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10. Comparison of the Effects of Fasting Glucose, Hemoglobin A 1c , and Triglyceride-Glucose Index on Cardiovascular Events in Type 2 Diabetes Mellitus.

Author

Su WY, Chen SC, Huang YT, Huang JC, Wu PY, Hsu WH, and Lee MY

Subjects
Aged, Biomarkers blood, Cardiovascular Diseases diagnosis, Databases, Factual, Diabetes Mellitus, Type 2 complications, Diabetes Mellitus, Type 2 diagnosis, Disease Progression, Female, Humans, Longitudinal Studies, Male, Middle Aged, Prognosis, Retrospective Studies, Risk Assessment, Risk Factors, Time Factors, Blood Glucose metabolism, Cardiovascular Diseases epidemiology, Diabetes Mellitus, Type 2 blood, Fasting blood, Glycated Hemoglobin metabolism, Triglycerides blood
Abstract

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.

Published
2019
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