Association Between the Triglyceride-Glucose Index and Incident Cardiovascular Disease in Non-diabetic Adults: A Prospective Cohort Study

Abstract

Background: Cardiovascular disease (CVD) often develops silently; therefore, early markers of cardiovascular risk should be identified before the onset of overt metabolic disorders. The study evaluated the association between the triglyceride-glucose (TyG) index and incident CVD among non-diabetic adults without established CVD. Methods: A total of 553 non-diabetic adults without established CVD were recruited using non-probability convenience sampling from tertiary care centres and followed for 12-29 months. We collected demographic, clinical, and laboratory parameters, and computed the TyG index from fasting triglyceride and glucose levels. A total of 125 (22.6%) participants developed incident CVD during follow-up. Results: We observed a clear dose-response relationship, with 10/139 (7.2%) participants in the lowest TyG quartile and 54/138 (39.1%) participants in the highest TyG quartile developing incident CVD. After adjustment for age, gender, BMI, smoking status, hypertension, physical activity, and family history of CVD, the TyG index remained strongly associated with incident CVD (adjusted HR = 4.597, p < 0.001), while only hypertension remained statistically significant. The receiver operating characteristic curve analysis demonstrated moderate discriminative ability for incident CVD (area under the curve (AUC): 0.694). Conclusion: The results suggest that the TyG index may serve as a complementary, low-cost marker for cardiovascular risk assessment in non-diabetic individuals; however, its moderate discriminative ability and lack of demonstrated incremental prognostic value warrant further validation.