
|
Body Mass Index (kg/m**2)
|
26.8 ± 6
|
28.5 ± 6.4
|
29.7 ± 6.9
|
30.2 ± 5.9
|
< 0.001
|
Waist Circumference (cm)
|
93.3 ± 14.6
|
98.5 ± 14.6
|
101.9 ± 14.1
|
104.1 ± 13.1
|
< 0.001
|
Direct HDL-Cholesterol (mg/dL)
|
65 ± 17
|
59 ± 16
|
53 ± 15
|
46 ± 13
|
< 0.001
|
Total cholesterol (mg/dL)
|
186 ± 37
|
196 ± 38
|
202 ± 38
|
219 ± 48
|
< 0.001
|
LDL-cholesterol (mg/dL)
|
108 ± 32
|
120 ± 34
|
124 ± 35
|
127 ± 42
|
< 0.001
|
Apolipoprotein (B) (mg/dL)
|
88 ± 21
|
98 ± 21
|
107 ± 24
|
118 ± 26
|
< 0.001
|
Albumin (g/L)
|
40 ± 3
|
40 ± 3
|
41 ± 3
|
41 ± 3
|
< 0.001
|
Creatinine, urine (mg/dL)
|
0.91 ± 0.36
|
0.93 ± 0.5
|
0.91 ± 0.37
|
0.93 ± 0.28
|
0.229
|
Doctor ever said you were overweight
|
Yes
|
420 (24.9%)
|
520 (30.8%)
|
614 (36.3%)
|
702 (41.6%)
|
< 0.001
|
No
|
1269 (75.1%)
|
1171 (69.2%)
|
1077 (63.7%)
|
987 (58.4%)
|
Ever told you had high blood pressure
|
Yes
|
616 (36.5%)
|
645 (38.3%)
|
752 (44.6%)
|
767 (45.5%)
|
< 0.001
|
No
|
1071 (63.5%)
|
1040 (61.7%)
|
934 (55.4%)
|
917 (54.5%)
|
Ever told had congestive heart failure
|
Yes
|
47 (2.8%)
|
51 (3.0%)
|
56 (3.3%)
|
73 (4.3%)
|
0.068
|
No
|
1633 (97.2%)
|
1632 (97.0%)
|
1619 (96.7%)
|
1609 (95.7%)
|
Ever told you had coronary heart disease
|
Yes
|
51 (3.0%)
|
78 (4.6%)
|
113 (6.7%)
|
113 (6.7%)
|
< 0.001
|
No
|
1632 (97.0%)
|
1605 (95.4%)
|
1568 (93.3%)
|
1570 (93.3%)
|
Ever told you had a stroke
|
Yes
|
60 (3.6%)
|
92 (5.4%)
|
111 (6.6%)
|
76 (4.5%)
|
0.001
|
No
|
1628 (96.4%)
|
1599 (94.6%)
|
1580 (93.4%)
|
1609 (95.5%)
|
Ever told you had heart attack
|
Yes
|
52 (3.1%)
|
90 (5.3%)
|
109 (6.5%)
|
121 (7.2%)
|
< 0.001
|
No
|
1638 (96.9%)
|
1601 (94.7%)
|
1577 (93.5%)
|
1566 (92.8%)
|
Angina
|
None
|
1225 (72.5%)
|
1211 (71.6%)
|
1201 (71.0%)
|
1146 (67.8%)
|
0.065
|
non-exertional chest pain
|
348 (20.6%)
|
353 (20.9%)
|
349 (20.6%)
|
393 (23.3%)
|
Possible
|
7 (0.4%)
|
16 (0.9%)
|
10 (0.6%)
|
16 (0.9%)
|
Definitive
|
110 (6.5%)
|
111 (6.6%)
|
131 (7.7%)
|
135 (8.0%)
|
Table 1: Association of baseline characteristics with TYG Index.
ANOVA for continuous variables and the Pearson chi-square test for categorical variables (Note: the ages start from 40 to 85 years).
Abbreviations: TYG: Triglyceride Glucose; LDL: Low Density Lipoprotein; HDL: High Density Lipoprotein. GED: General Educational Development Test.
Angina And TyG Index
Table 2 shows that 6762 patients were tested for angina using the diagnostic method "TYG.” Of these, 536 (7.9%) had angina. The results were further analyzed based on TYG levels, which were either high or low. Among patients with high TYG levels, 283 (8.8%) were suggestive of stroke and 2937 (91.2%) were not suggestive of stroke. Among patients with low TYG levels, 253 (7.1%) were suggestive of stroke and 3289 (92.9%) were not suggestive of stroke.
Characteristics of the study participants' baseline based on Angina categories
The study analyzed the association between angina categories and demographic variables, including age, sex, and race/ethnicity. Results showed that The mean age of patients with definitive angina was significantly higher (60 ± 12 years) than those with possible (56 ± 14 years) or non-exertional chest pain (60 ± 13 years) (p < 0.001). There were significant differences in the distribution of sex among the angina categories, with a higher percentage of females in the definitive angina group (61.0%) than in the non-exertional chest pain group (39.0%) (p < 0.001) (Table 2). Additionally, there were significant differences in the distribution of race/ethnicity among the angina categories (p < 0.001), with the highest percentage of non-Hispanic whites (55.8%) in the possible angina group and the highest percentage of non-Hispanic blacks (24.8%) in the definitive angina group.
