Skip to main content
SpringerLink
Log in

Association between triglyceride-glucose index and endothelial dysfunction

  • Original Article
  • Published:
Endocrine Aims and scope Submit manuscript

Abstract

Background

Triglyceride-glucose (TyG) index, a simple surrogate marker for insulin resistance (IR), has been reported as an independent predictor of arterial structural damage and future cardiovascular events. The association between TyG index and endothelial dysfunction remains uncertain.

Objective

The purpose of this study was to investigate the association between TyG index and endothelial dysfunction.

Methods

Endothelial dysfunction was measured using flow-mediated dilation (FMD). A total of 840 subjects, who voluntarily accepted FMD measurement at the Health Management Department of Xuanwu Hospital from October 2016 to January 2020, were included in this study. TyG index was calculated as Ln [fasting triglyceride (TG)(mg/dL) × fasting plasma glucose (FPG) (mg/dL)/2].

Results

The mean age was 59.92 ± 10.28 years and 559 (66.55%) participants were male. The TyG index was correlated with FMD values (P = 0.022). Each unit increment in TyG index was associated with lower FMD values (β = −0.330, 95%CI −0.609 to −0.052, P = 0.020) after adjusting for covariates. Age (β = −0.069, 95%CI −0.088 to −0.051, P < 0.001), female (β = 0.592, 95%CI 0.172 to1.012, P = 0.006), smoking (β = −0.430, 95%CI −0.859 to −0.002, P = 0.049) and hypertension (β = −0.741, 95%CI −1.117 to −0.365, P < 0.001) were also independent predictors for endothelial dysfunction. A significant association between the TyG index and endothelial dysfunction was found only in populations younger than 60 years (β = −0.843, 95%CI −1.371 to −0.316, P = 0.002), females (β = −0.612, 95%CI −1.147 to −0.077, P = 0.025), and populations without diabetes mellitus (DM) (β = −0.594, 95%CI −1.042 to −0.147, P = 0.009).

Conclusions

Subjects with an elevated TyG index are more likely to have endothelial dysfunction, particularly in populations without DM.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

Data availability

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.

References

  1. M. Laakso, J. Kuusisto, Insulin resistance and hyperglycaemia in cardiovascular disease development. Nat. Rev. Endocrinol. 10(5), 293–302 (2014)

    Article  CAS  PubMed  Google Scholar 

  2. C. Vlachopoulos et al. Acute systemic inflammation increases arterial stiffness and decreases wave reflections in healthy individuals. Circulation 112(14), 2193–200 (2005)

    Article  PubMed  Google Scholar 

  3. A.J. Hanley et al. Homeostasis model assessment of insulin resistance in relation to the incidence of cardiovascular disease: the San Antonio Heart Study. Diabetes Care 25(7), 1177–84 (2002)

    Article  PubMed  Google Scholar 

  4. G. Pacini, A. Mari, Methods for clinical assessment of insulin sensitivity and beta-cell function. Best Pract. Res. Clin. Endocrinol. Metab. 17(3), 305–22 (2003)

    Article  CAS  PubMed  Google Scholar 

  5. L.E. Simental-Mendía, M. Rodríguez-Morán, F. Guerrero-Romero, The product of fasting glucose and triglycerides as surrogate for identifying insulin resistance in apparently healthy subjects. Metab. Syndr. Relat. Disord. 6(4), 299–304 (2008)

    Article  PubMed  Google Scholar 

  6. G.L. Vega et al. Triglyceride-to-high-density-lipoprotein-cholesterol ratio is an index of heart disease mortality and incidence of type 2 diabetes mellitus in men. J. Investig. Med. 62(2), 345–9 (2014)

    Article  CAS  PubMed  Google Scholar 

  7. L. Sánchez-Íñigo et al. The TyG index may predict the development of cardiovascular events. Eur. J. Clin. Investig. 46(2), 189–97 (2016)

    Article  Google Scholar 

  8. M.R. Salazar et al. Comparison of two surrogate estimates of insulin resistance to predict cardiovascular disease in apparently healthy individuals. Nutr. Metab. Cardiovasc. Dis. 27(4), 366–373 (2017)

