Background
Methods
Patients
Data collection
Statistical analyses
Results
Baseline characteristics
Characteristic | Total (N = 10,535) | TyG index | P-value | |||
---|---|---|---|---|---|---|
Q1 (n = 2650) | Q2 (n = 2647) | Q3 (n = 2590) | Q4 (n = 2648) | |||
Sex, n (%) | < 0.001 | |||||
Male | 5121 (48.6) | 1375 (51.9) | 1256 (47.4) | 1183 (45.7) | 1307 (49.4) | |
Female | 5414 (51.4) | 1275 (48.1) | 1391 (52.6) | 1407 (54.3) | 1341 (50.6) | |
Age, years, median (IQR) | < 0.001 | |||||
Total | 64.0 (59.0–70.0) | 65.0 (60.0–71.0) | 64.0 (59.0–69.0) | 64.0 (59.0–69.0) | 63.0 (57.0–68.0) | |
≤ 60 | 55.0 (51.0–58.0) | 55.0 (51.0–58.0) | 55.0 (52.0–58.0) | 55.0 (52.0–58.0) | 55.0 (51.0–57.0) | |
> 60 | 67.0 (64.0–71.0) | 68.0 (64.0–72.0) | 67.0 (64.0–71.0) | 67.0 (63.0–71.0) | 67.0 (64.0–71.0) | |
SBP, mmHg, median (IQR) | 140.0 (128.0–156.0) | 139.0 (124.0–152.0) | 140.0 (126.0–155.0) | 140.0 (130.0–159.0) | 141.0 (130.0–159.0) | < 0.001 |
DBP, mmHg, median (IQR) | 83.0 (77.0–90.0) | 80.0 (75.0–90.0) | 82.0 (76.0–90.0) | 83.0 (78.0–90.0) | 84.0 (78.0–91.0) | < 0.001 |
CRP, mg/L, median (IQR) | 4.2 (2.0–12.8) | 4.1 (1.9–14.9) | 4.3 (2.0–14.2) | 4.0 (2.0–11.3) | 4.5 (2.2–11.2) | < 0.001 |
FPG, mmol/L, median (IQR) | 6.2 (5.3–8.1) | 5.3 (4.8–5.9) | 5.8 (5.1–6.8) | 6.54 (5.6–8.1) | 9.4 (7.0–12.6) | < 0.001 |
LDL-C, mmol/L, median (IQR) | 2.8 (2.1–3.4) | 2.5 (1.9–3.1) | 2.8 (2.2–3.4) | 3.0 (2.3–3.6) | 2.8 (2.2–3.5) | < 0.001 |
HDL-C, mmol/L, median (IQR) | 1.1 (0.9–1.3) | 1.2 (1.0–1.4) | 1.1 (0.9–1.3) | 1.1 (0.9–1.2) | 1.0 (0.8–1.1) | < 0.001 |
TG, mmol/L, median (IQR) | 1.4 (1.0–2.1) | 0.9 (0.7–1.0) | 1.3 (1.1–1.5) | 1.8 (1.5–2.1) | 2.6 (2.0–3.5) | < 0.001 |
TC, mmol/L, median (IQR) | 4.6 (3.8–5.4) | 4.1 (3.4–4.9) | 4.5 (3.8–5.2) | 4.7 (4.0–5.5) | 5.0 (4.2–5.7) | < 0.001 |
HbA1c, mmol/L, median (IQR) | 6.0 (5.6–7.0) | 5.7 (5.4–6.2) | 5.9 (5.5–6.5) | 6.1 (5.6–6.9) | 7.1 (6.1–8.6) | < 0.001 |
TyG index | 9.0 (8.5–9.4) | 8.2 (8.0–8.4) | 8.7 (8.6–8.8) | 9.1 (9.0–9.3) | 9.8 (9.6–10.2) | < 0.001 |
Smoking, n (%) | 4590 (43.6) | 1173 (44.3) | 1121 (42.3) | 1101 (42.5) | 1195 (45.1) | < 0.001 |
Drinking, n (%) | 5863 (55.7) | 1457 (55) | 1480 (55.9) | 1421 (54.9) | 1505 (56.8) | < 0.001 |
Hypertension, n (%) | 8875 (84.2) | 2114 (23.8) | 2201 (24.8) | 2241(25.3) | 2319 (26.1) | < 0.001 |