Regarding the association between education level and angina categories, the results showed a significant difference in the distribution of education levels among angina categories (p < 0.001). Patients with less than 9th-grade education had the highest percentage in the non-exertional chest pain group (20.4%), while those with a college degree or above had the highest percentage in the definitive angina group (9.2%). The percentage of patients with possible angina was the highest among those with a high school diploma or General Educational Development Test (GED) equivalent (24.5%).
The distribution of marital status among the participants was as follows:62.1% were married, 17.2% were widowed, 10.8% were divorced, 2.1% were separated, 4.6% were never married, and 3.3% were living with a partner. The prevalence of angina differed significantly across these categories (p<0.001), with the highest prevalence observed among participants who were widowed (19.1%). Those with an annual household income < $20,000 were more likely to report non-exertional chest pain than those with an income over $20,000 (46.4% vs. 53.6%, p < 0.001).
Life Style Risk Factors and Angina Pain
Those who reported never consuming alcohol were less likely to report non-exertional chest pain than those who had (9.1% vs. 90.9%, p = 0.002) (Table 2). There was no significant difference in the prevalence of non-exertional chest pain between those who usually worked 35 hours or more per week and those who did d not. There was no significant difference in the prevalence of non-exertional chest pain between those who reported engaging in vigorous work activities and those who did not. Smoking was significantly associated with angina, with higher percentages of possible and definitive angina observed among smokers than among non-smokers (42.9% vs. 43.8% vs. 32.7%).
Prescription Medications and Angina
Daily low-dose aspirin use was also significantly associated with angina, with higher percentages of possible and definitive angina among those who did not take aspirin than among those who did (55.6% and 60.8% vs. 44.4% and 39.2%, respectively) (Table 2). However, taking a prescription for hypertension was not significantly associated with angina (p=0.508), with similar percentages observed between those with and without hypertension medication use. Additionally, there was a significant association between the prescription of cholesterol-lowering drugs and the occurrence of angina (p < 0.001). Those who were advised to take cholesterol-lowering drugs (42.4%) had a higher prevalence of angina than those who were not advised to take them (57.6%).
Baseline Characteristics and Angina
Participants with definitive angina had the highest body mass index (BMI) of 30.4 ± 7.3 kg/m² and waist circumference of 102.4 ± 15 cm, as well as lower direct HDL-cholesterol levels of 51 ± 14 mg/dL, but higher total cholesterol levels of 198 ± 41 mg/dL, LDL-cholesterol levels of 117 ± 37 mg/dL, and apolipoprotein (B) levels of 103 ± 25 mg/dL compared to those with non-exertional chest pain or no angina (Table 2). They also had a higher resting heart rate of 71 ± 13 bpm, a higher systolic blood pressure reading of 131 ± 22 mmHg, and a diastolic blood pressure reading of 75 ± 15 mmHg.
Association Between Cardiovascular Risk Factors, Diseases and Angina
The results indicated that individuals who were identified as being overweight or with high blood pressure had a higher percentage of non-exertional chest pain, possible angina, and definitive angina than those who were not told (Table 2). Moreover, among those who were identified as overweight, 39.7%, 50.0%, and 46.8% experienced non-exertional chest pain, possible angina, and definitive angina, respectively, compared with 60.3%, 50.0%, and 53.2%, respectively. Similarly, among those who were reported to have high blood pressure, 46.9%, 59.2%, and 59.8% experienced non-exertional chest pain, possible angina, and definitive angina, respectively, compared with 53.1%, 40.8%, and 40.2% among those not reported with high blood pressure. These differences were statistically significant (p <0.001), indicating a strong association between being overweight or having high blood pressure and experiencing chest pain. Additionally, the results suggest that individuals who have been diagnosed with congestive heart failure are more likely to experience non-exertional chest pain, possible angina, and definitive angina than those who have not been diagnosed, and the association was also statistically significant (p <0.001).
The results showed a significant association between stroke and angina categories (p<0.001), with a higher proportion of individuals with non-exertional chest pain and possible and definitive angina reporting having had a stroke. Similarly, there was a significant association between heart attack and angina categories (p<0.001), with a higher proportion of individuals with non-exertional chest pain and possible and definitive angina reporting a heart attack. The TYG index also showed some association with angina categories (p=0.065), with higher TYG index values being associated with possible and definitive angina.
