Triglyceride Glucose Index and The Triglyceride/HDL Ratio as Predictors of Coronary Artery Disease

Yıl 2021, Cilt: 11 Sayı: 2, 235 - 241, 07.05.2021

Hatice Tolunay , Serdar Fırtına

https://doi.org/10.33631/duzcesbed.882401

Öz

Aim: Triglyceride to high density lipoprotein cholesterol (TG/HDL-C) ratio and triglyceride-glucose (TyG) index are simple, reliable screening methods. It has been shown that the TyG index predicts mortality in cardiovascular diseases and the TG/HDL-C ratio predicts the severity of coronary artery disease (CAD). We planned a study to define the relationship between the SYNTAX score, which indicates the severity of CAD, and the TyG index and TG / HDL-C ratio.
Material and Methods: A total of 408 patients who underwent coronary angiography were evaluated in this study. TyG index, TG/HDL-C ratio and SYNTAX scores were calculated. Patients were grouped according to their diagnosis and SYNTAX scores. Relationships between TyG index, TG / HDL-C ratio and SYNTAX score were examined.
Results: There is a significant relationship between the TyG index and the presence of CAD (p<0.001). When the TyG index was evaluated in terms of the severity of CAD, there was a positive significant relationship between mild and severe CAD (p<0.040). While there was a significant positive correlation between TG/HDL-C ratio and the presence of CAD (p<0.001), there was no significant relationship between severity of CAD (p:0.814). There was a low level significant positive correlation in terms of TyG index between patients with unstable angina pectoris and ST-elevation myocardial infarction (p:0.046).
Conclusion: The TyG index and TG/HDL-C ratio are predictors of the presence of CAD and the TyG index also provides guidance on the severity of CAD. Standard use may be considered in addition to risk scoring in the diagnosis of CAD and planning coronary angiography.

Anahtar Kelimeler

Triglyceride-Glucose Index, Triglyceride / High Density Lipoprotein Ratio, SYNTAX Score, Coronary Artery Disease

Koroner Arter Hastalığının Öngördürücüleri Olarak Trigliserid Glikoz İndeksi ve Trigliserid / HDL Oranı

Öz

Amaç: Trigliserid / yüksek yoğunluklu lipoprotein kolesterol oranı (TG / HDL-C) ve trigliserid-glikoz (TyG) indeksi basit, güvenilir tarama yöntemleridir. TyG indeksinin kardiyovasküler hastalıklarda mortaliteyi öngördüğü ve TG / HDL-C oranının koroner arter hastalığının (KAH) ciddiyetini öngördüğü gösterilmiştir. Koroner arter hastalığı ciddiyetini gösteren SYNTAX skoru ile TyG indeksi ve TG / HDL-C oranı arasındaki ilişkiyi tanımlamak için bir çalışma planladık.
Gereç ve Yöntemler: Bu çalışmada koroner anjiyografi yapılan toplam 408 hasta değerlendirildi. TyG indeksi, TG / HDL-C oranı ve SYNTAX skorları hesaplandı. Hastalar tanılarına ve SYNTAX puanlarına göre gruplandırıldı. TyG indeksi, TG / HDL-C oranı ve SYNTAX skor arası ilişki incelendi.
Bulgular: TyG indeksi ile KAH varlığı arasında anlamlı bir ilişki vardır (p <0,001). TyG indeksi KAH şiddeti açısından değerlendirildiğinde hafif ve şiddetli KAH arasında pozitif yönde anlamlı ilişki vardı (p <0,040). TG / HDL-K oranı ile KAH varlığı arasında anlamlı pozitif korelasyon varken (p <0,001), KAH şiddeti arasında anlamlı bir ilişki yoktu (p: 0,814). Kararsız angina pektorisli hastalar ile ST elevasyonlu miyokard infarktüsü arasında TyG indeksi açısından düşük düzeyde anlamlı pozitif korelasyon vardı (p: 0.046).
Sonuç: TyG indeksi ve TG / HDL-C oranı, KAH varlığının öngörücüleridir ve TyG indeksi, KAH'ı ciddiyeti hakkında da yol gösterir. KAH tanısında ve koroner anjiyografi planlamasında risk skorlamalarına ek olarak standart kullanımı düşünülebilir.