    Article  CAS  PubMed  Google Scholar 

  9. S. Li et al. The role of the triglyceride (triacylglycerol) glucose index in the development of cardiovascular events: a retrospective cohort analysis. Sci. Rep. 9(1), 7320 (2019)

    Article  PubMed  PubMed Central  Google Scholar 

  10. Q. Zhang et al. The triglyceride-glucose index is a predictor for cardiovascular and all-cause mortality in CVD patients with diabetes or pre-diabetes: evidence from NHANES 2001-2018. Cardiovasc. Diabetol. 22(1), 279 (2023)

    Article  PubMed  PubMed Central  Google Scholar 

  11. A. Yamashina et al. Brachial-ankle pulse wave velocity as a marker of atherosclerotic vascular damage and cardiovascular risk. Hypertens. Res. 26(8), 615–22 (2003)

    Article  PubMed  Google Scholar 

  12. Y. Matsuzawa et al. Prognostic value of flow-mediated vasodilation in brachial artery and fingertip artery for cardiovascular events: a systematic review and meta-analysis. J. Am. Heart. Assoc. 4, 11 (2015)

    Article  Google Scholar 

  13. S. Al-Kindi et al. Relation of coronary calcium scoring with cardiovascular events in patients with diabetes: the CLARIFY registry. J. Diabetes Complic. 36(11), 108269 (2022)

    Article  CAS  Google Scholar 

  14. J.J. Cao et al. Association of carotid artery intima-media thickness, plaques, and C-reactive protein with future cardiovascular disease and all-cause mortality: the Cardiovascular Health Study. Circulation 116(1), 32–8 (2007)

    Article  PubMed  Google Scholar 

  15. C. Vlachopoulos, K. Aznaouridis, C. Stefanadis, Prediction of cardiovascular events and all-cause mortality with arterial stiffness: a systematic review and meta-analysis. J. Am. Coll. Cardiol. 55(13), 1318–27 (2010)

    Article  PubMed  Google Scholar 

  16. S. Wu et al. Association between triglyceride-glucose index and risk of arterial stiffness: a cohort study. Cardiovasc. Diabetol. 20(1), 146 (2021)

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. M. Li et al. Positive association between triglyceride glucose index and arterial stiffness in hypertensive patients: the China H-type Hypertension Registry Study. Cardiovasc. Diabetol. 19(1), 139 (2020)

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. K.B. Won et al. Relationship of insulin resistance estimated by triglyceride glucose index to arterial stiffness. Lipids Health Dis. 17(1), 268 (2018)

    Article  PubMed  PubMed Central  Google Scholar 

  19. S. Zhao et al. Association between macro- and microvascular damage and the triglyceride glucose index in community-dwelling elderly individuals: the Northern Shanghai Study. Cardiovasc. Diabetol. 18(1), 95 (2019)

    Article  PubMed  PubMed Central  Google Scholar 

  20. K. Park et al. Elevated TyG index predicts progression of coronary artery calcification. Diabetes Care 42(8), 1569–1573 (2019)

    Article  CAS  PubMed  Google Scholar 

  21. K.B. Won et al. Triglyceride glucose index is an independent predictor for the progression of coronary artery calcification in the absence of heavy coronary artery calcification at baseline. Cardiovasc. Diabetol. 19(1), 34 (2020)

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. S. Özbiçer, G. Yüksel, Ö. Deniz Urgun, Triglyceride glucose index is independently associated with aortic intima-media thickness in patients without known atherosclerotic cardiovascular disease or diabetes. Diab. Vasc. Dis. Res. 19(5), 14791641221136203 (2022)

    Article  PubMed  PubMed Central  Google Scholar 

  23. D.H.J. Thijssen et al. Expert consensus and evidence-based recommendations for the assessment of flow-mediated dilation in humans. Eur. Heart J. 40(30), 2534–2547 (2019)

    Article  PubMed  Google Scholar 

  24. R.M. Bruno et al. Intima media thickness, pulse wave velocity, and flow mediated dilation. Cardiovasc. Ultrasound. 12, 34 (2014)

    Article  PubMed  PubMed Central  Google Scholar 

  25. T. Nakamura et al. Ultrasound assessment of brachial endothelial vasomotor function in addition to carotid plaque echolucency for predicting cardiovascular events in patients with coronary artery disease. Int. J. Cardiol. 167(2), 555–60 (2013)

