The interaction between triglyceride-glucose index and visceral adiposity in cardiovascular disease risk: findings from a nationwide Chinese cohort
Abstract Background Globally, cardiovascular disease (CVD) constitutes the primary cause of death, with insulin resistance (IR), measured by the triglyceride-glucose (TyG) index, and visceral obesity, reflected by the Chinese Visceral Adiposity Index (CVAI), as key contributors. However, the relatio...
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| Format: | Article |
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BMC
2024-11-01
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| Series: | Cardiovascular Diabetology |
| Online Access: | https://doi.org/10.1186/s12933-024-02518-2 |
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| author | Yuhao Yang Shengxi Li Qiao Ren Yu Qiu Mengjia Pan Guanglei Liu Rise Zheng Zhenmei An Shuangqing Li |
| author_facet | Yuhao Yang Shengxi Li Qiao Ren Yu Qiu Mengjia Pan Guanglei Liu Rise Zheng Zhenmei An Shuangqing Li |
| author_sort | Yuhao Yang |
| collection | DOAJ |
| description | Abstract Background Globally, cardiovascular disease (CVD) constitutes the primary cause of death, with insulin resistance (IR), measured by the triglyceride-glucose (TyG) index, and visceral obesity, reflected by the Chinese Visceral Adiposity Index (CVAI), as key contributors. However, the relationship between the TyG index and CVAI regarding CVD risk remains insufficiently understood. This research investigates the interactive impact of the TyG index and CVAI on the risk of cardiovascular disease. Methods We analyzed data from 8,358 participants from the China Health and Retirement Longitudinal Study (CHARLS) over a 9-year follow-up period. Participants were classified into four groups based on median TyG index (8.59) and CVAI values (101.26), and baseline characteristics were summarized. Missing data were addressed using multiple imputation by chained equations (MICE). Cox proportional hazards models assessed associations between TyG index, CVAI, CVD, coronary heart disease (CHD), and stroke risks, with Kaplan-Meier analysis used for cumulative hazard. Interaction effects were evaluated using both multiplicative and additive measures. Subgroup analyses by age, gender, and clinical conditions were conducted to explore interaction effects across different populations. Sensitivity analyses re-tested models, excluding the covariates BMI and diabetes, using tertiles for classification, and re-evaluating imputed data. Results Over the 9-year follow-up, 1,240 participants (14.8%) developed CVD, including 896 cases of CHD and 475 strokes. Kaplan-Meier curves indicated that participants with low TyG index but high CVAI had the highest cumulative hazard of CVD. Cox regression showed that this group had the highest CVD risk (HR = 1.87, 95% CI: 1.57–2.24), followed by those with both high TyG index and high CVAI (HR = 1.75, 95% CI: 1.49–2.06). Interaction analysis revealed a negative interaction effect between high TyG and high CVAI on CVD and CHD risks, with no significant effect on stroke. Subgroup and sensitivity analyses further confirmed these findings, showing consistent results across demographic groups and under various analytical conditions. Conclusion This study suggests that the interaction between IR (TyG index) and visceral fat accumulation (CVAI) plays a complex role in CVD risk, with a potential antagonistic effect observed between high TyG and high CVAI on CVD events. These findings highlight the importance of considering both IR and visceral adiposity in CVD risk assessments to improve the identification of high-risk individuals. |
| format | Article |
| id | doaj-art-9e2028d6a6ca4758a095b96bdcc45bcc |
| institution | DOAJ |
| issn | 1475-2840 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Cardiovascular Diabetology |