Hyperlipidemia, n (%) | 5770 (54.8) | 690 (12.0) | 961 (16.7) | 1326 (23.0) | 1981 (34.3) | < 0.001 |
Use of antihypertensives, n (%) | 5239 (49.7) | 1160 (43.8) | 1240 (46.8) | 1363 (52.6) | 1476 (55.7) | < 0.001 |
Use of antilipidemic, n (%) | 7787 (73.9) | 1703 (64.3) | 1947 (73.6) | 2026 (78.2) | 2111 (79.7) | < 0.001 |
CIMT, mm, median (IQR) | 0.10 (0.09–0.12) | 0.10 (0.09–0.12) | 0.10 (0.09- 0.12) | 0.10 (0.09–0.12) | 0.10 (0.09–0.12) | 0.742 |
Carotid artery plaque, n (%) | 8079 (76.69) | 1985 (74.91) | 1996 (75.41) | 2006 (77.45) | 2092 (79.00) | < 0.001 |
Glucose regulation state, n (%) | < 0.001 | |||||
Normal glucose regulation | 3756 (35.7) | 1735 (65.5) | 1160 (43.8) | 654 (25.3) | 207 (7.8) | |
Prediabetes | 2813 (26.7) | 694 (26.2) | 861 (32.5) | 834 (32.2) | 424 (16.0) | |
Diabetes | 3966 (37.6) | 221 (8.3) | 626 (23.7) | 1102 (42.5) | 2017 (76.2) | |
No. of carotid artery plaque, n (%) | < 0.001 | |||||
0 | 2456 (23.3) | 665 (25.1) | 651 (24.6) | 584 (22.5) | 556 (21) | |
1 | 406 (3.9) | 96 (3.6) | 100 (3.8) | 100 (3.9) | 110 (4.2) | |
≥ 2 | 7673 (72.8) | 1889 (71.3) | 1896 (71.6) | 1906 (73.6) | 1982 (74.8) | |
Carotid artery plaque echo property, n (%) | < 0.001 | |||||
Hypoechoic plaque | 497 (4.7) | 114 (4.3) | 131 (4.9) | 130 (5) | 122 (4.6) | |
Isoechoic plaque | 548 (5.2) | 137 (5.2) | 133 (5) | 136 (5.3) | 142 (5.4) | |
Hyperechoic plaque | 4792 (45.5) | 1211 (45.7) | 1162 (43.9) | 1194 (46.1) | 1225 (46.3) | |
Mixture plaque | 2242 (21.3) | 523 (19.7) | 570 (21.5) | 546 (21.1) | 603 (22.8) |
Association between the TyG index and the risk of carotid artery plaques
Variables | Carotid artery plaques | |||||
---|---|---|---|---|---|---|
OR (95% CI)a | P-value | OR (95% CI)b | P-value | OR (95% CI)c | P-value | |
TyG index | 1.14 (1.11–1.17) | < 0.001 | 1.28 (1.24–1.31) | < 0.001 | 1.29 (1.24–1.34) | < 0.001 |
Q1 | Reference | Reference | Reference | |||
Q2 | 1.00 (0.95–1.05) | 0.969 | 1.10 (1.04–1.16) | 0.537 | 1.01 (0.96–1.07) | 0.682 |
Q3 | 1.09 (1.04–1.15) | 0.001 | 1.22 (1.16–1.29) | 0.013 | 1.07 (1.01–1.14) | 0.025 |
Q4 | 1.22 (1.16–1.28) | < 0.001 | 1.51 (1.43–1.59) | < 0.001 | 1.37 (1.28–1.47) | < 0.001 |
P-trend | < 0.001 | < 0.001 | < 0.001 |
Sex | Variables | Carotid artery plaques | |||||
