Triglyceride glucose index is an independent predictor for the progression of coronary artery calcification in the absence of heavy coronary artery calcification at baseline

Background Data on the relationship between the triglyceride glucose (TyG) index and coronary artery calcification (CAC) progression is limited. This longitudinal study evaluated the association of TyG index with CAC progression in asymptomatic adults. Methods We enrolled 12,326 asymptomatic Korean adults who had at least two CAC evaluations. The TyG index was determined using ln (fasting triglycerides [mg/dL] x fasting glucose [mg/dL]/2). CAC progression was defined as a difference >= 2.5 between the square roots (root) of the baseline and follow-up coronary artery calcium score (CACS) (Delta root transformed CACS). Annualized Delta root transformed CACS was defined as Delta root transformed CACS divided by the inter-scan period. Results During a mean 3.3 years, the overall incidence of CAC progression was 30.6%. The incidence of CAC progression (group I [lowest]: 22.7% versus [vs.] group II: 31.7% vs. group III [highest]: 37.5%, P < 0.001) and annualized Delta root transformed CACS (group I: 0.46 +/- 1.44 vs. group II: 0.71 +/- 2.02 vs. group III: 0.87 +/- 1.75, P < 0.001) were markedly elevated with increasing TyG index tertiles. Multivariate linear regression analysis showed that TyG index was associated with annualized Delta root transformed CACS (beta = 0.066, P = 0.036). In multivariate logistic regression analysis, the TyG index was significantly associated with CAC progression in baseline CACS <= 100. Conclusion The TyG index is an independent predictor of CAC progression, especially in adults without heavy baseline CAC.