Variable
|
Categories
|
Angina
|
None
|
Non-exertional chest pain
|
Possible
|
Definitive
|
P-value
|
N (%)
Mean ± SD
|
N (%)
Mean ± SD
|
N (%)
Mean ± SD
|
N (%)
Mean ± SD
|
Age
|
60 ± 13
|
60 ± 13
|
56 ± 14
|
60 ± 12
|
< 0.001
|
Gender
|
Male
|
2373 (49.6%)
|
731 (50.7%)
|
24 (49.0%)
|
190 (39.0%)
|
< 0.001
|
Female
|
2410 (50.4%)
|
712 (49.3%)
|
25 (51.0%)
|
297 (61.0%)
|
Race/Ethnicity
|
Mexican American
|
703 (14.7%)
|
172 (11.9%)
|
9 (18.4%)
|
57 (11.7%)
|
< 0.001
|
Other Hispanic
|
297 (6.2%)
|
85 (5.9%)
|
1 (2.0%)
|
49 (10.1%)
|
Non-Hispanic White
|
2264 (47.3%)
|
805 (55.8%)
|
23 (46.9%)
|
227 (46.6%)
|
Non-Hispanic Black
|
995 (20.8%)
|
283 (19.6%)
|
6 (12.2%)
|
121 (24.8%)
|
Other Race - Including Multi-Racial
|
524 (11.0%)
|
98 (6.8%)
|
10 (20.4%)
|
33 (6.8%)
|
Education Level
|
Less Than 9th Grade
|
567 (11.9%)
|
162 (11.2%)
|
10 (20.4%)
|
80 (16.4%)
|
< 0.001
|
9-11th Grade (Includes 12th grade with no diploma)
|
617 (12.9%)
|
161 (11.2%)
|
9 (18.4%)
|
78 (16.0%)
|
High School Grad/GED or Equivalent
|
1126 (23.6%)
|
341 (23.6%)
|
12 (24.5%)
|
146 (30.0%)
|
Some College or AA degree
|
1287 (27.0%)
|
476 (33.0%)
|
8 (16.3%)
|
138 (28.3%)
|
College Graduate or above
|
1172 (24.6%)
|
303 (21.0%)
|
10 (20.4%)
|
45 (9.2%)
|
Marital Status
|
Married
|
2965 (62.1%)
|
829 (57.5%)
|
29 (59.2%)
|
239 (49.1%)
|
< 0.001
|
Widowed
|
822 (17.2%)
|
276 (19.1%)
|
9 (18.4%)
|
94 (19.3%)
|
Divorced
|
514 (10.8%)
|
184 (12.8%)
|
8 (16.3%)
|
77 (15.8%)
|
Separated
|
99 (2.1%)
|
35 (2.4%)
|
1 (2.0%)
|
16 (3.3%)
|
Never married
|
219 (4.6%)
|
75 (5.2%)
|
2 (4.1%)
|
41 (8.4%)
|
Living with partner
|
157 (3.3%)
|
43 (3.0%)
|
0 (0.0%)
|
20 (4.1%)
|
Annual Household Income
|
Under $20,000
|
902 (28.8%)
|
286 (29.6%)
|
13 (46.4%)
|
123 (39.8%)
|
< 0.001
|
Over $20,000
|
2235 (71.2%)
|
681 (70.4%)
|
15 (53.6%)
|
186 (60.2%)
|
Ever had a drink of any kind of alcohol
|
Yes
|
1941 (89.4%)
|
604 (94.4%)
|
20 (90.9%)
|
218 (92.4%)
|
0.002
|
No
|
230 (10.6%)
|
36 (5.6%)
|
2 (9.1%)
|
18 (7.6%)
|
Usually work 35 or more hours per week
|
Yes
|
242 (37.1%)
|
78 (38.2%)
|
3 (42.9%)
|
20 (39.2%)
|
0.969
|
No
|
411 (62.9%)
|
126 (61.8%)
|
4 (57.1%)
|
31 (60.8%)
|
Vigorous work activity
|
Yes
|
1069 (28.9%)
|
355 (31.6%)
|
10 (26.3%)
|
105 (30.0%)
|
0.337
|
No
|
2636 (71.1%)
|
768 (68.4%)
|
28 (73.7%)
|
245 (70.0%)
|
Do you now smoke cigarettes
|
Every day
|
733 (32.7%)
|
261 (32.7%)
|
12 (42.9%)
|
126 (43.8%)
|
0.001
|
Some days
|
122 (5.4%)
|
45 (5.6%)
|
4 (14.3%)
|
20 (6.9%)
|
Not at all
|
1386 (61.8%)
|
491 (61.6%)
|
12 (42.9%)
|
142 (49.3%)
|
Dr told to take daily low-dose aspirin?
