BACKGROUND Atherosclerotic cardiovascular (CV) events commonly occur in individuals with a low CV risk burden. This study evaluated the ability of the triglyceride glucose (TyG) index to predict subclinical coronary artery disease (CAD) in asymptomatic subjects without traditional CV risk factors (CVRFs). METHODS This retrospective, cross-sectional, and observational study evaluated the association of TyG index with CAD in 1250 (52.8 ± 6.5 years, 46.9% male) asymptomatic individuals without traditional CVRFs (defined as systolic/diastolic blood pressure ≥ 140/90 mmHg; fasting glucose ≥126 mg/dL; total cholesterol ≥240 mg/dL; low-density lipoprotein cholesterol ≥160 mg/dL; high-density lipoprotein cholesterol < 40 mg/dL; body mass index ≥25.0 kg/m2; current smoking; and previous medical history of hypertension, diabetes, or dyslipidemia). CAD was defined as the presence of any coronary plaque on coronary computed tomographic angiography. The participants were divided into three groups based on TyG index tertiles. RESULTS The prevalence of CAD increased with elevating TyG index tertiles (group I: 14.8% vs. group II: 19.3% vs. group III: 27.6%; P < 0.001). Multivariate logistic regression models showed that TyG index was associated with an increased risk of CAD (odds ratio [OR] 1.473, 95% confidence interval [CI] 1.026-2.166); especially non-calcified (OR 1.581, 95% CI 1.002-2.493) and mixed plaques (OR 2.419, 95% CI 1.051-5.569) (all P < 0.05). The optimal TyG index cut-off for predicting CAD was 8.44 (sensitivity 47.9%; specificity 68.5%; area under the curve 0.600; P < 0.001). The predictive value of this cut-off improved after considering the non-modifiable factors of old age and male sex. CONCLUSIONS TyG index is an independent marker for predicting subclinical CAD in individuals conventionally considered healthy.

中文翻译：

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在没有传统危险因素的情况下，甘油三酸酯葡萄糖指数是预测亚临床冠状动脉疾病的有用标志物。

背景技术动脉粥样硬化性心血管（CV）事件通常发生在具有低CV风险负担的个体中。这项研究评估了甘油三酸酯葡萄糖（TyG）指数在无传统CV危险因素（CVRFs）的无症状受试者中预测亚临床冠状动脉疾病（CAD）的能力。方法这项回顾性，横断面和观察性研究评估了1250名（52.8±6.5岁，男性占46.9％）无传统CVRF（定义为收缩压/舒张压≥140/90 mmHg；无症状）的TyG指数与CAD的相关性。空腹血糖≥126mg / dL；总胆固醇≥240mg / dL；低密度脂蛋白胆固醇≥160mg / dL；高密度脂蛋白胆固醇<40 mg / dL；体重指数≥25.0kg / m2；目前吸烟；以及高血压，糖尿病或血脂异常的既往病史）。CAD被定义为在冠状动脉计算机断层造影术上存在任何冠状动脉斑块。根据TyG指数三分位数将参与者分为三组。结果CAD的患病率随TyG指数三分位数的升高而增加（I组：14.8％，II组：19.3％，III组：27.6％； P <0.001）。多元逻辑回归模型显示，TyG指数与CAD风险增加相关（赔率[OR] 1.473，95％置信区间[CI] 1.026-2.166）；尤其是未钙化（OR 1.581，95％CI 1.002-2.493）和混合斑块（OR 2.419，95％CI 1.051-5.569）（所有P <0.05）。预测CAD的最佳TyG指数临界值为8.44（敏感性47.9％；特异性68.5％；曲线下面积0.600； P <0.001）。考虑到老年人和男性的不可改变因素后，该临界值的预测值有所提高。结论TyG指数是预测通常认为健康的个体亚临床CAD的独立指标。