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Triglyceride-glucose index and the risk of heart failure: Evidence from two large cohorts and a mendelian randomization analysis

Li, Xintao, Chan, Jeffrey Shi Kai, Guan, Bo, Peng, Shi, Wu, Xiaoyu, Lu, Xiaofeng, Zhou, Jiandong, Hui, Jeremy Man Ho, Lee, Yan Hiu Athena, Satti, Danish Iltaf, and others. (2022) Triglyceride-glucose index and the risk of heart failure: Evidence from two large cohorts and a mendelian randomization analysis. Cardiovascular diabetology, 21 (1). Article Number 229. ISSN 1475-2840. (doi:10.1186/s12933-022-01658-7) (KAR id:98132)


The relationship between triglyceride-glucose (TyG) index, an emerging marker of insulin resistance, and the risk of incident heart failure (HF) was unclear. This study thus aimed to investigate this relationship. Subjects without prevalent cardiovascular diseases from the prospective Kailuan cohort (recruited during 2006-2007) and a retrospective cohort of family medicine patients from Hong Kong (recruited during 2000-2003) were followed up until December 31st, 2019 for the outcome of incident HF. Separate adjusted hazard ratios (aHRs) summarizing the relationship between TyG index and HF risk in the two cohorts were combined using a random-effect meta-analysis. Additionally, a two-sample Mendelian randomization (MR) of published genome-wide association study data was performed to assess the causality of observed associations. In total, 95,996 and 19,345 subjects from the Kailuan and Hong Kong cohorts were analyzed, respectively, with 2,726 cases of incident HF in the former and 1,709 in the latter. Subjects in the highest quartile of TyG index had the highest risk of incident HF in both cohorts (Kailuan: aHR 1.23 (95% confidence interval: 1.09-1.39), P<sub>Trend</sub> <0.001; Hong Kong: aHR 1.21 (1.04-1.40), P<sub>Trend</sub> =0.007; both compared with the lowest quartile). Meta-analysis showed similar results (highest versus lowest quartile: HR 1.22 (1.11-1.34), P < 0.001). Findings from MR analysis, which included 47,309 cases and 930,014 controls, supported a causal relationship between higher TyG index and increased risk of HF (odds ratio 1.27 (1.15-1.40), P < 0.001). A higher TyG index is an independent and causal risk factor for incident HF in the general population.

Item Type: Article
DOI/Identification number: 10.1186/s12933-022-01658-7
Uncontrolled keywords: Glucose, Mendelian randomization, Triglyceride-glucose index, Biomarkers, Mendelian Randomization Analysis, Blood Glucose - analysis, Risk Factors, Prospective Studies, Triglycerides, Genome-Wide Association Study, Retrospective Studies, Heart Failure - diagnosis - epidemiology - genetics, Humans, Heart failure, Insulin resistance, Risk stratification
Subjects: R Medicine
Divisions: Divisions > Division of Natural Sciences > Kent and Medway Medical School
Funders: National Natural Science Foundation of China (
SWORD Depositor: JISC Publications Router
Depositing User: JISC Publications Router
Date Deposited: 24 Nov 2022 09:54 UTC
Last Modified: 04 Mar 2024 18:02 UTC
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