|
Yes
|
637 (27.7%)
|
297 (45.1%)
|
12 (44.4%)
|
100 (39.2%)
|
< 0.001
|
No
|
1661 (72.3%)
|
361 (54.9%)
|
15 (55.6%)
|
155 (60.8%)
|
Taking prescription for hypertension (Antihypertensive drugs)
|
Yes
|
1605 (90.0%)
|
609 (90.2%)
|
28 (96.6%)
|
257 (88.3%)
|
0.508
|
No
|
178 (10.0%)
|
66 (9.8%)
|
1 (3.4%)
|
34 (11.7%)
|
Told to take prescript for cholesterol (Lowering cholesterol drugs)
|
Yes
|
1175 (42.4%)
|
480 (51.6%)
|
16 (48.5%)
|
179 (57.2%)
|
< 0.001
|
No
|
1598 (57.6%)
|
451 (48.4%)
|
17 (51.5%)
|
134 (42.8%)
|
60 sec. pulse (30 sec. pulse * 2):
|
69 ± 12
|
68 ± 12
|
73 ± 13
|
71 ± 13
|
< 0.001
|
Systolic: Blood pressure (3rd rdg) mm Hg
|
128 ± 20
|
128 ± 20
|
124 ± 19
|
131 ± 22
|
< 0.001
|
Diastolic: Blood pressures (3rd rdg) mm Hg
|
73 ± 13
|
72 ± 13
|
75 ± 11
|
75 ± 15
|
0.002
|
Systolic: Blood pressure (4th rdg) mm Hg
|
132 ± 21
|
132 ± 23
|
132 ± 14
|
133 ± 25
|
0.535
|
Diastolic: Blood pressure (4th rdg) mm Hg
|
72 ± 17
|
72 ± 18
|
84 ± 11
|
71 ± 18
|
0.291
|
Body Mass Index (kg/m**2)
|
28.6 ± 6.3
|
28.8 ± 6.5
|
30.6 ± 8.9
|
30.4 ± 7.3
|
< 0.001
|
Waist Circumference (cm)
|
98.9 ± 14.4
|
100.1 ± 15.3
|
100.6 ± 13.1
|
102.4 ± 15
|
< 0.001
|
Direct HDL-Cholesterol (mg/dL)
|
55 ± 17
|
54 ± 17
|
58 ± 18
|
51 ± 14
|
< 0.001
|
Total cholesterol (mg/dL)
|
202 ± 42
|
199 ± 44
|
194 ± 42
|
198 ± 41
|
< 0.001
|
LDL-cholesterol (mg/dL)
|
121 ± 36
|
117 ± 38
|
111 ± 37
|
117 ± 37
|
< 0.001
|
Apolipoprotein (B) (mg/dL)
|
105 ± 26
|
103 ± 26
|
106 ± 25
|
103 ± 25
|
< 0.001
|
Albumin (g/L)
|
41 ± 3
|
41 ± 3
|
41 ± 3
|
40 ± 3
|
< 0.001
|
Creatinine, urine (mg/dL)
|
0.92 ± 0.37
|
0.95 ± 0.36
|
0.87 ± 0.18
|
0.94 ± 0.63
|
0.229
|
Doctor ever said you were overweight
|
Yes
|
1432 (29.9%)
|
572 (39.7%)
|
24 (50.0%)
|
228 (46.8%)
|
< 0.001
|
No
|
3351 (70.1%)
|
870 (60.3%)
|
24 (50.0%)
|
259 (53.2%)
|
Ever told you had high blood pressure
|
Yes
|
1785 (37.4%)
|
675 (46.9%)
|
29 (59.2%)
|
291 (59.8%)
|
< 0.001
|
No
|
2982 (62.6%)
|
764 (53.1%)
|
20 (40.8%)
|
196 (40.2%)
|
Ever told had congestive heart failure
|
Yes
|
68 (1.4%)
|
88 (6.2%)
|
4 (8.5%)
|
67 (14.0%)
|
< 0.001
|
No
|
4697 (98.6%)
|
1340 (93.8%)
|
43 (91.5%)
|
413 (86.0%)
|
Ever told you had coronary heart disease
|
Yes
|
122 (2.6%)
|
157 (11.0%)
|
6 (12.8%)
|
70 (14.5%)
|
< 0.001
|
No
|
4645 (97.4%)
|
1276 (89.0%)
|
41 (87.2%)
|
413 (85.5%)
|
Ever told you had a stroke
|
Yes
|
190 (4.0%)
|
97 (6.7%)
|
4 (8.2%)
|
48 (9.9%)
|
< 0.001
|
No
|
4591 (96.0%)
|
1343 (93.3%)
|
45 (91.8%)
|
437 (90.1%)
|
Ever told you had heart attack
|
Yes
|
115 (2.4%)
|
182 (12.7%)
|
1 (2.0%)
|
74 (15.2%)
|
< 0.001
|
No
|
4666 (97.6%)
|
1256 (87.3%)
|
48 (98.0%)
|
412 (84.8%)
|
TYG Index
|
<= 8.22
|
1225 (25.6%)
|
348 (24.1%)
|
7 (14.3%)
|
110 (22.6%)
|
0.065
|
8.23 - 8.60
|
1211 (25.3%)
|
353 (24.5%)
|
16 (32.7%)
|
111 (22.8%)
|
8.61 - 9.01
|
1201 (25.1%)
|
349 (24.2%)
|
10 (20.4%)
|
131 (26.9%)
|
9.02+
|
1146 (24.0%)
|
393 (27.2%)
|
16 (32.7%)
|
135 (27.7%)
|
Table 2: Association of baseline characteristics, TYG index, lifestyle risk factors, cardiovascular risk factors, and prescription medications on Angina categories. ANOVA for continuous variables and the Pearson chi-square test for categorical variables (Note: the ages start from 40 to 85 years). Abbreviations: TYG: Triglyceride Glucose; LDL: Low Density Lipoprotein; HDL: High Density Lipoprotein.
Sensitivity And Specificity of TyG Index
The sensitivity of the test was 52.8%, which means that 52.8% of the patients with angina were correctly identified as having the disease by the TYG test (Table 3). The specificity of the test was 52.83%, indicating that 52.83% of patients who did not have angina were correctly identified as not having the disease by the TYG test. The PPV of the test was 8.76%, indicating that only 8.76% of patients tested positive for angina. The NPV of the test was 92.88%, indicating that among patients who tested negative for angina, 92.88% did not have the disease. The area under the curve (AUC) was 52.82%, indicating that the TYG test had a low diagnostic accuracy for identifying patients with angina. A p-value of 0.012 indicates that the difference in results between patients with high and low TYG levels was statistically significant.