---|---|---|---|---|---|---|---|
OR (95% CI)a | P-value | OR (95% CI)b | P-value | OR (95% CI)c | P-value | ||
Male | TyG index | 0.94 (0.91–0.98) | 0.003 | 1.14 (1.10–1.19) | < 0.001 | 1.20 (1.13–1.27) | < 0.001 |
Q1 | Reference | Reference | Reference | ||||
Q2 | 1.00 (0.91–1.07) | 0.789 | 1.13 (1.04–1.23) | 0.004 | 1.05 (0.96–1.15) | 0.268 | |
Q3 | 0.95 (0.88–1.03) | 0.213 | 1.17 (1.07–1.28) | < 0.001 | 1.03 (0.94–1.13) | 0.548 | |
Q4 | 0.87 (0.80–0.94) | < 0.001 | 1.23 (1.13–1.34) | < 0.001 | 1.18 (1.06–1.31) | 0.003 | |
Female | TyG index | 1.34 (1.30–1.39) | < 0.001 | 1.38 (1.33–1.44) | < 0.001 | 1.35 (1.29–1.43) | < 0.001 |
Q1 | Reference | Reference | Reference | ||||
Q2 | 1.08 (1.01–1.15) | 0.019 | 1.08 (1.01–1.16) | 0.031 | 0.99 (0.92–1.07) | 0.875 | |
Q3 | 1.31 (1.23–1.40) | < 0.001 | 1.25 (1.17–1.34) | < 0.001 | 1.10 (1.01–1.19) | 0.019 | |
Q4 | 1.62 (1.52–1.74) | < 0.001 | 1.74 (1.61–1.87) | < 0.001 | 1.52 (1.38–1.66) | < 0.001 |
Age | Variables | Carotid artery plaques | |||||
---|---|---|---|---|---|---|---|
OR (95% CI)a | P-value | OR (95% CI)b | P-value | OR (95% CI)c | P-value | ||
≤ 60 | TyG index | 1.37 (1.32–1.42) | < 0.001 | 1.27 (1.22–1.32) | < 0.001 | 1.34 (1.26–1.42) | < 0.001 |
Q1 | Reference | Reference | Reference | ||||
Q2 | 1.19 (1.09–1.29) | < 0.001 | 1.18 (1.08–1.30) | < 0.001 | 1.05(0.95–1.16) | 0.359 | |
Q3 | 1.59 (1.45–1.73) | < 0.001 | 1.45 (1.32–1.59) | < 0.001 | 1.23 (1.11–1.37) | < 0.001 | |
Q4 | 1.90 (1.75–2.06) | < 0.001 | 1.68 (1.54–1.83) | < 0.001 | 1.54 (1.37–1.72) | < 0.001 | |
> 60 | TyG index | 1.16 (1.12–1.21) | < 0.001 | 1.21 (1.16–1.25) | < 0.001 | 1.16 (1.11–1.22) | < 0.001 |
Q1 | Reference | Reference | Reference | ||||
Q2 | 0.99 (0.93–1.06) | 0.840 | 1.05 (1.00–1.12) | 0.170 | 0.98 (0.91–1.05) | 0.563 | |
Q3 | 0.99 (0.93–1.05) | 0.720 | 1.07 (1.00–1.15) | 0.040 | 0.95 (0.88–1.02) | 0.161 | |
Q4 | 1.23 (1.15–1.32) | < 0.001 | 1.30 (1.21–1.39) | < 0.001 | 1.15 (1.06–1.26) | 0.002 |
Association between the TyG index and CAP according to glucose regulation state
Glucose regulation state | Variables | Carotid artery plaques | |||||
---|---|---|---|---|---|---|---|
OR (95% CI)a | P-value | OR (95% CI)b | P-value | OR (95% CI)c | P-value | ||
