AUTHOR=Zeng Xianghui , Han Dunzheng , Zhou Haobin , Xue Yuting , Wang Xiao , Zhan Qiong , Bai Yujia , Huang Xingfu , Zeng Qingchun , Zhang Hao , Ma Zhuang , Ren Hao , Xu Dingli TITLE=Triglyceride-Glucose Index and Homeostasis Model Assessment-Insulin Resistance in Young Adulthood and Risk of Incident Congestive Heart Failure in Midlife: The Coronary Artery Risk Development in Young Adults Study JOURNAL=Frontiers in Cardiovascular Medicine VOLUME=Volume 9 - 2022 YEAR=2022 URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2022.944258 DOI=10.3389/fcvm.2022.944258 ISSN=2297-055X ABSTRACT=Objective: The aim of this study was to assess the association between triglyceride-glucose (TyG) index / homeostasis model assessment-insulin resistance (HOMA-IR) within young adults and congestive heart failure (CHF), and to explore whether TyG index can replace HOMA-IR as a surrogate marker for insulin resistance in predicting the risk of CHF. Methods:A total of 4992 participants between the ages of 18 and 30 were enrolled from the Coronary Artery Risk Development in Young Adults (CARDIA) investigation (from 1985 to 1986 [year 0]). Cox proportional hazard regression analysis was conducted for assessing correlations between baseline TyG index / HOMA-IR and congestive heart failure events, together with Receiver Operating Characteristic (ROC) Curve employed for scrutinizing TyG index / HOMA-IR and he risk of CHF. Results: During the 31-year follow-up period, 64 (1.3%) out of the 4992 participants developed CHF. In multivariable Cox proportional hazards models, adjusted for confounding factors for CHF, increased risk of CHF was associated with per-unit increase in TyG index (hazard ratio [HR] 2.8; 95% confidence interval [CI], 1.7-4.7) and HOMA-IR (HR 1.2; 95%CI, 1.1-1.3). Kaplan-Meier curve analysis showed that participants in the TyG index and HOMA-IR index Q4 group had a higher risk of congestive heart failure than those in the Q1 group. The area under curve (AUC) for TyG index and HOMA-IR consisted of 0.67 (95% CI, 0.6-0.742) and 0.675 (95%CI, 0.604-0.746), respectively. There were no significant differences between TyG index and HOMA-IR for AUC (P = 0.986). Conclusions: Higher TyG index and HOMA-IR are independent risk factors for CHF. The TyG index can replace HOMA-IR in young adulthood as a surrogate marker for IR to predict the risk of CHF.