Angina
|
Diagnostic method
|
Result
|
suggestive of STROKE n (%)
|
Not
Suggestive of STROKE n (%)
|
Total n (%)
|
P-value
|
Sensitivity
Specificity
|
PPV
NPV
|
AUC
|
TYG
|
High
|
283 (8.8%)
|
2937 (91.2%)
|
3220 (47.6%
|
0.012
|
52.8%
52.83%
|
8.76%
92.88%
|
52.82%
|
Low
|
253 (7.1%)
|
3289 (92.9%)
|
3542 (52.4%)
|
Total
|
536 (7.9%)
|
6226 (92.1%)
|
6762 (100%)
|
Table 3: Sensitivity and Specificity of TyG Index (Pearson Chi-Square for P-value). Abbreviations: PPV: Positive predictive Value; NPV: Negative Predictive Value; AUC: Area Under Curve.
ROC Curve
The Receiver Operating Characteristic curve showed values of 1.0 for both sensitivity and specificity, suggesting that the diagnostic test being evaluated is a perfect test, which means it correctly identifies all patients with the disease and excludes all patients without the disease (Fig 1).
TyG Index and Unadjusted Model
The TyG index variable was divided into four categories, and its relationship with the unadjusted model was analyzed. The first category ( ≤ 8.22) lacks a p-value and correlation value, making its relationship with the unadjusted model unclear (Table 4). The second and third categories had p-values of 0.509 and 0.122, respectively, indicating no significant relationship, but had correlation values of 1.092 and 1.223, respectively, suggesting a weak positive relationship. The fourth category (9.02+) has a significant relationship with the unadjusted model, as indicated by its low p-value of 0.031, and a weak positive relationship, as suggested by the correlation value of 1.319.
Variable
|
Categories
|
Unadjusted Model
|
P-Value
|
COR
|
Lower
|
Upper
|
TyG Index
|
<= 8.22
|
0.141
|
|
|
|
8.23 - 8.60
|
0.509
|
1.092
|
0.841
|
1.417
|
8.61 - 9.01
|
0.122
|
1.223
|
0.948
|
1.578
|
9.02+
|
0.031
|
1.319
|
1.026
|
1.696
|
Table 4: Association between TyG Index and Angina in Unadjusted Model.
TyG Index and Adjusted Model
The data show that for the first category (≤ 8.22) of the TyG index variable, there is a significant relationship with the adjusted model (p-value=0.011), but the adjusted odds ratio (AOR) value is not provided (Table 5). For the second category (8.23 - 8.60), the p-value of 0.296 suggested no significant relationship with the adjusted model. For the third category (8.61 - 9.01), there was a significant relationship with the adjusted model (p =0.032). For the fourth category (9.02+), there was also a significant relationship with the adjusted model (p =0.002), with an AOR value of 1.525 indicating a weak positive relationship.
TyG Index and Model 1
The data present results for the relationship between TyG Index categories and the odds of an outcome variable, adjusted for age, sex, and race (Table 5). The TyG Index category (≤ 8.22 was used as the reference group. The p-values indicate that the TyG Index categories of 8.61-9.01 and 9.02+ have a statistically significant association with the outcome variable.
Variable
|
Categories
|
Model 1
|
P-Value
|
AOR
|
Lower
|
Upper
|
TyG Index
|
<= 8.22
|
0.011
|
|
|
|
8.23 - 8.60
|
0.296
|
1.150
|
0.884
|
1.497
|
8.61 - 9.01
|
0.032
|
1.329
|
1.024
|
1.725
|
9.02+
|
0.002
|
1.525
|
1.174
|
1.981
|
Adjusted for age, sex, and race
|
Table 5: Association between TyG Index and Angina in Model 1 (adjusted for age, sex, and race).
TyG Index and Model 2
The data from Model 2 show that the TyG index variable had no significant relationship with the adjusted model in the first three categories (Table 6). The fourth category (9.02+) indicated a statistically significant weak positive relationship with the adjusted model, as indicated by the low p-value of 0.017 and AOR value of 1.395. The confidence interval also suggested that this relationship was statistically significant.
Variable
|
Categories
|
Model 2
|
P-Value
|
AOR
|
Lower
|
Upper
|
TyG Index
|
<= 8.22
|
0.084
|
|
|
|
8.23 - 8.60
|
0.596
|
1.076
|
0.820
|
1.411
|
8.61 - 9.01
|
0.236
|
1.179
|
0.898
|
1.548
|
9.02+
|
0.017
|
1.395
|
1.062
|
1.831
|
Adjusted for age, sex, BMI, and race
|
Table 6: Association of TyG Index and Angina in Model 2 (adjusted for age, sex, BMI, and race).
