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Table 1 Basic characteristics of the articles included in the meta-analysis of TyG and risk of CVD and mortality in general population

From: Relationship between the triglyceride-glucose index and risk of cardiovascular diseases and mortality in the general population: a systematic review and meta-analysis

Author, years, country

Study design/Mean follow-up time

Study population

Sample sizes

Mean age (years)/Male (%)

TyG detection

Endpoint detection

Endpoint

TyG index

Hazard risk (95% CI)

Adjustments

Barzegar, 2020, Iran

Prospective cohort study/16.1 years

Tehran Lipid and Glucose Study

Free of CVD at baseline

7521

46.60/44.80

NA

ECG and ICD-10

CAD (incidence)

 < 8.4

1

Age, gender, WC, BMI, education, smoking status, physical activity, FHCVD, T2D, hypertension, lipid lowering drugs, LDL-C, HDL-C

8.4–8.7

1.25 (0.93–1.67)

8.7–9.0

1.49 (1.12–1.98)

9.0–9.4

1.34 (1.01–1.80)

 ≥ 9.4

1.84 (1.37–2.48)

Per SD (0.48)

1.19 (1.10–1.29)

ECG and ICD-10

CVD (incidence)

 < 8.4

1

8.4–8.7

1.15 (0.89–1.49)

8.7–9.0

1.28 (0.99–1.65)

9.0–9.4

1.22 (0.94–1.58)

 ≥ 9.4

1.61 (1.23–2.11)

Per SD (0.48)

1.16 (1.07–1.25)

Hong, 2020, Korea

Retrospective cohort study/8.2 years

National Health Information Database

Free of ASCVD history, diabetes and hyperlipidemia

5,593,134

53.02/50.50

NA

ICD-10 code I21 or I22

MI (incidence)

Q1

1

Age, sex, smoking, alcohol consumption, regular physical activity, low socioeconomic status, BMI, hypertension, total cholesterol level, hypertension medications, warfarin, and aspirin

Q2

1.09 (1.07–1.12)

Q3

1.17 (1.14–1.19)

Q4

1.31 (1.28–1.35)

Kim, 2019, Korea

Retrospective cohort study/5.66 years

Kangbuk Samsung Health Study

General population

318,224

NA/51.89

NA

Derived from the Korea National Statistical Office

CV mortality

Highest vs. lowest

1.26 (1.02–1.55)

Age, sex, BMI

Derived from the Korea National Statistical Office

All-cause mortality

Highest vs. lowest

1.12 (1.03–1.22)

Kim, 2021, Korea

Retrospective cohort study/5.97 years

Korean National Health Insurance Service—National Health Screening cohort

Free of CVD, diabetes and tumor

144,603

56.00/53.96

NA

ICD-10 codes I20-I25

CVD (men, incidence)

 < 8.25

1

Age, smoking status, drinking status, physical activity, BMI, SBP, LDL-C, economic status, and anti-hypertensive medications

8.25–8.61

1.11 (0.97–1.28)

8.61–9.00

1.19 (1.03–1.36)

 ≥ 9.00

1.23 (1.07–1.42)

CVD (women, incidence)

 < 8.06

1

8.06–8.40

1.24 (1.02–1.51)

8.40–8.75

1.18 (0.97–1.44)

 ≥ 8.75

1.24 (1.02–1.51)

All-cause mortality (men)

 < 8.25

1

8.25–8.61

1.05 (0.91–1.21)

8.61–9.00

1.11 (0.96–1.28)

 ≥ 9.00

1.06 (0.91–1.25)

All-cause mortality (women)

 < 8.06

1

8.06–8.40

1.22 (0.94–1.58)

8.40–8.75

1.01 (0.78–1.31)

 ≥ 8.75

0.99 (0.76–1.28)

Li, 2019, China

Retrospective cohort study/5.52 years

Health check-up programme in Xinzheng and Xinmi City

Free of history of CVD, type 1 diabetes and obesity (BMI > 45 kg/m2)

6,078

70.45/53.08

Automatic biochemical analyser

ICD-10 codes I20-I25

CAD (incidence)

 < 8.32

1

Age and sex, living alone, current smoking, alcohol consumption, exercise, BMI, resting heart rate, SBP, HDL-C, LDL-C, and diabetic status, time-varying repeated measures of TyG

8.32–8.61

1.22 (0.93–1.60)

8.61–8.89

1.26 (0.96–1.66)

 ≥ 8.90

2.05 (1.58–2.64)

Per 1 unit

1.63 (1.39–1.90)

Hospital dataset for admissions

CVD (incidence)

 < 8.32

1

8.32–8.61

1.00 (0.80–1.25)

8.61–8.89

1.17 (0.94–1.45)

 ≥ 8.90

1.61 (1.31–1.99)

Per 1 unit

1.43 (1.24–1.63)

Liu, 2020, China

Retrospective cohort study/98.20 months

National Health and Nutrition Examination Survey

General population

19,420

47.10/48.90

Enzymatic assays and hexokinase method

ICD-10 codes I00–I09, I11, I13, I20–I51, I60–I69

CV mortality

 ≤ 8.00

1

Age, sex, race, smoking, BMI, SBP, Egfr, TC, HDL-C, comorbidities (cardiovascular disease, diabetes, and hypertension), and medicine use (hypotensive drugs, hypoglycemic drugs, lipid-lowering medication, and antiplatelet drugs)

8.00–9.00

0.63 (0.43–0.93)

9.00–10.00

0.64 (0.41–1.00)

 > 10.00

1.37 (0.78–2.42)

Per 1 unit

1.29 (1.05–1.57)

The National Center for Health Statistics with personal data and death certificate

All-cause mortality

 ≤ 8.00

1

8.00–9.00

0.93 (0.77–1.11)

