Table 1.
Basic characteristics of the articles included in the meta-analysis of TyG and risk of CVD and mortality in general population
| Author, years, country | Study design/Mean follow-up time | Study population | Sample sizes | Mean age (years)/Male (%) | TyG detection | Endpoint detection | Endpoint | TyG index | Hazard risk (95% CI) | Adjustments |
|---|---|---|---|---|---|---|---|---|---|---|
| Barzegar, 2020, Iran | Prospective cohort study/16.1 years |
Tehran Lipid and Glucose Study Free of CVD at baseline |
7521 | 46.60/44.80 | NA | ECG and ICD-10 | CAD (incidence) | < 8.4 | 1 | Age, gender, WC, BMI, education, smoking status, physical activity, FHCVD, T2D, hypertension, lipid lowering drugs, LDL-C, HDL-C |
| 8.4–8.7 | 1.25 (0.93–1.67) | |||||||||
| 8.7–9.0 | 1.49 (1.12–1.98) | |||||||||
| 9.0–9.4 | 1.34 (1.01–1.80) | |||||||||
| ≥ 9.4 | 1.84 (1.37–2.48) | |||||||||
| Per SD (0.48) | 1.19 (1.10–1.29) | |||||||||
| ECG and ICD-10 | CVD (incidence) | < 8.4 | 1 | |||||||
| 8.4–8.7 | 1.15 (0.89–1.49) | |||||||||
| 8.7–9.0 | 1.28 (0.99–1.65) | |||||||||
| 9.0–9.4 | 1.22 (0.94–1.58) | |||||||||
| ≥ 9.4 | 1.61 (1.23–2.11) | |||||||||
| Per SD (0.48) | 1.16 (1.07–1.25) | |||||||||
| Hong, 2020, Korea | Retrospective cohort study/8.2 years |
National Health Information Database Free of ASCVD history, diabetes and hyperlipidemia |
5,593,134 | 53.02/50.50 | NA | ICD-10 code I21 or I22 | MI (incidence) | Q1 | 1 | Age, sex, smoking, alcohol consumption, regular physical activity, low socioeconomic status, BMI, hypertension, total cholesterol level, hypertension medications, warfarin, and aspirin |
| Q2 | 1.09 (1.07–1.12) | |||||||||
| Q3 | 1.17 (1.14–1.19) | |||||||||
| Q4 | 1.31 (1.28–1.35) | |||||||||
| Kim, 2019, Korea | Retrospective cohort study/5.66 years |
Kangbuk Samsung Health Study General population |
318,224 | NA/51.89 | NA | Derived from the Korea National Statistical Office | CV mortality | Highest vs. lowest | 1.26 (1.02–1.55) | Age, sex, BMI |
| Derived from the Korea National Statistical Office | All-cause mortality | Highest vs. lowest | 1.12 (1.03–1.22) | |||||||
| Kim, 2021, Korea | Retrospective cohort study/5.97 years |
Korean National Health Insurance Service—National Health Screening cohort Free of CVD, diabetes and tumor |
144,603 | 56.00/53.96 | NA | ICD-10 codes I20-I25 | CVD (men, incidence) | < 8.25 | 1 | Age, smoking status, drinking status, physical activity, BMI, SBP, LDL-C, economic status, and anti-hypertensive medications |
| 8.25–8.61 | 1.11 (0.97–1.28) | |||||||||
| 8.61–9.00 | 1.19 (1.03–1.36) | |||||||||
| ≥ 9.00 | 1.23 (1.07–1.42) | |||||||||
| CVD (women, incidence) | < 8.06 | 1 | ||||||||
| 8.06–8.40 | 1.24 (1.02–1.51) | |||||||||
| 8.40–8.75 | 1.18 (0.97–1.44) | |||||||||
| ≥ 8.75 | 1.24 (1.02–1.51) | |||||||||
| All-cause mortality (men) | < 8.25 | 1 | ||||||||
| 8.25–8.61 | 1.05 (0.91–1.21) | |||||||||
| 8.61–9.00 | 1.11 (0.96–1.28) | |||||||||
| ≥ 9.00 | 1.06 (0.91–1.25) | |||||||||
| All-cause mortality (women) | < 8.06 | 1 | ||||||||
| 8.06–8.40 | 1.22 (0.94–1.58) | |||||||||
| 8.40–8.75 | 1.01 (0.78–1.31) | |||||||||
| ≥ 8.75 | 0.99 (0.76–1.28) | |||||||||
| Li, 2019, China | Retrospective cohort study/5.52 years |
Health check-up programme in Xinzheng and Xinmi City Free of history of CVD, type 1 diabetes and obesity (BMI > 45 kg/m2) |