Normal glucose regulation | TyG index | 0.95 (0.90–1.01) | 0.080 | 1.16 (1.09–1.24) | < 0.001 | 1.11 (1.02–1.22) | 0.017 |
Q1 | Reference | Reference | Reference | ||||
Q2 | 0.98 (0.92–1.05) | 0.526 | 1.11 (1.03–1.19) | 0.007 | 1.04 (0.95–1.13) | 0.412 | |
Q3 | 0.94 (0.86–1.02) | 0.112 | 1.18 (1.08–1.29) | < 0.001 | 1.03 (0.93–1.15) | 0.563 | |
Q4 | 0.81 (0.71–0.92) | 0.001 | 1.11 (0.97–1.28) | 0.129 | 1.11 (0.93–1.32) | 0.259 | |
Prediabetes | TyG index | 0.87 (0.82–0.92) | < 0.001 | 1.06 (0.99–1.14) | 0.078 | 1.08 (0.97–1.19) | 0.182 |
Q1 | Reference | Reference | Reference | ||||
Q2 | 0.90 (0.83–0.99) | 0.032 | 1.06 (0.96–1.17) | 0.288 | 0.94 (0.85–1.05) | 0.295 | |
Q3 | 1.02 (0.93–1.12) | 0.645 | 1.23 (1.11–1.37) | < 0.001 | 1.06 (0.94–1.20) | 0.330 | |
Q4 | 0.69 (0.62–0.77) | < 0.001 | 0.99 (0.88–1.12) | 0.879 | 0.90 (0.76–1.06) | 0.202 | |
Diabetes | TyG index | 1.16 (1.11–1.22) | < 0.001 | 1.36 (1.30–1.43) | < 0.001 | 1.36 (1.26–1.46) | < 0.001 |
Q1 | Reference | Reference | Reference | ||||
Q2 | 1.11 (0.97–1.28) | 0.142 | 1.26 (1.09–1.47) | 0.003 | 1.13 (0.96–1.33) | 0.147 | |
Q3 | 1.18 (1.03–1.35) | 0.017 | 1.37 (1.19–1.58) | < 0.001 | 1.07 (0.91–1.25) | 0.408 | |
Q4 | 1.39 (1.22–1.58) | < 0.001 | 1.87 (1.63–2.15) | < 0.001 | 1.42 (1.21–1.66) | < 0.001 |
Sex | Glucose regulation state | Variables | Carotid artery plaques | |||||
---|---|---|---|---|---|---|---|---|
OR (95% CI)a | P-value | OR (95% CI)b | P-value | OR (95% CI)c | P-value | |||
Male | Normal glucose regulation | TyG index | 0.88 (0.81–0.96) | 0.005 | 1.24 (1.13–1.36) | < 0.001 | 1.21 (1.06–1.39) | 0.005 |
Q1 | Reference | Reference | Reference | |||||
Q2 | 0.98 (0.88–1.10) | 0.751 | 1.23 (1.09–1.38) | 0.001 | 1.06 (0.93–1.21) | 0.398 | ||
Q3 | 0.79 (0.69–0.90) | < 0.001 | 1.10 (0.96–1.27) | 0.182 | 0.83 (0.70–0.96) | 0.033 | ||
Q4 | 0.57 (0.48–0.68) | < 0.001 | 1.00 (0.82–1.22) | 0.974 | 0.91 (0.69–1.19) | 0.494 | ||
Prediabetes | TyG index | 0.67 (0.61–0.74) | < 0.001 | 0.97 (0.87–1.07) | 0.505 | 0.95 (0.82–1.12) | 0.557 | |
Q1 | Reference | Reference | Reference | |||||
Q2 | 0.94 (0.81–1.10) | 0.420 | 1.05 (0.89–1.24) | 0.552 | 0.94 (0.79–1.12) | 0.511 | ||
Q3 | 0.85 (0.73–0.99) | 0.038 | 1.18 (1.00–1.39) | 0.055 | 1.02 (0.84–1.23) | 0.846 | ||
Q4 | 0.49 (0.42–0.58) | < 0.001 | 0.83 (0.69–1.00) | 0.045 | 0.67 (0.52–0.86) | 0.002 | ||