9.00–10.00

0.88 (0.72–1.09)

 > 10.00

1.51 (1.15–1.98)

Per 1 unit

1.10 (1.00–1.20)

Liu, 2021, China

Prospective cohort study/10.33 years

Kailuan General Hospital

Free of CVD and cancer history, and obesity (BMI > 45 kg/m2)

96,541

51.19/79.61

Hitachi 747 autoanalyzer

Basis of clinical symptoms and dynamic changes in cardiac enzymes and/or biomarker concentrations and electrocardiogram results

CVD (incidence)

 ≤ 8.18

1

Age, sex, education, and current smoking status, current drinking status, physical activity, BMI, hypertension, diabetes, HDL-C, LDL-C, hs-CRP, lipid-lowering medication, antidiabetic medication, and antihypertensive medication

8.18–8.57

1.09 (1.02–1.18)

8.57–9.05

1.18 (1.09–1.27)

 > 9.05

1.20 (1.11–1.30)

Per 1 unit

1.09 (1.05–1.13)

Mirshafiei, 2021, Iran

Prospective cohort study/6.00 years

Mashhad stroke and heart association disorder study

Free of diabetes, hyperlipidemia, hypertensive and CVD history

9704

48.09/40.13

NA

Clinic for confirmation and questionnaire

CVD (incidence)

Per 1 SD (0.82)

2.31 (1.93–2.76)

Sex, age, smoking, BMI, family history of CVD, HTN, diabetes, and LDL

Cardiac mortality

Per 1 SD (0.82)

2.30 (1.25–4.24)

Park, 2020, Korea

Prospective cohort study/50 months

A health risk assessment study

Free of IHD or ischemic stroke history, type 2 diabetes or a fasting plasma glucose level ≥ 126 mg/dL, current use of dyslipidaemia medication or aspirin, and hs-CRP levels ≥ 10 mg/L

16,455

46.1/51.21

Enzymatic methods using a Hitachi 7600 Automated Chemistry Analyzer

ICD-10 codes I20 and I21

Ischemic heart disease (incidence)

 ≤ 8.08

1

Age, sex, body mass index, smoking status, alcohol intake, physical activity, hs-CRP level, mean arterial blood pressure, chronic kidney disease, and hypertension medication

8.09–8.45

1.61 (1.05–2.48)

8.46–8.85

1.85 (1.21–2.83)

 ≥ 8.86

2.28 (1.48–3.51)

Sanchez-Inigo, 2016, Spain

Prospective cohort study/8.75 years

Vascular Metabolic CUN cohort

Free of CVD at baseline, history of type 1 diabetes or latent autoimmune diabetes in adults, cancer in the palliative phase, familial hypertriglyceridaemia, extreme BMI (> 45 kg/m2) or a hypercoagulable state

5014

54.41/61.19

Hitachi 711 Chemistry Analyzer and hexokinase method

ICD-10 code I20-I25, I63-I66, I73 and I74

CVD (incidence)

6.40–7.87

1

Age, sex, BMI, cigarette smoking, daily alcohol intake, lifestyle pattern (physically active/sedentary behavior), hypertension, T2D, anti-aggregation therapy, HDL-C, LDL-C

7.88–8.18

1.19 (0.83–1.71)

8.19–8.47

1.32 (0.93–1.88)

8.48–8.80

1.52 (1.07–2.16)

8.81–12.42

2.32 (1.65–3.26)

Tian, 2021, China

Prospective cohort study/11.03 years

Kailuan study

Free of MI history

98,849

51.81/79.75

Hexokinase/glucose-6-phosphate dehydrogenase method and enzymatic colorimetric method

Combinations of chest pain symptoms, electrocardiographic signs, and cardiac enzyme levels

MI (incidence)

7.70–8.06

1

Age, sex, level of education, income, smoking, alcohol abuse, physical activity, BMI, SBP, DBP, a history of hypertension, diabetes mellitus, and dyslipidemia, antidiabetic drugs, lipid-lowering drugs, antihypertensive drugs, HDL-C, LDL-C, and hs-CRP at baseline

8.29–8.48

1.07 (0.90–1.29)

8.68–8.91

1.30 (1.03–1.62)

9.23–9.82

1.58 (1.18–2.12)

Per 1 unit

1.49 (1.26–1.76)

Vega, 2014, USA

Retrospective cohort study/14.75 years

Cooper Center Longitudinal Study

General population

39,447

44.90/100.00

NA

ICD-9 codes 390Y449.9 for deaths before 1999 or ICD-10 codes I00YI78 for deaths occurring from 1999 to 2008

CV mortality

Highest vs. lowest

0.89 (0.77–1.03)

Age, BMI, RSBP, smoking, non-HDL-C

The National Death Index

All-cause mortality

Highest vs. lowest

0.89 (0.82–0.97)

  1. CAD: coronary artery disease; CVD: cardiovascular disease; ASCVD: atherosclerotic cardiovascular disease; TyG: triglyceride and glucose index; WC: waist circumference; BMI: body mass index; FHCVD: family history of cardiovascular disease; T2D: type 2 diabetes; HTP: hypertension; LDL: low density lipoprotein; LDL-C: low-density lipoprotein cholesterol; HDL-C: high-density lipoprotein cholesterol; MI: myocardial infarction; RSBP: resting systolic blood pressure; SBP: systolic blood pressure; eGFR: estimated glomerular filtration rate; TC: total cholesterol; hs-CRP: high-sensitive C-reactive protein; HbA1c: Glycated hemoglobin A1c; CT: computed tomography; MRI: magnetic resonance imaging; CCTA: coronary computed tomographic angiography; ECG: electrocardiogram; ICD-10: International Classification of Diseases, 10th Clinical Modification; NA: not application