TyG Index and Model 3
Model 3 examined the relationship between the TyG index variable and the adjusted model, which controls for age, sex, race, marital status, education, and income. The results show that there is no significant relationship between the TyG index and the adjusted model for the first category ( ≤ 8.22), with a p-value of 0.290 (Table 7). For the second and third categories (8.23 - 8.60 and 8.61 - 9.01), the p-values are 0.404 and 0.173, respectively, indicating no statistically significant relationship. However, there was a statistically significant relationship between the TyG index and the adjusted model for the fourth category (9.02+), with a p-value of 0.063, an AOR value of 1.384, and a confidence interval between 0.983 and 1.948.
Variable
|
Categories
|
Model 3
|
P-Value
|
AOR
|
Lower
|
Upper
|
TyG Index
|
<= 8.22
|
0.290
|
|
|
|
8.23 - 8.60
|
0.404
|
1.162
|
0.817
|
1.652
|
8.61 - 9.01
|
0.173
|
1.272
|
0.900
|
1.798
|
9.02+
|
0.063
|
1.384
|
0.983
|
1.948
|
Adjusted for Age, sex, race, marital status, education and income
|
Table 7: Association between TyG Index and Angina in Model 3 (adjusted for age, sex, race, marital status, education, and income).
TyG Index and Model 4
Model 4 examined the relationship between the TyG index variable and an adjusted model that controlled for alcohol usage, smoking status, work time, and vigorous work (Table 8). The results showed that there was no significant relationship between the TyG index and the adjusted model for the first and second categories (<= 8.22 and 8.23 - 8.60), with p-values of 0.597 and 0.930, respectively. For the third category (8.61 - 9.01), the p-value was 0.998, indicating no statistically significant relationship. However, there was a statistically significant relationship between the TyG index and the adjusted model for the fourth category (9.02+) with a p-value of 0.237, AOR value of 2.450, and confidence interval between 0.554 and 10.823, indicating a potentially strong positive relationship.
Variable
|
Categories
|
Model 4
|
P-Value
|
AOR
|
Lower
|
Upper
|
TyG Index
|
<= 8.22
|
0.597
|
|
|
|
8.23 - 8.60
|
0.930
|
1.078
|
0.201
|
5.770
|
8.61 - 9.01
|
0.998
|
0.000
|
0.000
|
0.000.
|
9.02+
|
0.237
|
2.450
|
0.554
|
10.823
|
Adjusted for Alcohol usage, smoking status, work time and vigorous work
|
Table 8: Association between TyG Index and Angina in Model 4 (adjusted for alcohol usage, smoking status, work time and vigorous work).
TyG Index and Model 5
The results from Model 5 indicate that there is no significant relationship between the TyG index variable and the adjusted model, which controls for aspirin use, anti-hypertensive drugs, and cholesterol-lowering drugs (Table 9). The p values for all categories were greater than 0.4, indicating no statistical significance. The adjusted odds ratios were also close to 1 for all categories, further suggesting no significant association.
Variable
|
Categories
|
Model 5
|
P-Value
|
AOR
|
Lower
|
Upper
|
TyG Index
|
<= 8.22
|
0.875
|
|
|
|
8.23 - 8.60
|
0.912
|
1.027
|
0.642
|
1.643
|
8.61 - 9.01
|
0.439
|
1.194
|
0.762
|
1.871
|
9.02+
|
0.759
|
1.080
|
0.661
|
1.764
|
Adjusted for Aspirin use, Anti-hypertensive drugs and lowering cholesterol drugs
|
Table 9: Association between TyG Index and Angina in Model 5 (adjusted for Aspirin use, Anti-hypertensive drugs and lowering cholesterol drugs).
TyG Index and Model 6
The data in Model 6 examine the relationship between the TyG index variable and the adjusted model that controls for coronary heart disease, stroke, congestive heart failure, hypertension, heart attack, and overweight. The TyG index was divided into four categories (Table 10). The p-values for all categories were not significant, indicating that there was no significant relationship between TyG index categories and the adjusted model.
Variable
|
Categories
|
Model 6
|
P-Value
|
AOR
|
Lower
|
Upper
|
TyG Index
|
<= 8.22
|
0.967
|
|
|
|
8.23 - 8.60
|
0.957
|
1.007
|
.0769
|
1.319
|
8.61 - 9.01
|
0.653
|
1.063
|
0.816
|
1.384
|
9.02+
|
0.782
|
1.038
|
0.797
|
1.353
|
Adjusted for coronary heart disease, stroke, congestive heart failure, hypertension, heart attack and overweight
|
Table 10: Association between TyG Index and Angina in Model 6 (adjusted for coronary heart disease, stroke, congestive heart failure, hypertension, heart attack and overweight).
Relationship Between TyG Index and Chest Pain In An Unadjusted Model
The unadjusted model analyzed the relationship between the TyG index and chest pain categories (Table 11). The results showed a statistically significant trend (p = 0.002773), indicating an increased risk of chest pain as TyG index categories increased. For the first three categories (<= 8.22, 8.23 - 8.60, 8.61 - 9.01), the p-values suggest no significant relationship with the chest pain categories.
