The triglyceride–glucose (TyG) index has been correlated with insulin resistance. We aim to investigate the role of the TyG index on cardiovascular (CV) events in type 2 diabetes mellitus and compare the roles of fasting glucose, hemoglobin A_1c, and the TyG index in predicting CV events. This retrospective study enrolled 3524 patients with type 2 diabetes from the Kaohsiung Medical University Research Database in 2009 in this longitudinal study and followed them until 2015. The TyG index was calculated as log (fasting triglyceride level (mg/dL) × fasting glucose level (mg/dL)/2). CV events included myocardial infarction, unstable angina, stroke, hospitalization for coronary artery disease, peripheral artery disease, and CV-related death. The association between variables and CV events was assessed using a multivariable stepwise Cox proportional hazard analysis. Two hundred and fifteen CV events (6.1%) were recorded during a follow-up period of 5.93 years. The multivariable stepwise analysis showed that high fasting glucose (HR, 1.007; p < 0.001) and a high TyG index (HR, 1.521; p = 0.004) but not hemoglobin A_1c or triglycerides were associated with a higher rate of CV events. Adding fasting glucose and the TyG index to the basic model improved the predictive ability of progression to a CV event (p < 0.001 and p = 0.018, respectively), over that of hemoglobin A_1c (p = 0.084) and triglyceride (p = 0.221). Fasting glucose and the TyG index are useful parameters and stronger predictive factors than hemoglobin A_1c and triglyceride for CV events and may offer an additional prognostic benefit in patients with type 2 diabetes.

The aim of this study was to investigate the associations between the triglyceride-glucose (TyG) index, a marker of insulin resistance, and microangiopathies and macroangiopathies in patients with type 2 diabetes mellitus (DM). Our study enrolled 1990 type 2 diabetic patients from local hospitals in Taiwan during the period of 2002–2004. Multivariate logistic regression analysis was used to identify the factors related to microangiopathies, macroangiopathiess and TyG index. The patients were stratified by TyG index quartile (Q1–Q4). Adjusted odds ratios (aORs) of albuminuria for Q3 versus Q1 and Q4 versus Q1 were 1.424 (95% confidence interval [CI], 1.062–1.910, p = 0.018) and 1.948 (95% CI, 1.437–2.642, p < 0.001), respectively. The aOR of cerebrovascular disease (CVA) was 2.264 for Q4 versus Q1 (95% CI, 1.243–4.122, p = 0.008), but there were no significant associations with diabetic retinopathy (DR), coronary artery disease (CAD) or peripheral artery occlusive disease (PAOD). Significant stepwise increases were found in CVA (p = 0.0013) and albuminuria ≥30 mg/g (p < 0.001) corresponding to TyG index quartiles, but not DR (p = 0.573), CAD (p = 0.880) or PAOD (p = 0.223). There was a significant association between a high TyG index and a high risk of microalbuminuria and CVA in the study cohort. Further studies to investigate the use of medications in patients with DM to prevent micro- and macro-angiopathies are thus warranted.

Chronic kidney disease (CKD), including end-stage renal disease (ESRD), is a public health issue worldwide, and is associated with high rates of morbidity and mortality. In addition, cardiovascular disease is a major cause of mortality in these patients. Both traditional and nontraditional risk factors associated with CKD can lead to remodeling of the myocardium and blood vessels, thereby resulting in cardiomyopathy, atherosclerosis and arterial stiffness. This can subsequently lead to ischemic heart disease, heart failure, cardiovascular death, rapid renal progression and progression to ESRD. Identifying these risk factors to allow for aggressive preventive and interventional strategies is important for the management of patients with CKD. This aim of this review was to survey the clinical outcomes of CKD using cardiac and vascular markers including echocardiographic parameters, systolic time intervals, electrocardiography, heart rate variability, ankle-brachial index, pulse wave velocity, differences between interarm and interankle blood pressure, and vascular calcification.

This study aimed to investigate the performance of innovative and traditional cardiometabolic indices, including body mass index (BMI), waist circumference (WC), Chinese visceral adiposity index (CVAI), visceral adiposity index, lipid accumulation product, a body shape index (ABSI), body roundness index, conicity index (CI), triglyceride-glucose (TyG) index, TyG-BMI, and TyG-WC, in estimating atherosclerotic cardiovascular disease (ASCVD) risk in 3143 Taiwanese adults aged 20–79 years. Elevated 10-year ASCVD risk was defined as ≥7.5% using the Pooled Cohort Equations. The performance of different indices in estimating elevated ASCVD risk was assessed by receiver operating characteristic (ROC) curves. In multivariate-adjusted logistic regression analyses, all cardiometabolic indices (p-value < 0.001) were significantly associated with elevated ASCVD risk in both genders, except for ABSI and CI in women. In particular, CVAI had the largest area under the curve (AUC) in men (0.721) and women (0.883) in the ROC analyses. BMI had the lowest AUC in men (0.617), while ABSI had the lowest AUC in women (0.613). The optimal cut-off value for CVAI was 83.7 in men and 70.8 in women. CVAI performed best among various cardiometabolic indices in estimating elevated ASCVD risk. CVAI may be a reliable index for identifying people at increased risk of ASCVD.

This study aimed to evaluate the performance of 11 obesity-related indices, including body mass index (BMI), waist circumference, waist-to-height ratio, waist–hip ratio, a body shape index, abdominal volume index, body adiposity index, body roundness index, conicity index, visceral adiposity index (VAI), and triglyceride glucose (TyG) index, in identifying metabolic syndrome (MetS) in adults. The information of 5000 participants was obtained from the Taiwan Biobank. Logistic regression analyses were performed to determine the associations between MetS and obesity-related indices with odds ratio (ORs). The predictive performance of the indices to identify MetS was compared using receiver operating characteristic (ROC) curves and areas under curves (AUCs). Multivariate-adjusted logistic regression showed that the ORs for MetS increased across the quartiles of each index. ROC curves analysis demonstrated that TyG index had the greatest AUC in men (AUC = 0.850) and women (AUC = 0.890). Furthermore, VAI had the greatest AUC in men (AUC = 0.867) and women (AUC = 0.925) aged 30−50 years, while TyG index had the greatest AUC in men (AUC = 0.849) and women (AUC = 0.854) aged 51−70 years. Among the studied obesity-related indices, TyG index and VAI exhibited the best performance for identifying MetS in adults. TyG index and VAI may be the relevant indices to assess MetS in clinical practice.