ORIGINAL RESEARCH article
Front. Cardiovasc. Med.
Sec. Cardio-Oncology
Triglyceride–glucose index (TyG) and atherogenic index of plasma (AIP) as predictors of cardiovascular risk in rectal cancer survivors
Fangmin Shi
Chengnan Liu
Wei Liu
Hao Cai
QiMing Zhao
Chen Zhang
QiYuan Liu
Nan Wu
You Guo
First Affiliated Hospital of Gannan Medical University, Ganzhou, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Abstract
Background Rectal cancer survivors face elevated cardiovascular disease (CVD) risk, but simple metabolic indices for risk stratification remain underexplored. We investigated associations of triglyceride-glucose index (TyG) and atherogenic index of plasma (AIP) with secondary CVD in rectal cancer patients. Methods We analyzed rectal cancer patient data from the First Affiliated Hospital of Gannan Medical University (January 2010 to December 2023) to evaluate the associations between TyG, AIP and CVD. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were performed using UK Biobank proteomics data to identify mediating proteins. Results This study included 1,431 cases, among which 1,240 had no CVD and 191 had CVD. Both TyG (OR 1.102, 95%CI:1.030-1.179, p=0.005) and AIP (OR 1.062, 95%CI: 1.010-1.116, p=0.018) showed independent associations with CVD risk in multivariable models. Age significantly modified these associations (interaction p<0.05), with stronger effects in patients ≥62 years. Combined TyG+AIP modestly improved prediction (IDI 1.2%, p=0.013) compared to clinical variables alone. Proteomic analysis identified 14 mediating proteins enriched in lipid metabolism, complement/coagulation, and tight junction pathways. Conclusions TyG and AIP indices were independently associated with secondary CVD risk in rectal cancer patients, with age-dependent effects. While the predictive improvement was modest, these easily obtainable indices may aid risk stratification when combined with traditional factors. Proteomic findings suggest potential mechanistic pathways warranting further investigation.
Summary
Keywords
AIP, cardiovascular disease, Plasma proteomics, rectal cancer, TyG
Received
31 October 2025
Accepted
19 February 2026
Copyright
© 2026 Shi, Liu, Liu, Cai, Zhao, Zhang, Liu, Wu and Guo. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: You Guo
Disclaimer
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.