Association between the triglyceride-glucose index and silent myocardial infarction in the general population

Abstract This study aimed to explore the relationship between the triglyceride-glucose (TyG) index and silent myocardial infarction (SMI) in the general population, with a focus on elucidating potential links and contributing to the understanding of risk factors for undetected cardiac events. This p...

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Main Authors: Min Dai, Dongze Li, Jing Yu, Yi Liu, Qin Zhang, Wei Zhang, Yan Zhong, Zhi Wan, Menglin Tang, Yongli Gao, Li Rao
Format: Article
Language:English
Published: Nature Portfolio 2025-03-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-92779-y
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author Min Dai
Dongze Li
Jing Yu
Yi Liu
Qin Zhang
Wei Zhang
Yan Zhong
Zhi Wan
Menglin Tang
Yongli Gao
Li Rao
author_facet Min Dai
Dongze Li
Jing Yu
Yi Liu
Qin Zhang
Wei Zhang
Yan Zhong
Zhi Wan
Menglin Tang
Yongli Gao
Li Rao
author_sort Min Dai
collection DOAJ
description Abstract This study aimed to explore the relationship between the triglyceride-glucose (TyG) index and silent myocardial infarction (SMI) in the general population, with a focus on elucidating potential links and contributing to the understanding of risk factors for undetected cardiac events. This prospective cohort study was carried out within a community-based population, using data from the Atherosclerosis Risk in Communities study in the United States. The dataset included information on demographics, cardiovascular risk factors, blood lipids, liver and kidney function, and other variables. Participants were categorized into four quartiles based on their TyG index scores. Cox regression analysis was used to examine the relationship between the different ranges of TyG indices and SMI. In total, 14,211 community residents were enrolled and followed up for 36 years. Among them, 7,316 (51.48%) developed SMI. TyG index measurements were divided into quartiles: Q1 (≤ 8.26), Q2 (8.26–8.62), Q3 (8.62–9.02), and Q4 (≥ 9.02). Restricted cubic spline curves indicated that higher TyG indices correlated with a greater risk of SMI. Results of the Kaplan–Meier analysis suggested that participants with a higher TyG index had a lower cumulative survival rate for SMI (P < 0.001). Through multivariate Cox regression analysis, the TyG index was identified as an independent predictor of SMI risk (P < 0.001). Further stratified analyses reinforced the link between the TyG index and the risk of SMI, demonstrating its consistent influence across diverse population subsets. Mediation analysis revealed significant effects of hypertension, diabetes, body mass index and sex on SMI risk. The overall effect sizes ranged from 1.77 to 1.95, with direct effects accounting for 52.7–99.6% and mediation effects ranging from 0.4 to 47.3%. In the general population, the TyG index as an independent predictor of SMI risk, emphasizing its importance in cardiovascular disease assessment.
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spelling doaj-art-e8c5a7fe2c9648e7aa9c1bbbcc94bcce2025-08-20T03:01:41ZengNature PortfolioScientific Reports2045-23222025-03-0115111010.1038/s41598-025-92779-yAssociation between the triglyceride-glucose index and silent myocardial infarction in the general populationMin Dai0Dongze Li1Jing Yu2Yi Liu3Qin Zhang4Wei Zhang5Yan Zhong6Zhi Wan7Menglin Tang8Yongli Gao9Li Rao10Department of Emergency Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan UniversityDepartment of Cardiac Surgery, West China Hospital, Sichuan University/West China School of Nursing, Sichuan UniversityDepartment of Emergency Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan UniversityDepartment of Emergency Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan UniversityDepartment of Emergency Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan UniversityDepartment of Emergency Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan UniversityDepartment of Emergency Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan UniversityDepartment of Emergency Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan UniversityDepartment of Cardiac Surgery, West China Hospital, Sichuan University/West China School of Nursing, Sichuan UniversityDepartment of Emergency Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan UniversityDepartment of Geriatric Nursing, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of ChinaAbstract This study aimed to explore the relationship between the triglyceride-glucose (TyG) index and silent myocardial infarction (SMI) in the general population, with a focus on elucidating potential links and contributing to the understanding of risk factors for undetected cardiac events. This prospective cohort study was carried out within a community-based population, using data from the Atherosclerosis Risk in Communities study in the United States. The dataset included information on demographics, cardiovascular risk factors, blood lipids, liver and kidney function, and other variables. Participants were categorized into four quartiles based on their TyG index scores. Cox regression analysis was used to examine the relationship between the different ranges of TyG indices and SMI. In total, 14,211 community residents were enrolled and followed up for 36 years. Among them, 7,316 (51.48%) developed SMI. TyG index measurements were divided into quartiles: Q1 (≤ 8.26), Q2 (8.26–8.62), Q3 (8.62–9.02), and Q4 (≥ 9.02). Restricted cubic spline curves indicated that higher TyG indices correlated with a greater risk of SMI. Results of the Kaplan–Meier analysis suggested that participants with a higher TyG index had a lower cumulative survival rate for SMI (P < 0.001). Through multivariate Cox regression analysis, the TyG index was identified as an independent predictor of SMI risk (P < 0.001). Further stratified analyses reinforced the link between the TyG index and the risk of SMI, demonstrating its consistent influence across diverse population subsets. Mediation analysis revealed significant effects of hypertension, diabetes, body mass index and sex on SMI risk. The overall effect sizes ranged from 1.77 to 1.95, with direct effects accounting for 52.7–99.6% and mediation effects ranging from 0.4 to 47.3%. In the general population, the TyG index as an independent predictor of SMI risk, emphasizing its importance in cardiovascular disease assessment.https://doi.org/10.1038/s41598-025-92779-ySilent myocardial infarctionCardiovascular risk factorsTriglyceride glucose index
spellingShingle Min Dai
Dongze Li
Jing Yu
Yi Liu
Qin Zhang
Wei Zhang
Yan Zhong
Zhi Wan
Menglin Tang
Yongli Gao
Li Rao
Association between the triglyceride-glucose index and silent myocardial infarction in the general population
Scientific Reports
Silent myocardial infarction
Cardiovascular risk factors
Triglyceride glucose index
title Association between the triglyceride-glucose index and silent myocardial infarction in the general population
title_full Association between the triglyceride-glucose index and silent myocardial infarction in the general population
title_fullStr Association between the triglyceride-glucose index and silent myocardial infarction in the general population
title_full_unstemmed Association between the triglyceride-glucose index and silent myocardial infarction in the general population
title_short Association between the triglyceride-glucose index and silent myocardial infarction in the general population
title_sort association between the triglyceride glucose index and silent myocardial infarction in the general population
topic Silent myocardial infarction
Cardiovascular risk factors
Triglyceride glucose index
url https://doi.org/10.1038/s41598-025-92779-y
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