This preprint is under consideration at Cardiovascular Diabetology. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
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Original investigation
Shouling Wu
Kailuan General Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0001-7095-6022
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: The relationship between baseline triglyceride-glucose (TyG) index and cardiovascular disease (CVD) has been confirmed by former studies. However, the effect of longitudinal changes in TyG index on CVD remains uncertain. This study aimed to investigate the association of changes in TyG index with CVD in the general population.
Methods: The current study included 62,443 Chinese population who were free of CVD. TyG index was calculated as ln [fasting triglyceride (mg/dL) × fasting glucose (mg/dL)/2], changes in TyG index was defined as the difference in TyG index between 2010 and 2006. Cox proportional hazard model and restricted cubic spline was used to examine the association between changes in TyG index and CVD.
Results: During a median follow-up of 7.01 years, 2,530 (4.05%) incident CVD occurred, including 2,018 (3.23%) stroke and 545 (0.87%) MI. Risk of CVD was increased with quartiles of changes in TyG index, the adjusted hazard ratio (HR) in Q4 group versus Q1 group was 1.37 (95% confidence interval [CI], 1.21-1.54) for the overall CVD, 1.38 (95% CI, 1.19-1.60) for stroke, and 1.36 (95% CI, 1.05-1.76) for MI. Restricted cubic spline also showed cumulative increased risk of CVD with increasing changes in TyG index. Furthermore, the addition of changes in TyG index to a baseline risk model for CVD improved the C-statistics (P=0.0097), the integrated discrimination improvement (P<0.0001), and the category-free net reclassification improvement (P<0.0001). Similar results were observed for stroke and MI.
Conclusions: Substantial changes in TyG index can independently predict the risk of CVD in the general population. Monitoring long-term changes in TyG may be helpful in the early identification of individuals at high risk of CVD.
Keywords
Triglyceride-glucose index, Longitudinal changes, Cardiovascular disease, Stroke, Myocardial infarction, Predictive value
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Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 01 Apr, 2021
No community comments so far
Editorial decision: Major Revision
On 02 May, 2021
Review #1 received
Received 20 Apr, 2021
Reviewer #3 agreed
On 05 Apr, 2021
Review #3 received
Received 05 Apr, 2021
Review #2 received
Received 05 Apr, 2021
Reviews received
Received 02 Apr, 2021
Reviewer #2 agreed
On 02 Apr, 2021
Reviewer #1 agreed
On 31 Mar, 2021
Reviewers invited
Invitations sent on 29 Mar, 2021
First submitted
On 28 Mar, 2021
Editor assigned
On 28 Mar, 2021
Submission checks complete
On 28 Mar, 2021
Editor invited
On 28 Mar, 2021
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Cardiac & Cardiovascular Systems
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This preprint is under consideration at Cardiovascular Diabetology. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Original investigation
Shouling Wu
Kailuan General Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0001-7095-6022
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 01 Apr, 2021
No community comments so far
Editorial decision: Major Revision
On 02 May, 2021
Review #1 received
Received 20 Apr, 2021
Reviewer #3 agreed
On 05 Apr, 2021
Review #3 received
Received 05 Apr, 2021
Review #2 received
Received 05 Apr, 2021
Reviews received
Received 02 Apr, 2021
Reviewer #2 agreed
On 02 Apr, 2021
Reviewer #1 agreed
On 31 Mar, 2021
Reviewers invited
Invitations sent on 29 Mar, 2021
First submitted
On 28 Mar, 2021
Editor assigned
On 28 Mar, 2021
Submission checks complete
On 28 Mar, 2021
Editor invited
On 28 Mar, 2021
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Cardiac & Cardiovascular Systems
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: The relationship between baseline triglyceride-glucose (TyG) index and cardiovascular disease (CVD) has been confirmed by former studies. However, the effect of longitudinal changes in TyG index on CVD remains uncertain. This study aimed to investigate the association of changes in TyG index with CVD in the general population.
Methods: The current study included 62,443 Chinese population who were free of CVD. TyG index was calculated as ln [fasting triglyceride (mg/dL) × fasting glucose (mg/dL)/2], changes in TyG index was defined as the difference in TyG index between 2010 and 2006. Cox proportional hazard model and restricted cubic spline was used to examine the association between changes in TyG index and CVD.
Results: During a median follow-up of 7.01 years, 2,530 (4.05%) incident CVD occurred, including 2,018 (3.23%) stroke and 545 (0.87%) MI. Risk of CVD was increased with quartiles of changes in TyG index, the adjusted hazard ratio (HR) in Q4 group versus Q1 group was 1.37 (95% confidence interval [CI], 1.21-1.54) for the overall CVD, 1.38 (95% CI, 1.19-1.60) for stroke, and 1.36 (95% CI, 1.05-1.76) for MI. Restricted cubic spline also showed cumulative increased risk of CVD with increasing changes in TyG index. Furthermore, the addition of changes in TyG index to a baseline risk model for CVD improved the C-statistics (P=0.0097), the integrated discrimination improvement (P<0.0001), and the category-free net reclassification improvement (P<0.0001). Similar results were observed for stroke and MI.
Conclusions: Substantial changes in TyG index can independently predict the risk of CVD in the general population. Monitoring long-term changes in TyG may be helpful in the early identification of individuals at high risk of CVD.
Figure 1
Figure 2
Figure 3
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