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Original investigation
Dong-Hyuk Jung
Associate Professor, 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
Corresponding Author
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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. Until now, the association between early insulin resistance and IHD among nondiabetic adults has been poorly understood. We prospectively investigated the relationship between the triglyceride-glucose (TyG) index, a surrogate marker of early insulin resistance, and incident IHD risk in a large cohort of nondiabetic adults using National Health Insurance data.
Methods: We assessed 16,455 participants (8,426 men and 8,029 women) without diabetes using data from a health risk assessment study (HERAS) and Korea Health Insurance Review & 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 1–4 were 1.00, 1.63 (95% CI, 1.06–2.49), 1.88 (95% CI, 1.23–2.87), and 2.35 (95% CI, 1.53–3.61), respectively, after adjusting for age, sex, body mass index, smoking status, alcohol intake, physical activity, high sensitivity C-reactive protein, and mean arterial blood pressure.
Conclusion: A higher TyG index precedes and significantly predicts future IHD among nondiabetic Koreans. Accordingly, a high TyG index may be a useful additional measure in assessing cardiovascular risks for apparently healthy adults in clinical practice.
Keywords
triglyceride glucose index, early insulin resistance, prospective cohort study, incident ischemic heart disease
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CURRENT STATUS: Published
View the published article at Cardiovascular Diabetology.
Version 1
Posted 12 Oct, 2020
No community comments so far
Review #1 received
Received 25 Oct, 2020
Editorial decision: Major Revision
On 25 Oct, 2020
Review #2 received
Received 17 Oct, 2020
Review #3 received
Received 11 Oct, 2020
Reviewer #3 agreed
On 10 Oct, 2020
Reviewer #2 agreed
On 06 Oct, 2020
Editor assigned
On 05 Oct, 2020
Reviewers invited
Invitations sent on 05 Oct, 2020
Reviewer #1 agreed
On 05 Oct, 2020
Submission checks complete
On 04 Oct, 2020
Editor invited
On 04 Oct, 2020
First submitted
On 02 Oct, 2020
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Subject Areas
Cardiac & Cardiovascular Systems
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A new preprint design is coming!
We have improved readability, clarity, accessibility, and opportunities for engagement.
See the published version of this preprint at Cardiovascular Diabetology.
This is a preprint, 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
Dong-Hyuk Jung
Associate Professor, 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
Corresponding Author
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: Published
View the published article at Cardiovascular Diabetology.
Version 1
Posted 12 Oct, 2020
No community comments so far
Review #1 received
Received 25 Oct, 2020
Editorial decision: Major Revision
On 25 Oct, 2020
Review #2 received
Received 17 Oct, 2020
Review #3 received
Received 11 Oct, 2020
Reviewer #3 agreed
On 10 Oct, 2020
Reviewer #2 agreed
On 06 Oct, 2020
Editor assigned
On 05 Oct, 2020
Reviewers invited
Invitations sent on 05 Oct, 2020
Reviewer #1 agreed
On 05 Oct, 2020
Submission checks complete
On 04 Oct, 2020
Editor invited
On 04 Oct, 2020
First submitted
On 02 Oct, 2020
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
View the published article at Cardiovascular Diabetology.
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. Until now, the association between early insulin resistance and IHD among nondiabetic adults has been poorly understood. We prospectively investigated the relationship between the triglyceride-glucose (TyG) index, a surrogate marker of early insulin resistance, and incident IHD risk in a large cohort of nondiabetic adults using National Health Insurance data.
Methods: We assessed 16,455 participants (8,426 men and 8,029 women) without diabetes using data from a health risk assessment study (HERAS) and Korea Health Insurance Review & 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 1–4 were 1.00, 1.63 (95% CI, 1.06–2.49), 1.88 (95% CI, 1.23–2.87), and 2.35 (95% CI, 1.53–3.61), respectively, after adjusting for age, sex, body mass index, smoking status, alcohol intake, physical activity, high sensitivity C-reactive protein, and mean arterial blood pressure.
Conclusion: A higher TyG index precedes and significantly predicts future IHD among nondiabetic Koreans. Accordingly, a high TyG index may be a useful additional measure in assessing cardiovascular risks for apparently healthy adults in clinical practice.
Figure 1
Figure 2
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