    Article  PubMed  Google Scholar 

  26. L. Wang et al. Triglyceride-glucose index predicts adverse cardiovascular events in patients with diabetes and acute coronary syndrome. Cardiovasc. Diabetol. 19(1), 80 (2020)

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. F. Guerrero-Romero et al. The product of triglycerides and glucose, a simple measure of insulin sensitivity. Comparison with the euglycemic-hyperinsulinemic clamp. J. Clin. Endocrinol. Metab. 95(7), 3347–51 (2010)

    Article  CAS  PubMed  Google Scholar 

  28. D. Prieto, C. Contreras, A. Sánchez, Endothelial dysfunction, obesity and insulin resistance. Curr. Vasc. Pharmacol. 12(3), 412–26 (2014)

    Article  CAS  PubMed  Google Scholar 

  29. K.E. Bornfeldt, I. Tabas, Insulin resistance, hyperglycemia, and atherosclerosis. Cell Metab. 14(5), 575–85 (2011)

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. J.D. Symons et al. Contribution of insulin and Akt1 signaling to endothelial nitric oxide synthase in the regulation of endothelial function and blood pressure. Circ. Res. 104(9), 1085–94 (2009)

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. C. Rask-Madsen et al. Loss of insulin signaling in vascular endothelial cells accelerates atherosclerosis in apolipoprotein E null mice. Cell Metab. 11(5), 379–89 (2010)

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. J.F. Ndisang, A. Vannacci, S. Rastogi, Insulin resistance, type 1 and type 2 diabetes, and related complications 2017. J. Diabetes Res. 2017, 1478294 (2017)

    Article  PubMed  PubMed Central  Google Scholar 

  33. A.M. Chang, J.B. Halter, Aging and insulin secretion. Am. J. Physiol. Endocrinol. Metab. 284(1), E7–12 (2003)

    Article  CAS  PubMed  Google Scholar 

  34. R. Basu et al. Mechanisms of the age-associated deterioration in glucose tolerance: contribution of alterations in insulin secretion, action, and clearance. Diabetes 52(7), 1738–48 (2003)

    Article  CAS  PubMed  Google Scholar 

  35. Y.S. Levitzky et al. Impact of impaired fasting glucose on cardiovascular disease: the Framingham Heart Study. J. Am. Coll. Cardiol. 51(3), 264–70 (2008)

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

The authors thank the staff and participants of our study for their important contributions.

Funding

This study was supported by the Program of the National Natural Science Foundation of China (Serial Number: 82170347).

Author information

Author notes

  1. These authors contributed equally: Yan Li, Ming Yi, Xinyi Wang

Authors and Affiliations

  1. Department of Geriatrics, Xuanwu Hospital, National Clinical Research Center for Geriatric Diseases, Capital Medical University, Beijing, 100053, China

    Yan Li, Ming Yi, Xinyi Wang, Keling Xiao, Jin Si, Lijie Sun, Haoyu Zhang, Jinghao Sun, Zhaoli Liu & Jing Li

  2. Department of Cardiology, Chui Yang Liu Hospital affiliated to Tsinghua University, Beijing, 100021, China

    Yinghua Zhang

  3. Health Management Center, Xuanwu hospital, Capital Medical University, Beijing, 100053, China

    Jing Zhao & Xi Chu

Authors
  1. Yan Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ming Yi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Xinyi Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yinghua Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Keling Xiao
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jin Si
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Lijie Sun
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Haoyu Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Jinghao Sun
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Zhaoli Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Jing Zhao
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Xi Chu
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Jing Li
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Y.L., X.C., and J.L. contributed to the conception and design of this article. Y.L., M.Y., and X.Y. drafted and revised the manuscript. Y.L., Y.Z., K.X., J.S., and J.Z. contributed to the case collection and database organization. Y.L., L.S., and H.Z. were responsible for statistical analysis of the data. Y.L., J.S., and Z.L. interpreted the results. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Xi Chu or Jing Li.

Ethics declarations

Conflict of interest

The authors declare no competing interests.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Li, Y., Yi, M., Wang, X. et al. Association between triglyceride-glucose index and endothelial dysfunction. Endocrine (2024). https://doi.org/10.1007/s12020-024-03785-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s12020-024-03785-5

Keywords

Search

Navigation