Browse by author
Lookup NU author(s): Professor Konstantinos StellosORCiD, Professor Kimon Stamatelopoulos
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND).
© 2025 The Author(s). Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.Background and Aims: Triglyceride-glucose (TyG) index, is an emerging prognostic biomarker in atherosclerotic cardiovascular disease (ASCVD). Validation of its clinical value and of clinically relevant prognostic cut-off, remains an unmet need to integrate TyG into primary prevention protocols. Methods: To assess the clinical applicability of TyG, a composite of cardiovascular mortality, myocardial infarction, coronary revascularization or stroke was used as the primary endpoint in a general population cohort (ATTICA cohort, n = 1677, derivation cohort). Next, we derived an optimal prognostic TyG cut-off and externally validated it in a primary prevention cohort (n = 1237). To assess the clinical value of TyG, we analysed 1170 consecutively recruited patients from an ongoing registry aiming to stratify ASCVD risk (Athens Cardiometabolic Cohort) and assessed indices of subclinical arterial injury and progression of atherosclerosis. The TyG index was calculated by the formula: ln[fasting triglycerides (mg/dL) × fasting glucose (mg/dL)/2]. Results: TyG index was independently associated with increased CVD events in the derivation cohort (HR = 1.33, p = 0.020). The incremental value of a derived optimal cut-off of 8.46 over SCORE2 was confirmed in both derivation and validation cohorts [net reclassification index (NRI) = 0.668 and 0.469 respectively, Delta Harrell's C index = 0.054 and 0.044 respectively, p < 0.05 for all]. Elevated TyG index was associated with more diseased vascular beds (OR = 2.00, 95% CI 1.24–3.24), progression of subclinical carotid atherosclerosis (OR = 2.99, 95% CI 1.10–8.17) at follow-up and established ASCVD (p < 0.05 for all). Conclusions: TyG is associated with increased prevalence and progression of subclinical and clinically overt ASCVD. In individuals assessed for primary prevention a TyG≥8.46 may serve as a risk enhancer.
Author(s): Mavraganis G, Georgiopoulos G, Athanasopoulos S, Terentes-Printzios D, Zervas G, Konstantaki C, Koilakou ME, Giannakopoulou S-P, Dimopoulou M-A, Chrysochoou C, Tsioufis K, Pitsavos C, Liberopoulos E, Stellos K, Vlachopoulos C, Panagiotakos D, Stamatelopoulos K
Publication type: Article
Publication status: Published
Journal: Diabetes, Obesity and Metabolism
Year: 2025
Pages: epub ahead of print
Online publication date: 03/11/2025
Acceptance date: 24/10/2025
Date deposited: 25/11/2025
ISSN (print): 1462-8902
ISSN (electronic): 1463-1326
Publisher: John Wiley and Sons Inc
URL: https://doi.org/10.1111/dom.70270
DOI: 10.1111/dom.70270
Data Access Statement: The data underlying this article will be shared on reasonable request to the corresponding author.
PubMed id: 41178693
Altmetrics provided by Altmetric