6,078 | 70.45/53.08 | Automatic biochemical analyser | ICD-10 codes I20-I25 | CAD (incidence) | < 8.32 | 1 | Age and sex, living alone, current smoking, alcohol consumption, exercise, BMI, resting heart rate, SBP, HDL-C, LDL-C, and diabetic status, time-varying repeated measures of TyG |
| 8.32–8.61 | 1.22 (0.93–1.60) | |||||||||
| 8.61–8.89 | 1.26 (0.96–1.66) | |||||||||
| ≥ 8.90 | 2.05 (1.58–2.64) | |||||||||
| Per 1 unit | 1.63 (1.39–1.90) | |||||||||
| Hospital dataset for admissions | CVD (incidence) | < 8.32 | 1 | |||||||
| 8.32–8.61 | 1.00 (0.80–1.25) | |||||||||
| 8.61–8.89 | 1.17 (0.94–1.45) | |||||||||
| ≥ 8.90 | 1.61 (1.31–1.99) | |||||||||
| Per 1 unit | 1.43 (1.24–1.63) | |||||||||
| Liu, 2020, China | Retrospective cohort study/98.20 months |
National Health and Nutrition Examination Survey General population |
19,420 | 47.10/48.90 | Enzymatic assays and hexokinase method | ICD-10 codes I00–I09, I11, I13, I20–I51, I60–I69 | CV mortality | ≤ 8.00 | 1 | Age, sex, race, smoking, BMI, SBP, Egfr, TC, HDL-C, comorbidities (cardiovascular disease, diabetes, and hypertension), and medicine use (hypotensive drugs, hypoglycemic drugs, lipid-lowering medication, and antiplatelet drugs) |
| 8.00–9.00 | 0.63 (0.43–0.93) | |||||||||
| 9.00–10.00 | 0.64 (0.41–1.00) | |||||||||
| > 10.00 | 1.37 (0.78–2.42) | |||||||||
| Per 1 unit | 1.29 (1.05–1.57) | |||||||||
| The National Center for Health Statistics with personal data and death certificate | All-cause mortality | ≤ 8.00 | 1 | |||||||
| 8.00–9.00 | 0.93 (0.77–1.11) | |||||||||
| 9.00–10.00 | 0.88 (0.72–1.09) | |||||||||
| > 10.00 | 1.51 (1.15–1.98) | |||||||||
| Per 1 unit | 1.10 (1.00–1.20) | |||||||||
| Liu, 2021, China | Prospective cohort study/10.33 years |
Kailuan General Hospital Free of CVD and cancer history, and obesity (BMI > 45 kg/m2) |
96,541 | 51.19/79.61 | Hitachi 747 autoanalyzer | Basis of clinical symptoms and dynamic changes in cardiac enzymes and/or biomarker concentrations and electrocardiogram results | CVD (incidence) | ≤ 8.18 | 1 | Age, sex, education, and current smoking status, current drinking status, physical activity, BMI, hypertension, diabetes, HDL-C, LDL-C, hs-CRP, lipid-lowering medication, antidiabetic medication, and antihypertensive medication |
| 8.18–8.57 | 1.09 (1.02–1.18) | |||||||||
| 8.57–9.05 | 1.18 (1.09–1.27) | |||||||||
| > 9.05 | 1.20 (1.11–1.30) | |||||||||
| Per 1 unit | 1.09 (1.05–1.13) | |||||||||
| Mirshafiei, 2021, Iran | Prospective cohort study/6.00 years |
Mashhad stroke and heart association disorder study Free of diabetes, hyperlipidemia, hypertensive and CVD history |
9704 | 48.09/40.13 | NA | Clinic for confirmation and questionnaire | CVD (incidence) | Per 1 SD (0.82) | 2.31 (1.93–2.76) | Sex, age, smoking, BMI, family history of CVD, HTN, diabetes, and LDL |
| Cardiac mortality | Per 1 SD (0.82) | 2.30 (1.25–4.24) | ||||||||
| Park, 2020, Korea | Prospective cohort study/50 months |
A health risk assessment study Free of IHD or ischemic stroke history, type 2 diabetes or a fasting plasma glucose level ≥ 126 mg/dL, current use of dyslipidaemia medication or aspirin, and hs-CRP levels ≥ 10 mg/L |