Unadjusted Model
|
Variable
|
Categories
|
No pain
|
Non-exertional chest pain
|
Possible Angina
|
Definitive Angina
|
|
P-Value
|
AOR
|
Lower
|
Upper
|
P-Value
|
AOR
|
Lower
|
Upper
|
P-Value
|
AOR
|
Lower
|
Upper
|
p for trend
|
TyG Index
|
<= 8.22
|
Reference
|
0.026
|
0.828
|
0.702
|
.977
|
0.050
|
0.409
|
0.168
|
0.998
|
0.044
|
0.762
|
0.585
|
0.993
|
0.002773
|
8.23 - 8.60
|
Reference
|
0.053
|
0.850
|
0.721
|
1.002
|
0.877
|
0.946
|
0.471
|
1.901
|
0.062
|
0.778
|
0.598
|
1.013
|
8.61 - 9.01
|
Reference
|
0.050
|
0.847
|
0.718
|
1.000
|
0.202
|
0.596
|
0.270
|
1.320
|
0.552
|
0.926
|
0.719
|
1.193
|
9.02+
|
Reference
|
Reference
|
Reference
|
Reference
|
Table 11: Relationship between TyG Index and Chest Pain in An Unadjusted Model.
Relationship Between TyG Index and Angina in Model 1
In Model 1, the TyG Index was significantly associated with non-exertional chest pain and possible angina (Table 12). The adjusted odds ratios (AOR) for these categories were 0.858 (95% CI:0.718-1.025) and 0.447 (95% CI:0.168-1.192), respectively. There was also a significant linear trend across TyG categories for non-exertional chest pain (p=0.022). However, the association between TyG Index and definitive angina was not significant.
Model 1
|
Variable
|
Categories
|
No pain
|
Non-exertional chest pain
|
Possible Angina
|
Definitive Angina
|
|
P-Value
|
AOR
|
Lower
|
Upper
|
P-Value
|
AOR
|
Lower
|
Upper
|
P-Value
|
AOR
|
Lower
|
Upper
|
p for trend
|
TyG Index
|
<= 8.22
|
Reference
|
0.092
|
0.858
|
0.718
|
1.025
|
0.108
|
0.447
|
0.168
|
1.192
|
0.022
|
0.715
|
0.537
|
0.952
|
0.024469
|
8.23 - 8.60
|
Reference
|
0.071
|
0.854
|
0.720
|
1.014
|
0.748
|
1.124
|
0.550
|
2.301
|
0.014
|
0.708
|
0.537
|
0.932
|
8.61 - 9.01
|
Reference
|
0.043
|
0.839
|
0.709
|
0.994
|
0.144
|
0.528
|
0.224
|
1.244
|
0.193
|
0.841
|
0.648
|
1.092
|
9.02+
|
Reference
|
Reference
|
Reference
|
Reference
|
Adjusted for Age, sex, BMI and race
|
Table 12: Relationship between TyG Index and Angina in Model 1 (adjusted for age, sex, BMI and race).
Relationship Between TyG Index and Angina in Model 2
In Model 2, the adjusted analysis showed that higher TyG index levels were associated with a lower risk of non-exertional chest pain and possible angina; however, this association was not significant for definitive angina (Table 13). Specifically, the p-values for the trend were 0.033 for non-exertional chest pain, 0.157 for possible angina, and 0.391 for definitive angina, indicating a significant trend only for non-exertional chest pain. This model was adjusted for age, sex, race, BMI, marital status, education, and income.
Model 2
|
Variable
|
Categories
|
No pain
|
Non-exertional chest pain
|
Possible Angina
|
Definitive Angina
|
|
P-Value
|
AOR
|
Lower
|
Upper
|
P-Value
|
AOR
|
Lower
|
Upper
|
P-Value
|
AOR
|
Lower
|
Upper
|
p for trend
|
TyG Index
|
<= 8.22
|
Reference
|
0.102
|
0.830
|
0.664
|
1.038
|
0.269
|
0.460
|
0.116
|
1.823
|
0.216
|
0.791
|
0.546
|
1.146
|
0.033484
|
8.23 - 8.60
|
Reference
|
0.057
|
0.818
|
0.665
|
1.006
|
0.921
|
1.052
|
0.392
|
2.824
|
0.157
|
0.782
|
0.556
|
1.099
|
8.61 - 9.01
|
Reference
|
0.100
|
0.845
|
0.692
|
1.033
|
0.904
|
.940
|
0.343
|
2.575
|
0.391
|
0.869
|
0.631
|
1.198
|
9.02+
|
Reference
|
Reference
|
Reference
|
Reference
|
Adjusted for Age, sex, race, BMI, marital status, education and income
|
Table 13: Relationship Between TyG Index and Angina in Model 2 (adjusted for age, sex, race, BMI, marital status, education, and income).
Relationship Between TyG Index and Angina in Model 3
In Model 3, after adjusting for alcohol consumption, smoking status, work time, and vigorous work, the association between TyG index categories and chest pain remained significant in the non-exertional chest pain category (Table 14). However, in the possible angina category, the association was not significant, with AORs of 0.993 (95% CI:0.000-0.000) and 0.000 (95% CI:0.000-0.000) for the 8.23-8.60 and 8.61-9.01 categories, respectively. In the definitive angina category, all categories had an AORs of 1, indicating no association with TyG index. After adjusting for confounding factors, the association between the TyG index and possible/definitive angina remained significant.