Anahtar Kelimeler

Trigliserid-Glikoz İndeksi, Trigliserit / Yüksek Yoğunluklu Lipoprotein Oranı, SYNTAX Skoru, Koroner Arter Hastalığı

Kaynakça

• 1) Malakar AK, Choudhury D, Halder B, Paul P, Uddin A, Chakraborty S. A review on coronary artery disease, its risk factors, and therapeutics. J Cell Physiol. 2019 Aug;234(10):16812-16823.
• 2) Yadav M, Palmerini T, Caixeta A, Madhavan MV, Sanidas E, Kirtane AJ, et al. Prediction of coronary risk by SYNTAX and derived scores: Synergy between percutaneous coronary intervention with taxus and cardiac surgery. J Am Coll Cardiol. 2013;62(14):1219–30.
• 3) Wang XR, Song GR, Li M, Sun HG, Fan YJ, Liu Y, et al. Longitudinal associations of high-density lipoprotein cholesterol or low-density lipoprotein cholesterol with metabolic syndrome in the Chinese population: a prospective cohort study. BMJ Open. 2018 May 9;8(5): e018659.
• 4) Lee EY, Yang HK, Lee J, Kang B, Yang Y, Lee SH, et al. Triglyceride glucose index, a marker of insulin resistance, is associated with coronary artery stenosis in asymptomatic subjects with type 2 diabetes. Lipids Health Dis. 2016 Sep 15;15(1):155.
• 5) Mach F, Baigent C, Catapano AL, Koskinas KC, Casula M, Badimon L, et al; ESC Scientific Document Group. 2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk. Eur Heart J. 2020 Jan 1;41(1):111-188.
• 6) Patel A, Barzi F, Jamrozik K, Lam TH, Ueshima H, Whitlock G, et al. Serum triglycerides as a risk factor for cardiovascular diseases in the Asia-Pacific region. Circulation 2004;110: 2678e86.
• 7) Gaziano JM, Hennekens CH, O'Donnell CJ, Breslow JL, Buring JE. Fasting triglycerides, high-density lipoprotein, and risk of myocardial infarction. Circulation. 1997; 96: 2520–2525.
• 8) Barzi F, Patel A, Woodward M, Lawes CM, Ohkubo T, Gu D, et al. A comparison of lipid variables as predictors of cardiovascular disease in the Asia Pacific region. Ann Epidemiol 2005;15: 405e13.
• 9) Gaziano JM, Hennekens CH, O’Donnell CJ, Breslow JL, Buring JE. Fasting triglycerides, high-density lipoprotein, and risk of myocardial infarction. Circulation 1997; 96:2520e5.
• 10) Wan GX, Xia WB, Ji LH, Qin HL, Zhang YG. Triglyceride to high density lipoprotein cholesterol ratio may serve as a useful predictor of major adverse coronary event in female revascularized ST-elevation myocardial infarction. Clin Chim Acta. 2018 Oct;485:166-172.
• 11) Sianos G, Morel MA, Kappetein AP, Morice MC, Colombo A, Dawkins K, et al. The SYNTAX Score: an angiographic tool grading the complexity of coronary artery disease. EuroIntervention: journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology. 2005;1(2):219-27.
• 12) da Silva A, Caldas APS, Hermsdorff HHM, Bersch-Ferreira ÂC, Torreglosa CR, Weber B, et al. Triglyceride-glucose index is associated with symptomatic coronary artery disease in patients in secondary care. Cardiovasc Diabetol. 2019 Jul 11;18(1):89.
• 13) Won KB, Park GM, Lee SE, Cho IJ, Kim HC, Lee BK, et al. Relationship of insulin resistance estimated by triglyceride glucose index to arterial stiffness. Lipids Health Dis. 2018 Nov 24;17(1):268.