16,455 | 46.1/51.21 | Enzymatic methods using a Hitachi 7600 Automated Chemistry Analyzer | ICD-10 codes I20 and I21 | Ischemic heart disease (incidence) | ≤ 8.08 | 1 | Age, sex, body mass index, smoking status, alcohol intake, physical activity, hs-CRP level, mean arterial blood pressure, chronic kidney disease, and hypertension medication |
| 8.09–8.45 | 1.61 (1.05–2.48) | |||||||||
| 8.46–8.85 | 1.85 (1.21–2.83) | |||||||||
| ≥ 8.86 | 2.28 (1.48–3.51) | |||||||||
| Sanchez-Inigo, 2016, Spain | Prospective cohort study/8.75 years |
Vascular Metabolic CUN cohort Free of CVD at baseline, history of type 1 diabetes or latent autoimmune diabetes in adults, cancer in the palliative phase, familial hypertriglyceridaemia, extreme BMI (> 45 kg/m2) or a hypercoagulable state |
5014 | 54.41/61.19 | Hitachi 711 Chemistry Analyzer and hexokinase method | ICD-10 code I20-I25, I63-I66, I73 and I74 | CVD (incidence) | 6.40–7.87 | 1 | Age, sex, BMI, cigarette smoking, daily alcohol intake, lifestyle pattern (physically active/sedentary behavior), hypertension, T2D, anti-aggregation therapy, HDL-C, LDL-C |
| 7.88–8.18 | 1.19 (0.83–1.71) | |||||||||
| 8.19–8.47 | 1.32 (0.93–1.88) | |||||||||
| 8.48–8.80 | 1.52 (1.07–2.16) | |||||||||
| 8.81–12.42 | 2.32 (1.65–3.26) | |||||||||
| Tian, 2021, China | Prospective cohort study/11.03 years |
Kailuan study Free of MI history |
98,849 | 51.81/79.75 | Hexokinase/glucose-6-phosphate dehydrogenase method and enzymatic colorimetric method | Combinations of chest pain symptoms, electrocardiographic signs, and cardiac enzyme levels | MI (incidence) | 7.70–8.06 | 1 | Age, sex, level of education, income, smoking, alcohol abuse, physical activity, BMI, SBP, DBP, a history of hypertension, diabetes mellitus, and dyslipidemia, antidiabetic drugs, lipid-lowering drugs, antihypertensive drugs, HDL-C, LDL-C, and hs-CRP at baseline |
| 8.29–8.48 | 1.07 (0.90–1.29) | |||||||||
| 8.68–8.91 | 1.30 (1.03–1.62) | |||||||||
| 9.23–9.82 | 1.58 (1.18–2.12) | |||||||||
| Per 1 unit | 1.49 (1.26–1.76) | |||||||||
| Vega, 2014, USA | Retrospective cohort study/14.75 years |
Cooper Center Longitudinal Study General population |
39,447 | 44.90/100.00 | NA | ICD-9 codes 390Y449.9 for deaths before 1999 or ICD-10 codes I00YI78 for deaths occurring from 1999 to 2008 | CV mortality | Highest vs. lowest | 0.89 (0.77–1.03) | Age, BMI, RSBP, smoking, non-HDL-C |
| The National Death Index | All-cause mortality | Highest vs. lowest | 0.89 (0.82–0.97) |
CAD: coronary artery disease; CVD: cardiovascular disease; ASCVD: atherosclerotic cardiovascular disease; TyG: triglyceride and glucose index; WC: waist circumference; BMI: body mass index; FHCVD: family history of cardiovascular disease; T2D: type 2 diabetes; HTP: hypertension; LDL: low density lipoprotein; LDL-C: low-density lipoprotein cholesterol; HDL-C: high-density lipoprotein cholesterol; MI: myocardial infarction; RSBP: resting systolic blood pressure; SBP: systolic blood pressure; eGFR: estimated glomerular filtration rate; TC: total cholesterol; hs-CRP: high-sensitive C-reactive protein; HbA1c: Glycated hemoglobin A1c; CT: computed tomography; MRI: magnetic resonance imaging; CCTA: coronary computed tomographic angiography; ECG: electrocardiogram; ICD-10: International Classification of Diseases, 10th Clinical Modification; NA: not application