Diabetes | TyG index | 0.91 (0.84–0.97) | 0.005 | 1.11 (1.03–1.19) | 0.009 | 1.23 (1.10–1.37) | < 0.001 | |
Q1 | Reference | Reference | Reference | |||||
Q2 | 0.99 (0.78–1.24) | 0.904 | 1.19 (0.94–1.51) | 0.143 | 1.13 (0.88–1.45) | 0.331 | ||
Q3 | 1.06 (0.85–1.32) | 0.592 | 1.34 (1.07–1.67) | 0.011 | 1.13 (0.90–1.44) | 0.284 | ||
Q4 | 0.98 (0.79–1.20) | 0.821 | 1.48 (1.19–1.84) | < 0.001 | 1.37 (1.08–1.74) | 0.010 | ||
Female | Normal glucose regulation | TyG index | 1.05 (0.97–1.14) | 0.198 | 1.09 (1.00–1.19) | 0.046 | 1.02 (0.90–1.15) | 0.794 |
Q1 | Reference | Reference | Reference | |||||
Q2 | 1.06 (0.97–1.15) | 0.223 | 1.04 (0.94–1.14) | 0.469 | 1.01 (0.91–1.23) | 0.825 | ||
Q3 | 1.17 (1.06–1.30) | 0.003 | 1.22 (1.09–1.37) | 0.001 | 1.16 (1.01–1.33) | 0.043 | ||
Q4 | 1.03 (0.86–1.24) | 0.739 | 1.23 (1.01–1.5) | 0.041 | 1.22 (0.95–1.56) | 0.115 | ||
Prediabetes | TyG index | 1.05 (0.97–1.14) | 0.244 | 1.14 (1.04–1.24) | 0.005 | 1.17 (1.02–1.35) | 0.023 | |
Q1 | Reference | Reference | Reference | |||||
Q2 | 0.94 (0.84–1.06) | 0.327 | 1.05 (0.93–1.20) | 0.410 | 0.93 (0.81–1.07) | 0.336 | ||
Q3 | 1.22 (1.08–1.38) | 0.001 | 1.26 (1.11–1.44) | < 0.001 | 1.10 (0.94–1.29) | 0.222 | ||
Q4 | 0.89 (0.77–1.03) | 0.127 | 1.12 (0.96–1.31) | 0.145 | 1.12 (0.89–1.40) | 0.328 | ||
Diabetes | TyG index | 1.44 (1.35–1.53) | < 0.001 | 1.58 (1.48–1.69) | < 0.001 | 1.45 (1.32–1.60) | < 0.001 | |
Q1 | Reference | Reference | Reference | |||||
Q2 | 1.31 (1.08–1.59) | 0.005 | 1.30 (1.06–1.59) | 0.012 | 1.14 (0.91–1.42) | 0.261 | ||
Q3 | 1.44 (1.21–1.73) | < 0.001 | 1.38 (1.14–1.67) | 0.001 | 1.01 (0.82–1.25) | 0.930 | ||
Q4 | 1.97 (1.65–2.34) | < 0.001 | 2.15 (1.78–2.58) | < 0.001 | 1.42 (1.14–1.77) | 0.002 |
Age | Glucose regulation state | Variables | carotid artery plaques | |||||
---|---|---|---|---|---|---|---|---|
OR (95% CI)a | P-value | OR (95% CI)b | P-value | OR (95% CI)c | P-value | |||
≤ 60 | Normal glucose regulation | TyG index | 1.32 (1.22–1.44) | < 0.001 | 1.16 (1.06–1.28) | < 0.001 | 1.12 (0.98–1.28) | 0.099 |
Q1 | Reference | Reference | Reference | |||||
Q2 | 1.27 (1.14–1.43) | < 0.001 | 1.24 (1.10–1.40) | < 0.001 | 1.17 (1.02–1.33) | 0.026 | ||
Q3 | 1.53 (1.34–1.74) | < 0.001 | 1.40 (1.22–1.60) | < 0.001 | 1.24 (1.04–1.46) | 0.015 | ||