• 14) Mao Q, Zhou D, Li Y, Wang Y, Xu SC, Zhao XH. The Triglyceride-Glucose Index Predicts Coronary Artery Disease Severity and Cardiovascular Outcomes in Patients with Non-ST-Segment Elevation Acute Coronary Syndrome. Dis Markers. 2019 Jun 11;2019:6891537.
• 15) Luo E, Wang D, Yan G, Qiao Y, Liu B, Hou J, et al. High triglyceride-glucose index is associated with poor prognosis in patients with acute ST-elevation myocardial infarction after percutaneous coronary intervention. Cardiovasc Diabetol. 2019 Nov 13;18(1):150.
• 16) Bhalodkar NC, Blum S, Enas EA. Accuracy of the ratio of triglycerides to high-density lipoprotein cholesterol for predicting low-density lipoprotein cholesterol particle sizes, phenotype B, and particle concentrations among Asian Indians. Am J Cardiol. 2006; 97: 1007–1009.
• 17) Hadaegh F, Khalili D, Ghasemi A, Tohidi M, Sheikholeslami F, Azizi F. Triglyceride/HDL-cholesterol ratio is an independent predictor for coronary heart disease in a population of Iranian men. Nutr Metab Cardiovasc Dis. 2009; 19: 401–408.
• 18) Masson W, Siniawski D, Lobo M, Molinero G, Huerín M. Association between triglyceride/HDL cholesterol ratio and carotid atherosclerosis in postmenopausal middle-aged women. Endocrinol Nutr. 2016 Aug-Sep;63(7):327-32.
• 19) Dogan C, Bayram Z, Karagoz A, Bakal RB, Erdogan E, Yilmaz F, et al. Is elevated triglyceride high density lipoprotein cholesterol ratio a risk factor that causes acute coronary syndrome to appear earlier? Bratisl Lek Listy. 2018;119(12):770-775.
• 20) Su YM, Zhang R, Xu RF, Wang HL, Geng HH, Pan M, et al. Triglyceride to high-density lipoprotein cholesterol ratio as a risk factor of repeat revascularization among patients with acute coronary syndrome after first-time percutaneous coronary intervention. J Thorac Dis. 2019 Dec;11(12):5087-5095.
• 21) Yunke Z, Guoping L, Zhenyue C. Triglyceride-to-HDL cholesterol ratio. Predictive value for CHD severity and new-onset heart failure. Herz. 2014 Feb;39(1):105-10.
• 22) Chen BD, Chen XC, Yang YN, Gao XM, Ma X, Huang Y, et al. Apolipoprotein A1 is associated with SYNTAX score in patients with a non-ST segment elevation myocardial infarction. Lipids Health Dis. 2019 Aug 7;18(1):159.
• 23) Volkan Emren S, Gediz RB, Şenöz O, Karagöz U, Şimşek EÇ, Levent F, et al. Decreased heart rate recovery may predict a high SYNTAX score in patients with stable coronary artery disease. Bosn J Basic Med Sci. 2019 Feb 12;19(1):109-115.
• 24) Strisciuglio T, Izzo R, Barbato E, Di Gioia G, Colaiori I, Fiordelisi A, et al. Insulin Resistance Predicts Severity of Coronary Atherosclerotic Disease in Non-Diabetic Patients. J Clin Med. 2020 Jul 7;9(7):2144.
• 25) Srinivasan MP, Kamath PK, Bhat NM, Pai ND, Bhat RU, Manjrekar PA, et al. Manipal diabetes coronary artery severity score. Diabetes Metab Syndr. 2017 Nov;11 Suppl 1:S33-S37.
• 26) Khan SH, Sobia F, Niazi NK, Manzoor SM, Fazal N, Ahmad F. Metabolic clustering of risk factors: evaluation of Triglyceride-glucose index (TyG index) for evaluation of insulin resistance. Diabetol Metab Syndr. 2018 Oct 5;10:74.
• 27) Raimi TH, Dele-Ojo BF, Dada SA, Fadare JO, Ajayi DD, Ajayi EA, et al. Triglyceride-Glucose Index and Related Parameters Predicted Metabolic Syndrome in Nigerians. Metab Syndr Relat Disord. 2020 Nov 9.