Association between TyG index and risk of carotid atherosclerosis in NAFLD patients: a retrospective cohort study

Abstract

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BackgroundThe TyG index, or triglyceride-glucose index, is primarily used as a marker to assess insulin resistance and metabolic health. It increases mortality risk in patients with NAFLD, atherosclerosis, ischemic stroke, or heart failure. However, its association with Carotid Atherosclerosis (CAS) risk in NAFLD patients remains uncertain.MethodsThis retrospective cohort study enrolled 739 individuals who participated comprehensive health evaluations at a large public hospital in Yangzhou, China, between January 2021 and December 2023. Among them, 436 were men and 303 were women, and their mean (SD) age was 51.53 ± 11.46 years. The individuals were categorized into three tertiles (Q1, Q2, and Q3), according to the baseline TyG index. Our investigation focused on exploring the correlativity between the TyG and the occurrence of CAS utilizing Cox regression and RCS analyses.ResultsDuring a 3-year follow-up period, 199 patients developed CAS (cumulative incidence rate: 26.93%). A statistical model, adjusted for age, gender, BMI, and other confounders indicated that the HR (95%CI) values for CAS risk in the Q2 and Q3 groups were 3.11(1.87-5.17) and 4.51(2.69-7.56), respectively, with P-values <0.001 for both groups. A sensitivity analysis confirmed these results. Kaplan–Meier survival analysis revealed that CAS risk varied across the groups (P non-linear < 0.05).ConclusionIn individuals diagnosed as NAFLD, the possibility for CAS escalates with the elevation of the TyG value. Therefore, the TyG index is an effective marker for assessing the risk of CAS within this demographic. Large-sample prospective studies are needed to confirm this conclusion in the future.

Keywords

• triglyceride-glucose index
• NAFLD
• cohort study
• carotid atherosclerosis
• insulin resistance