| spelling | doaj-art-9e2028d6a6ca4758a095b96bdcc45bcc2025-08-20T02:51:48ZengBMCCardiovascular Diabetology1475-28402024-11-0123111310.1186/s12933-024-02518-2The interaction between triglyceride-glucose index and visceral adiposity in cardiovascular disease risk: findings from a nationwide Chinese cohortYuhao Yang0Shengxi Li1Qiao Ren2Yu Qiu3Mengjia Pan4Guanglei Liu5Rise Zheng6Zhenmei An7Shuangqing Li8General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan UniversityClinical Medical College, Southwest Medical UniversityDepartment of Endocrinology and Metabolism, West China Hospital, Sichuan UniversityGeneral Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan UniversityGeneral Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan UniversityDepartment of Endocrinology and Metabolism, West China Hospital, Sichuan UniversityGeneral Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan UniversityDepartment of Endocrinology and Metabolism, West China Hospital, Sichuan UniversityGeneral Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan UniversityAbstract Background Globally, cardiovascular disease (CVD) constitutes the primary cause of death, with insulin resistance (IR), measured by the triglyceride-glucose (TyG) index, and visceral obesity, reflected by the Chinese Visceral Adiposity Index (CVAI), as key contributors. However, the relationship between the TyG index and CVAI regarding CVD risk remains insufficiently understood. This research investigates the interactive impact of the TyG index and CVAI on the risk of cardiovascular disease. Methods We analyzed data from 8,358 participants from the China Health and Retirement Longitudinal Study (CHARLS) over a 9-year follow-up period. Participants were classified into four groups based on median TyG index (8.59) and CVAI values (101.26), and baseline characteristics were summarized. Missing data were addressed using multiple imputation by chained equations (MICE). Cox proportional hazards models assessed associations between TyG index, CVAI, CVD, coronary heart disease (CHD), and stroke risks, with Kaplan-Meier analysis used for cumulative hazard. Interaction effects were evaluated using both multiplicative and additive measures. Subgroup analyses by age, gender, and clinical conditions were conducted to explore interaction effects across different populations. Sensitivity analyses re-tested models, excluding the covariates BMI and diabetes, using tertiles for classification, and re-evaluating imputed data. Results Over the 9-year follow-up, 1,240 participants (14.8%) developed CVD, including 896 cases of CHD and 475 strokes. Kaplan-Meier curves indicated that participants with low TyG index but high CVAI had the highest cumulative hazard of CVD. Cox regression showed that this group had the highest CVD risk (HR = 1.87, 95% CI: 1.57–2.24), followed by those with both high TyG index and high CVAI (HR = 1.75, 95% CI: 1.49–2.06). Interaction analysis revealed a negative interaction effect between high TyG and high CVAI on CVD and CHD risks, with no significant effect on stroke. Subgroup and sensitivity analyses further confirmed these findings, showing consistent results across demographic groups and under various analytical conditions. Conclusion This study suggests that the interaction between IR (TyG index) and visceral fat accumulation (CVAI) plays a complex role in CVD risk, with a potential antagonistic effect observed between high TyG and high CVAI on CVD events. These findings highlight the importance of considering both IR and visceral adiposity in CVD risk assessments to improve the identification of high-risk individuals.https://doi.org/10.1186/s12933-024-02518-2 |
| spellingShingle | Yuhao Yang Shengxi Li Qiao Ren Yu Qiu Mengjia Pan Guanglei Liu Rise Zheng Zhenmei An Shuangqing Li The interaction between triglyceride-glucose index and visceral adiposity in cardiovascular disease risk: findings from a nationwide Chinese cohort Cardiovascular Diabetology |
| title | The interaction between triglyceride-glucose index and visceral adiposity in cardiovascular disease risk: findings from a nationwide Chinese cohort |
| title_full | The interaction between triglyceride-glucose index and visceral adiposity in cardiovascular disease risk: findings from a nationwide Chinese cohort |
| title_fullStr | The interaction between triglyceride-glucose index and visceral adiposity in cardiovascular disease risk: findings from a nationwide Chinese cohort |
| title_full_unstemmed | The interaction between triglyceride-glucose index and visceral adiposity in cardiovascular disease risk: findings from a nationwide Chinese cohort |
| title_short | The interaction between triglyceride-glucose index and visceral adiposity in cardiovascular disease risk: findings from a nationwide Chinese cohort |
| title_sort | interaction between triglyceride glucose index and visceral adiposity in cardiovascular disease risk findings from a nationwide chinese cohort |
| url | https://doi.org/10.1186/s12933-024-02518-2 |
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