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Comparison of the Effects of Fasting Glucose, Hemoglobin A1c, and Triglyceride–Glucose Index on Cardiovascular Events in Type 2 Diabetes Mellitus

by 1,†, 2,3,4,†, 5, 2,3,4, 2,3, 3,6 and 4,6,*
1
Department of General Medicine, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan
2
Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
3
Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 812, Taiwan
4
Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
5
Division of Medical Statistics and Bioinformatics, Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
6
Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
*
Author to whom correspondence should be addressed.
These two contribute equally to this article.
Nutrients 2019, 11(11), 2838; https://doi.org/10.3390/nu11112838
Received: 25 September 2019 / Revised: 12 November 2019 / Accepted: 15 November 2019 / Published: 19 November 2019
The triglyceride–glucose (TyG) index has been correlated with insulin resistance. We aim to investigate the role of the TyG index on cardiovascular (CV) events in type 2 diabetes mellitus and compare the roles of fasting glucose, hemoglobin A1c, and the TyG index in predicting CV events. This retrospective study enrolled 3524 patients with type 2 diabetes from the Kaohsiung Medical University Research Database in 2009 in this longitudinal study and followed them until 2015. The TyG index was calculated as log (fasting triglyceride level (mg/dL) × fasting glucose level (mg/dL)/2). CV events included myocardial infarction, unstable angina, stroke, hospitalization for coronary artery disease, peripheral artery disease, and CV-related death. The association between variables and CV events was assessed using a multivariable stepwise Cox proportional hazard analysis. Two hundred and fifteen CV events (6.1%) were recorded during a follow-up period of 5.93 years. The multivariable stepwise analysis showed that high fasting glucose (HR, 1.007; p < 0.001) and a high TyG index (HR, 1.521; p = 0.004) but not hemoglobin A1c or triglycerides were associated with a higher rate of CV events. Adding fasting glucose and the TyG index to the basic model improved the predictive ability of progression to a CV event (p < 0.001 and p = 0.018, respectively), over that of hemoglobin A1c (p = 0.084) and triglyceride (p = 0.221). Fasting glucose and the TyG index are useful parameters and stronger predictive factors than hemoglobin A1c and triglyceride for CV events and may offer an additional prognostic benefit in patients with type 2 diabetes. View Full-Text
Keywords: fasting glucose; hemoglobin A1c; triglyceride-glucose index; cardiovascular events; type 2 diabetes mellitus fasting glucose; hemoglobin A1c; triglyceride-glucose index; cardiovascular events; type 2 diabetes mellitus
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MDPI and ACS Style

Su, W.-Y.; Chen, S.-C.; Huang, Y.-T.; Huang, J.-C.; