TY - JOUR
T1 - Triglyceride-glucose index and the risk of heart failure
T2 - Evidence from two large cohorts and a mendelian randomization analysis
AU - Li, Xintao
AU - Chan, Jeffrey Shi Kai
AU - Guan, Bo
AU - Peng, Shi
AU - Wu, Xiaoyu
AU - Lu, Xiaofeng
AU - Zhou, Jiandong
AU - Hui, Jeremy Man Ho
AU - Lee, Yan Hiu Athena
AU - Satti, Danish Iltaf
AU - Tsang, Shek Long
AU - Wu, Shouling
AU - Chen, Songwen
AU - Tse, Gary
AU - Liu, Shaowen
N1 - Publisher Copyright:
© 2022, The Author(s).
PY - 2022/12
Y1 - 2022/12
N2 - Background: The relationship between triglyceride-glucose (TyG) index, an emerging marker of insulin resistance, and the risk of incident heart failure (HF) was unclear. This study thus aimed to investigate this relationship. Methods: Subjects without prevalent cardiovascular diseases from the prospective Kailuan cohort (recruited during 2006–2007) and a retrospective cohort of family medicine patients from Hong Kong (recruited during 2000–2003) were followed up until December 31st, 2019 for the outcome of incident HF. Separate adjusted hazard ratios (aHRs) summarizing the relationship between TyG index and HF risk in the two cohorts were combined using a random-effect meta-analysis. Additionally, a two-sample Mendelian randomization (MR) of published genome-wide association study data was performed to assess the causality of observed associations. Results: In total, 95,996 and 19,345 subjects from the Kailuan and Hong Kong cohorts were analyzed, respectively, with 2,726 cases of incident HF in the former and 1,709 in the latter. Subjects in the highest quartile of TyG index had the highest risk of incident HF in both cohorts (Kailuan: aHR 1.23 (95% confidence interval: 1.09–1.39), PTrend <0.001; Hong Kong: aHR 1.21 (1.04–1.40), PTrend =0.007; both compared with the lowest quartile). Meta-analysis showed similar results (highest versus lowest quartile: HR 1.22 (1.11–1.34), P < 0.001). Findings from MR analysis, which included 47,309 cases and 930,014 controls, supported a causal relationship between higher TyG index and increased risk of HF (odds ratio 1.27 (1.15–1.40), P < 0.001). Conclusion: A higher TyG index is an independent and causal risk factor for incident HF in the general population. Clinical Trial Registration: URL: https://www.chictr.org.cn; Unique identifier: ChiCTR-TNRC-11,001,489.
AB - Background: The relationship between triglyceride-glucose (TyG) index, an emerging marker of insulin resistance, and the risk of incident heart failure (HF) was unclear. This study thus aimed to investigate this relationship. Methods: Subjects without prevalent cardiovascular diseases from the prospective Kailuan cohort (recruited during 2006–2007) and a retrospective cohort of family medicine patients from Hong Kong (recruited during 2000–2003) were followed up until December 31st, 2019 for the outcome of incident HF. Separate adjusted hazard ratios (aHRs) summarizing the relationship between TyG index and HF risk in the two cohorts were combined using a random-effect meta-analysis. Additionally, a two-sample Mendelian randomization (MR) of published genome-wide association study data was performed to assess the causality of observed associations. Results: In total, 95,996 and 19,345 subjects from the Kailuan and Hong Kong cohorts were analyzed, respectively, with 2,726 cases of incident HF in the former and 1,709 in the latter. Subjects in the highest quartile of TyG index had the highest risk of incident HF in both cohorts (Kailuan: aHR 1.23 (95% confidence interval: 1.09–1.39), PTrend <0.001; Hong Kong: aHR 1.21 (1.04–1.40), PTrend =0.007; both compared with the lowest quartile). Meta-analysis showed similar results (highest versus lowest quartile: HR 1.22 (1.11–1.34), P < 0.001). Findings from MR analysis, which included 47,309 cases and 930,014 controls, supported a causal relationship between higher TyG index and increased risk of HF (odds ratio 1.27 (1.15–1.40), P < 0.001). Conclusion: A higher TyG index is an independent and causal risk factor for incident HF in the general population. Clinical Trial Registration: URL: https://www.chictr.org.cn; Unique identifier: ChiCTR-TNRC-11,001,489.
KW - Heart failure
KW - Insulin resistance
KW - Mendelian randomization
KW - Risk stratification
KW - Triglyceride-glucose index
UR - http://www.scopus.com/inward/record.url?scp=85141195681&partnerID=8YFLogxK
U2 - 10.1186/s12933-022-01658-7
DO - 10.1186/s12933-022-01658-7
M3 - Article
C2 - 36329456
AN - SCOPUS:85141195681
VL - 21
JO - Cardiovascular Diabetology
JF - Cardiovascular Diabetology
IS - 1
M1 - 229
ER -