Combined effect of insulin resistance and altitude of residence on 10 years risk of atherosclerotic cardiovascular diseases

Yu Xia¹Liping He²Linhong Pang³Wenlong Zhu¹Nan Zhang¹Yue Gao¹Lin Duo¹Zhongjie Wang²Wenhui Yang¹Mingjing Tang¹Zhiling Luo¹Da Zhu^1*Heng Su^1*

• ¹Fuwai Yunnan Hospital, Chinese Academy of Medical Sciences, Affiliated Cardiovascular Hospital of Kunming Medical University, Kunming, China
• ²School of Public Health, Kunming Medical University, Kunming, China
• ³School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China

Background: The combined health effects of triglyceride-glucose (TyG) and altitude of residence on 10-years risk of atherosclerotic cardiovascular diseases (ASCVD) are unknown. We examined the combined effect of TyG index and altitude of residence on ASCVD using two cross-sectional studies. Methods: We included 6861 participants with no history of ASCVD in two cross-sectional studies and assessed their 10-years risk of ASCVD using the China-PAR model. We stratified the TyG index, altitude of residence, and used multivariate-adjusted logistic models to estimate odds ratio (ORs) and 95% confidence intervals (CIs) for 10-years high-risk of ASCVD. Additive and multiplicative effects were also considered. Results: A total of 6861 participants free of ASCVD at baseline were included. 559 study participants were assessed as ASCVD high-risk individuals. Compared with participants with the lowest TyG levels, those with the highest TyG levels were more likely to be classified as being at high risk for ASCVD [(OR): 2.17, 95% C1:1.67, 2.82], and the nonlinear relationships were found in the restricted cubic splines. The altitude of residence was also associated with an increased risk of ASCVD (OR): per standard deviation:1.46, 95%Cl: 1.29, 1.65. Limited evidence of interaction between TyG index and altitude of residence was found. Similar findings were observed in a series of sensitivity analyses. Conclusion: TyG index and altitude of residence were positively associated with high risk of ASCVD separately, but there was no significant interaction between the associations.