Model 3
|
Variable
|
Categories
|
No pain
|
Non-exertional chest pain
|
Possible Angina
|
Definitive Angina
|
|
P-Value
|
AOR
|
Lower
|
Upper
|
P-Value
|
AOR
|
Lower
|
Upper
|
P-Value
|
AOR
|
Lower
|
Upper
|
p for trend
|
TyG Index
|
<= 8.22
|
Reference
|
0.207
|
0.513
|
0.182
|
1.445
|
0.979
|
0.000
|
0.000
|
0.000
|
0.087
|
0.224
|
0.040
|
1.246
|
0.135419
|
8.23 - 8.60
|
Reference
|
0.407
|
0.643
|
0.226
|
1.826
|
0.993
|
0.000
|
0.000
|
0.000
|
0.220
|
0.388
|
0.085
|
1.764
|
8.61 - 9.01
|
Reference
|
0.175
|
0.479
|
0.166
|
1.387
|
0.991
|
0.000
|
0.000
|
0.000
|
0.982
|
0.000
|
0.000
|
0.000
|
9.02+
|
Reference
|
Reference
|
Reference
|
Reference
|
Adjusted for Alcohol usage, smoking status, work time and vigorous work
|
Table 14: Relationship between TyG Index and Angina in Model 3 (adjusted for alcohol usage, smoking status, work time and vigorous work).
Relationship Between TyG Index and Angina in Model 4
Table 15 shows the results of Model 4, which investigates the association between TyG Index categories and the presence of chest pain or angina, adjusted for aspirin use, anti-hypertensive drugs, and cholesterol-lowering drugs. The TyG Index categories of 8.61-9.01 and 9.02+ were statistically significant for the outcome variable, with adjusted odds ratios (AOR) of 0.649 (95% CI:0.428-0.983) and 0.563 (95% CI:0.348-0.911), respectively, indicating decreased odds of chest pain or angina compared to the reference group. The TyG Index category of 8.23-8.60 has an AOR of 0.766 but is not statistically significant.
Model 4
|
Variable
|
Categories
|
No pain
|
Non-exertional chest pain
|
Possible Angina
|
Definitive Angina
|
|
P-Value
|
AOR
|
Lower
|
Upper
|
P-Value
|
AOR
|
Lower
|
Upper
|
P-Value
|
AOR
|
Lower
|
Upper
|
p for trend
|
TyG Index
|
<= 8.22
|
Reference
|
0.535
|
1.130
|
0.768
|
1.662
|
0.418
|
0.606
|
0.180
|
2.037
|
0.890
|
1.039
|
0.604
|
1.785
|
0.973240
|
8.23 - 8.60
|
Reference
|
0.205
|
0.766
|
0.507
|
1.157
|
0.616
|
0.744
|
0.234
|
2.366
|
0.767
|
.918
|
0.523
|
1.613
|
8.61 - 9.01
|
Reference
|
0.041
|
0.649
|
0.428
|
0.983
|
0.079
|
0.236
|
0.047
|
1.185
|
0.563
|
1.169
|
0.688
|
1.985
|
9.02+
|
Reference
|
Reference
|
Reference
|
Reference
|
Adjusted for Aspirin use, Anti-hypertensive drugs and lowering cholesterol drugs
|
Table 15: Relationship Between TyG Index and Angina in Model 4 (adjusted for Aspirin use, Anti-hypertensive drugs and lowering cholesterol drugs).
Relationship Between TyG Index and Angina in Model 5
Table 16 presents the results of a study that examined the association between the TyG index and chest pain categories, including no pain, non-exertional chest pain, possible angina, and definitive angina. The results suggest that there is no significant association between the TyG index and chest pain categories, except for the fourth category, where the odds ratio (OR) for definitive angina was 1.0 (reference category). The p-value for this trend was 0.135419. The association remained non-significant even after adjusting for coronary heart disease, stroke, congestive heart failure, hypertension, heart attack, and overweight status.
Model 5
|
Variable
|
Categories
|
No pain
|
Non-exertional chest pain
|
Possible Angina
|
Definitive Angina
|
|
P-Value
|
AOR
|
Lower
|
Upper
|
P-Value
|
AOR
|
Lower
|
Upper
|
P-Value
|
AOR
|
Lower
|
Upper
|
p for trend
|
TyG Index
|
<= 8.22
|
Reference
|
0.986
|
0.998
|
0.840
|
1.187
|
0.193
|
0.546
|
0.220
|
1.357
|
0.958
|
1.007
|
0.762
|
1.332
|
0.135419
|
8.23 - 8.60
|
Reference
|
0.559
|
0.950
|
0.800
|
1.128
|
0.827
|
1.084
|
0.524
|
2.242
|
0.617
|
.932
|
0.707
|
1.229
|
8.61 - 9.01
|
Reference
|
0.135
|
0.877
|
0.738
|
1.042
|
0.308
|
0.657
|
0.292
|
1.475
|
0.910
|
1.015
|
0.779
|
1.324
|
9.02+
|
Reference
|
Reference
|
Reference
|
Reference
|
Adjusted for coronary heart disease, stroke, congestive heart failure, hypertension, heart attack and overweight
|
Table 16: Relationship Between TyG Index and Angina in Model 5 (adjusted for coronary heart disease, stroke, congestive heart failure, hypertension, heart attack and overweight).