Association of the triglyceride glucose index as a measure of insulin resistance with mortality and cardiovascular disease in populations from five continents (PURE study): a prospective cohort study

作者：Patricio López‐Jaramillo, Diego Gómez-Arbeláez, Daniel Martínez-Bello, Marc Evans M. Abat, Khalid F. AlHabib, Álvaro Avezum, О. Л. Барбараш, Jephat Chifamba, Maria Luz Díaz, Sadi Güleç, Noor Hassim Ismail, Romaina Iqbal, Roya Kelishadi, Rasha Khatib, Fernando Laņas, Naomi Levitt, Yang Li, Viswanathan Mohan, Prem Mony, Paul Poirier, Annika Rosengren, Biju Soman, Chuangshi Wang, Yang Wang, Karen Yeates, Rita Yusuf, Afzalhussein Yusufali, Katarzyna Zatońska, Sumathy Rangarajan, Salim Yusuf · 发表于：The Lancet Healthy Longevity · 年份：2022 · DOI：10.1016/s2666-7568(22)00247-1 · 被引用次数：369 · 研究领域：Diabetes, Cardiovascular Risks, and Lipoproteins、Adipokines, Inflammation, and Metabolic Diseases、Metabolism, Diabetes, and Cancer

Background The triglyceride glucose (TyG) index is an easily accessible surrogate marker of insulin resistance, an important pathway in the development of type 2 diabetes and cardiovascular diseases. However, the association of the TyG index with cardiovascular diseases and mortality has mainly been investigated in Asia, with few data available from other regions of the world. We assessed the association of insulin resistance (as determined by the TyG index) with mortality and cardiovascular diseases in individuals from five continents at different levels of economic development, living in urban or rural areas. We also examined whether the associations differed according to the country's economical development. Methods We used the TyG index as a surrogate measure for insulin resistance. Fasting triglycerides and fasting plasma glucose were measured at the baseline visit in 141 243 individuals aged 35–70 years from 22 countries in the Prospective Urban Rural Epidemiology (PURE) study. The TyG index was calculated as Ln (fasting triglycerides [mg/dL] x fasting plasma glucose [mg/dL]/2). We calculated hazard ratios (HRs) using a multivariable Cox frailty model with random effects to test the associations between the TyG index and risk of cardiovascular diseases and mortality. The primary outcome of this analysis was the composite of mortality or major cardiovascular events (defined as death from cardiovascular causes, and non-fatal myocardial infarction, or stroke). Secondary ou...