Relationship between the triglyceride–glucose index and coronary artery calcification in asymptomatic, non-diabetic patients undergoing maintenance hemodialysis

Abstract

Objective

Coronary artery calcification (CAC) is positively and independently associated with cardiovascular disease (CVD) in patients undergoing maintenance hemodialysis (MHD). Insulin resistance is independently associated with CAC and is an important risk factor for CVD. The triglyceride–glucose (TyG) index is a reliable biomarker of insulin resistance. This cross-sectional, observational study aimed to investigate the relationship between the TyG index and CAC in asymptomatic non-diabetic patients undergoing MHD.

Methods

The quantitative coronary artery calcification score (CACS) was calculated and expressed using the Agatston score. The TyG index was calculated as ln [fasting triglyceride (mg/dL) × fasting glucose (mg/dL)/2]. Multiple Poisson regression analysis, Spearman correlation analysis, and receiver operating characteristic (ROC) curves were used to investigate the relationship between the TyG index and CAC.

Results

The 151 patients were divided into three groups according to the tertiles of the TyG index. With an increase in the TyG index, the CACS significantly increased (Spearman’s rho = 0.414, p < 0.001). Poisson regression analysis indicated that the TyG index was independently related to the presence of CAC (prevalence ratio, 1.281 [95% confidence interval, 1.121–1.465], p < 0.001). Furthermore, ROC curve analysis showed that the TyG index was of value in predicting the CAC in asymptomatic non-diabetic patients undergoing MHD, with an area under the curve of 0.667 (p = 0.010).

Conclusion

The TyG index is independently related to the presence of CAC in asymptomatic, non-diabetic patients undergoing MHD.

Keywords:

• Triglyceride–glucose index
• cardiovascular disease
• coronary artery calcification
• non-diabetic
• maintenance hemodialysis

Acknowledgments

The authors are grateful for the continued support of the People’s Hospital of Yangzhong city and Zhongda Hospital, Southeast University School of Medicine. We thank the doctors at People’s Hospital of Yangzhong city: Guozhong Du, Yongjun He, and Yida Han in the CT department; Aifang Chen and Dong Wang in the color ultrasound department; and Feng Wang, Zhijian Bao, and Chengfang Wang in the clinical laboratory for their help and support in this study.

Author contributions

Hong Ding designed the study and prepared the manuscript. Ying Tian, Li Xu, Lei Song, Ying Shi, and Dongxing Mu contributed to clinical data acquisition and drafted the manuscript. Jinhua Zhu and Ruoxin Chen performed statistical analyses and discussed the data. Hong Liu and Bicheng Liu contributed to the design of this study and revised the manuscript. All the authors have read and approved the final version of the manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The data analyzed in this study are available from the corresponding author upon reasonable request.

Additional information

Funding

This work was supported by the Primary Research & Development Plan of Zhenjiang City under Grant SH2019027.