Q4 | 1.38 (1.15–1.64) | < 0.001 | 1.09 (0.91–1.32) | 0.360 | 1.11 (0.86–1.43) | 0.430 | ||
Prediabetes | TyG index | 1.05 (0.96–1.15) | 0.290 | 0.99 (0.90–1.09) | 0.770 | 0.93 (0.80–1.09) | 0.367 | |
Q1 | Reference | Reference | Reference | |||||
Q2 | 0.86 (0.73–1.02) | 0.090 | 0.92 (0.77–1.09) | 0.320 | 0.74 (0.61–0.90) | 0.002 | ||
Q3 | 1.21 (1.02–1.43) | 0.030 | 1.12 (0.94–1.34) | 0.190 | 0.86 (0.70–1.05) | 0.141 | ||
Q4 | 1.08 (0.91–1.29) | 0.390 | 1.04 (0.87–1.26) | 0.650 | 0.89 (0.69–1.15) | 0.374 | ||
Diabetes | TyG index | 1.21 (1.13–1.30) | < 0.001 | 1.16 (1.08–1.25) | < 0.001 | 1.21(1.08–1.35) | 0.001 | |
Q1 | Reference | Reference | Reference | |||||
Q2 | 1.32 (0.98–1.78) | 0.070 | 1.23 (0.91–1.67) | 0.190 | 0.90 (0.64–1.26) | 0.544 | ||
Q3 | 1.71 (1.29–2.27) | < 0.001 | 1.49 (1.11–2.00) | 0.010 | 0.95 (0.68–1.31) | 0.738 | ||
Q4 | 1.98 (1.51–2.60) | < 0.001 | 1.69 (1.27–2.24) | < 0.001 | 1.03 (0.74–1.43) | 0.866 | ||
> 60 | Normal glucose regulation | TyG index | 0.94 (0.87–1.02) | 0.160 | 1.05 (0.96–1.14) | 0.300 | 0.99 (0.88–1.11) | 0.817 |
Q1 | Reference | Reference | Reference | |||||
Q2 | 0.94 (0.86–1.03) | 0.200 | 1.01 (0.92–1.11) | 0.780 | 0.94 (0.85–1.04) | 0.241 | ||
Q3 | 0.85 (0.76–0.95) | < 0.001 | 0.99 (0.88–1.11) | 0.890 | 0.87 (0.76–1.00) | 0.048 | ||
Q4 | 0.90 (0.74–1.10) | 0.320 | 0.95 (0.77–1.17) | 0.640 | 0.90 (0.70–1.16) | 0.420 | ||
Prediabetes | TyG index | 0.98 (0.90–1.07) | 0.640 | 1.03 (0.94–1.13) | 0.510 | 0.96 (0.84–1.10) | 0.568 | |
Q1 | Reference | Reference | Reference | |||||
Q2 | 1.03 (0.91–1.15) | 0.680 | 1.08 (0.96–1.21) | 0.230 | 0.97 (0.85–1.11) | 0.686 | ||
Q3 | 1.09 (0.97–1.23) | 0.150 | 1.19 (1.05–1.35) | 0.010 | 1.01 (0.87–1.17) | 0.916 | ||
Q4 | 0.76 (0.66–0.88) | < 0.001 | 0.80 (0.69–0.94) | 0.010 | 0.65 (0.52–0.80) | < 0.001 | ||
Diabetes | TyG index | 1.38 (1.29–1.47) | < 0.001 | 1.43 (1.34–1.53) | < 0.001 | 1.35 (1.24–1.48) | < 0.001 | |
Q1 | Reference | Reference | Reference | |||||
Q2 | 1.18 (0.99–1.40) | 0.060 | 1.25 (1.05–1.49) | 0.010 | 1.19 (0.99–1.43) | 0.059 | ||
Q3 | 1.15 (0.98–1.35) | 0.080 | 1.25 (1.06–1.47) | 0.010 | 1.05 (0.88–1.25) | 0.618 | ||
Q4 | 1.63 (1.39–1.90) | < 0.001 | 1.78 (1.52–2.09) | < 0.001 | 1.45 (1.21–1.74) | < 0.001 |