Does diabetes modify the triglyceride-glucose index associated with cardiovascular events and mortality? A meta-analysis of 50 cohorts involving 7,239,790 participants.

IF 10.6 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Cardiovascular Diabetology Pub Date : 2025-01-27 DOI:10.1186/s12933-025-02585-z

Jun Zhang, Qiye Zhan, Zhihao Deng, Ling Lin, Zhaolan Feng, Huabin He, Deju Zhang, Huilei Zhao, Xiang Gu, Xiaoping Yin, Peng Yu, Xiao Liu

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Abstract

Introduction: Previous studies highlighted the association between the triglyceride-glucose (TyG) index and cardiovascular events in patients with diabetes. However, whether diabetes affects TyG-cardiovascular diseases (CVD) is still unclear. This study aimed to evaluate the association between the TyG index and CVD risk, stratified by diabetes status, as well as the potential modifying effect of diabetic status.

Methods/design: The PubMed, Cochrane Library, and Embase databases were searched for studies on the associations between the TyG index and cardiovascular events and mortality in patients with and without diabetes from inception to December 2, 2024. The random effects model was employed to pool the effect sizes.

Results: A total of 50 cohort studies (7,239,790 participants) were included. The mean age of participants was 31.46 years (diabetes mellitus [DM]: 65.18; non-DM: 31.23), and 40.66% of participants were female (DM: 36.07%; non-DM: 40.70%). The associations between the TyG index and cardiovascular events (HR: 1.72 vs. 1.55, P = 0.55), major adverse cardiovascular and cerebrovascular events (HR: 2.02 vs. 1.91, P = 0.84), stroke (HR: 1.46 vs. 1.39, P = 0.77) and cardiovascular death (HR: 1.85 vs. 1.60, P = 0.56) were similar among DM and non-DM individuals. However, the associations between the TyG index and ischemic heart disease (IHD) (HR: 2.20 vs. 1.57, P = 0.03) as well as all-cause mortality (HR: 1.94 vs. 1.24, P = 0.01) were stronger in DM patients than in non-DM patients.

Conclusion: TyG index showed association with cardiovascular events, mortality, and all-cause mortality independent of diabetic status, with low to moderate certainty. The associations for IHD and all-cause death were stronger in diabetic patients than in individuals without diabetes. Future studies should explore the role of diabetes in the TyG index-associated CVD outcomes and mortality.

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糖尿病是否会改变与心血管事件和死亡率相关的甘油三酯-葡萄糖指数？一项涉及7,239,790名参与者的50个队列的荟萃分析。

先前的研究强调了甘油三酯-葡萄糖（TyG）指数与糖尿病患者心血管事件之间的关联。然而，糖尿病是否影响tyg -心血管疾病（CVD）仍不清楚。本研究旨在评估TyG指数与CVD风险之间的关系，并按糖尿病状态分层，以及糖尿病状态的潜在调节作用。方法/设计：检索PubMed、Cochrane Library和Embase数据库，检索从发病到2024年12月2日期间糖尿病患者和非糖尿病患者的TyG指数与心血管事件和死亡率之间的关联研究。采用随机效应模型汇总效应量。结果：共纳入50项队列研究（7239790名受试者）。参与者平均年龄31.46岁(糖尿病[DM]: 65.18岁；非糖尿病：31.23)，女性占40.66%(糖尿病：36.07%；non-DM: 40.70%)。糖尿病和非糖尿病患者TyG指数与心血管事件（HR: 1.72 vs. 1.55, P = 0.55）、主要不良心脑血管事件（HR: 2.02 vs. 1.91, P = 0.84）、卒中（HR: 1.46 vs. 1.39, P = 0.77）和心血管死亡（HR: 1.85 vs. 1.60, P = 0.56）之间的相关性相似。然而，与非糖尿病患者相比，糖尿病患者TyG指数与缺血性心脏病（IHD）（HR: 2.20 vs. 1.57, P = 0.03）以及全因死亡率（HR: 1.94 vs. 1.24, P = 0.01）之间的相关性更强。结论：TyG指数与心血管事件、死亡率和全因死亡率相关，与糖尿病无关，具有低到中等的确定性。糖尿病患者与非糖尿病患者相比，IHD和全因死亡的相关性更强。未来的研究应探讨糖尿病在TyG指数相关的心血管疾病结局和死亡率中的作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cardiovascular Diabetology 医学-内分泌学与代谢

CiteScore

12.30

自引率

15.10%

发文量

240

审稿时长

1 months

期刊介绍： Cardiovascular Diabetology is a journal that welcomes manuscripts exploring various aspects of the relationship between diabetes, cardiovascular health, and the metabolic syndrome. We invite submissions related to clinical studies, genetic investigations, experimental research, pharmacological studies, epidemiological analyses, and molecular biology research in this field.