ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Cardiovascular Endocrinology
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1524786
This article is part of the Research TopicRe-visiting Risk Factors for Cardiometabolic Diseases: Towards a New Epidemiological FrontierView all 30 articles
Association between triglyceride-glucose index and the risk of cardiometabolic diseases in metabolically healthy obese individuals: a prospective cohort study
Provisionally accepted
Yanjuan Chen1Weiqiang Wu1Zefeng Cai1Kuangyi Wu1Huancong Zheng1Peng Fu1
Yuxian Wang1
Xianxuan Wang2
Yulong Lan1
Shuohua Chen3
Shouling Wu3*
Youren Chen1*- 1Second Affiliated Hospital of Shantou University Medical College, Shantou, China
- 2University of Toronto, Toronto, Ontario, Canada
- 3Kailuan General Hospital, Tangshan, Hebei Province, China
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Background: Metabolically healthy obese (MHO) individuals meet the criteria for obesity with normal blood glucose and lipid metabolism parameters, absence of hypertension, and no concurrent cardiovascular diseases. However, the association between the triglyceride-glucose (TyG) index and the risk of cardiometabolic disease (CMD) in MHO individuals remains unclear.This study included obese individuals who underwent health examinations at Kailuan Group from 2006 to 2010, whom without a history of hypertension, diabetes, hyperlipidemia, cardiovascular disease, as the study participants. A total of 4750 participants were included in this study. The TyG index was calculated as ln[TG (mg/dL) × FPG (mg/dL)/2] and divided into four groups based on quartiles: Q1 group (<8.18); Q2 group (8.18-8.41); Q3 group (8.42-8.62); Q4 group (≥8.63). The Cox proportional hazards model was used to assess the relationship between the TyG index and risk of CMD incidence. During a median follow-up period of 11 (IQR 10.3, 11.2) years, 826 participants experienced CMD, among whom 131 participants developed coronary heart disease, 215 participants developed stroke, and 542 participants developed diabetes. After adjusting for multiple confounding factors, compared with the Q1 group, the adjusted HRs (95% CI) for CMD in the Q2-Q4 groups were 1.33 (1.03, 1.65), 1.37 (1.04, 1.82), and 2.04 (1.56, 2.68) (P<0.0001). A similar trend was found in the subtypes of CMD in coronary heart disease, stroke, and diabetes. Restrictive cubic spline analysis revealed a linear dose-response relationship between the TyG index and the risk of CMD. 4 Conclusions: A high TyG index increases the risk of CMD in MHO individuals. Monitoring and maintaining an appropriate TyG index may contribute to the prevention of CMD risk in MHO individuals.
Keywords: Triglyceride-glucose index, Metabolically healthy obese, cardiometabolic disease, diabetes, Stroke, coronary heart disease
Received: 08 Nov 2024; Accepted: 27 Apr 2025.
Copyright: © 2025 Chen, Wu, Cai, Wu, Zheng, Fu, Wang, Wang, Lan, Chen, Wu and Chen. 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:
Shouling Wu, Kailuan General Hospital, Tangshan, Hebei Province, China
Youren Chen, Second Affiliated Hospital of Shantou University Medical College, Shantou, China
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