Effect of changes in the triglyceride-glucose index on atherogenic lipid profiles in coronary artery disease patients receiving lipid-lowering therapy: a prospective cohort study

作者：Zhi-Fan Li, Zheng Yin, Xi Li, Meng-Ying Lu, Wenjia Zhang, Fang Luo, Yan-Lu Xu, Jianjun Li, Ke-Fei Dou, Xiao Wang, Hong Qiu, Na-Qiong Wu · 发表于：Cardiovascular Diabetology · 年份：2025 · DOI：10.1186/s12933-025-02910-6 · 被引用次数：4 · 研究领域：Diabetes, Cardiovascular Risks, and Lipoproteins、Lipoproteins and Cardiovascular Health、Cardiovascular Function and Risk Factors

BACKGROUND: Insulin resistance (IR) is a key driver of cardiovascular disease. The triglyceride-glucose (TyG) index, derived from fasting triglyceride and glucose levels, has been proposed as a surrogate marker of IR. However, its effect on lipid control in patients with coronary artery disease (CAD) receiving lipid-lowering therapy (LLT) remains unclear. METHODS: In this prospective cohort study, biochemical parameters of 1393 CAD patients were measured and followed over a median of one year. Participants received either low-/moderate-intensity LLT or high-intensity LLT. Linear regression models, logistic regression analyses, and change-to-change analyses were conducted to comprehensively assess the associations between baseline levels, longitudinal changes, and status transitions of the TyG index and lipid parameters. RESULTS: Lipid levels differed significantly across TyG index tertiles, with the highest tertile showing more adverse profiles at baseline and follow-up. Higher baseline TyG levels were independently associated with increased follow-up atherogenic lipid parameters and failure to achieve targets of non-high-density lipoprotein cholesterol (Non-HDL-C, OR = 1.23, 95% CI 1.01-1.51) and remnant cholesterol (RC, OR = 1.38, 95% CI 1.09-1.76). Participants in the highest tertile had the highest odds of not achieving targets for LDL-C, Non-HDL-C, and RC. Each 1% increase in the index was associated with percent increases in lipids including LDL-C (β = 1.10), Non-HDL-C ...