Triglyceride-Glucose Index is a Risk Marker of Incident COPD Events in Women

Figures & data

Table 1 Baseline Characteristics per Quartile (Q1–4) of TyG Index (n = 28,282)

	Q1 (n=7060)	Q2 (n=7085)	Q3 (n=7066)	Q4 (n=7071)	p-value
TyG index	3.38–4.40	4.40–4.57	4.57–4.75	4.75–6.70	-
Age (years)	44.7 (±7.5)	44.5 (±7.3)	44.2 (±7.3)	44.6 (±6.7)	0.037
Sex (%women)	41.8	28.1	21.7	13.0	<0.001
Height (m)	1.72 (±0.09)	1.73 (±0.09)	1.74 (±0.09)	1.75 (±0.08)	<0.001
BMI (kg/m^2)	23.1 (±2.9)	23.8 (±3.2)	24.7 (±3.4)	26.2 (±3.7)	<0.001
ESR (mm/h) ^a	4.70	4.73	4.79	4.93	<0.001
Never smokers,	43.7	35.7	32.5	28.1	<0.001
Ever smokers (%)	56.3	64.3	67.5	71.9
Smoking amount >20 cig/day (%)	6.0	9.5	11.4	15.1	<0.001
FEV1/FVC	0.80 (±0.09)	0.79 (±0.09)	0.78 (±0.09)	0.78 (±0.09)	<0.001
Prevalent CVD (%)	0.6	0.8	0.8	1.6	<0.001
Prevalent diabetes (%)	0.6	0.7	1.6	9.4	<0.001
AHT (%)	2.6	3.7	4.3	8.4	<0.001
Insulin (mIU/l)* ^a	5.69	6.52	7.28	9.49	0.001

Notes: Data presented as mean (±standard deviation) unless otherwise stated. ^aGeometric mean presented for ESR. Linear by linear association for chi square tests used for p value for categorical variables, ANOVA test for linearity used for p value for continuous variables. *Data from 6770 subjects.

Abbreviations: TyG, triglyceride-glucose; FEV₁, forced expiratory volume in 1 second; FVC, forced vital capacity; ESR, erythrocyte sedimentation rate; CVD, cardiovascular disease; BMI, body mass index; AHT, antihypertensive drug treatment.

Table 2 Incidence of COPD Events by Quartiles of and by 1 Unit Increase in TyG Index

	Q1	Q2	Q3	Q4	Per 1 Unit Increase	p-value for 1 Unit Increase
All (n=28,282)	3.38–4.40 (n=7060)	4.40–4.57 (n=7085)	4.57–4.75 (n=7066)	4.75–6.70 (n=7071)
COPD events n (n /1000 person-years)	719 (3.1)	874 (3.9)	891 (4.0)	885 (4.2)
Model 1	1.00 (reference)	1.25 (1.14–1.39)	1.31 (1.19–1.44)	1.42 (1.29–1.57)	1.61 (1.43–1.82)	<0.001
Model 2	1.00 (reference)	1.20 (1.08–1.32)	1.26 (1.14–1.39)	1.29 (1.16–1.43)	1.44 (1.26–1.65)	<0.001
Model 3	1.00 (reference)	1.16 (1.05–1.29)	1.23 (1.11–1.36)	1.21 (1.09–1.35)	1.33 (1.16–1.53)	<0.001
Women (n=7390)	3.58–4.30 (n=1845)	4.30–4.46 (n=1851)	4.46–4.62 (n=1847)	4.62–6.24 (n=1847)
COPD events n (n /1000 person-years)	174 (2.9)	235 (4.1)	270 (4.7)	340 (6.2)
Model 1	1.00 (reference)	1.41 (1.16–1.72)	1.64 (1.36–1.99)	2.21 (1.84–2.66)	3.38 (2.66–4.28)	<0.001
Model 2	1.00 (reference)	1.29 (1.06–1.57)	1.45 (1.19–1.75)	1.86 (1.54–2.25)	2.50 (1.94–3.23)	<0.001
Model 3	1.00 (reference)	1.25 (1.03–1.53)	1.34 (1.10–1.62)	1.72 (1.41–2.09)	2.19 (1.67–2.88)	<0.001
Men (n=20,892)	3.38–4.44 (n=5237)	4.44–4.60 (n=5206)	4.61–4.79 (n=5225)	4.79–6.70 (n=5224)
COPD events n (n /1000 person-years)	566 (3.3)	570 (3.4)	620 (3.8)	594 (3.8)
Model 1	1.00 (reference)	1.07 (0.95–1.20)	1.19 (1.06–1.33)	1.25 (1.12–1.40)	1.50 (1.29–1.73)	<0.001
Model 2	1.00 (reference)	0.96 (0.86–1.08)	1.05 (0.93–1.18)	1.02 (0.91–1.16)	1.18 (1.01–1.39)	0.041
Model 3	1.00 (reference)	0.99 (0.88–1.11)	1.06 (0.95–1.19)	1.01 (0.89–1.14)	1.14 (0.97–1.34)	0.118

Notes: Model 1: Unadjusted. Model 2: age, sex, height, BMI, smoking status, smoking amount >20 cig/day. Model 3: age, sex, height, BMI, smoking status, smoking amount >20 cig/day, FEV₁/FVC, physical activity, prevalent CVD, prevalent diabetes, antihypertensive drugs. Adjusted for sex only in overall analysis (n=28,282).

Abbreviations: Q, quartiles; COPD, chronic obstructive pulmonary disease.

Table 3 Incidence of COPD Events by Quartiles of and by 1 Unit Increase in the TyG Index in Never Smokers (n = 9898)

	Q1 3.38–4.35	Q2 4.35–4.52	Q3 4.52–4.70	Q44.70–6.14	Per 1 Unit Increase	p-value for 1 Unit Increase
COPD events n (n /1000 person-years)	77 (0.9)	90 (1.0)	105 (1.2)	132 (1.6)
Model 1	1.00 (reference)	1.15 (0.85–1.56)	1.36 (1.01–1.82)	1.83 (1.38–2.43)	2.41 (1.71–3.38)	<0.001
Model 2	1.00 (reference)	1.12 (0.83–1.53)	1.27 (0.93–1.72)	1.53 (1.13–2.08)	1.91 (1.30–2.78)	<0.001
Model 3	1.00 (reference)	1.07 (0.78–1.45)	1.22 (0.90–1.65)	1.47 (1.08–2.01)	1.80 (1.21–2.67)	0.004

Notes: Model 1: Unadjusted. Model 2: age, sex, height, BMI. Model 3: age, sex, height, BMI, FEV₁/FVC, physical activity, prevalent CVD, prevalent diabetes, antihypertensive drugs.

Abbreviations: Q, quartiles; COPD, chronic obstructive pulmonary disease.

Figure 1 Kaplan–Meier survival curves of incident COPD by quartiles of TyG index. Q1: lowest TyG index, Q4: Highest TyG index.

Figure 2 Kaplan–Meier event-free survival curves of incident COPD by quartiles of TyG index in women Q1: lowest TyG index, Q4: Highest TyG index.

Figure 3 Kaplan–Meier event-free survival curves of incident COPD by quartiles of TyG index in men Q1: lowest TyG index, Q4: Highest TyG index.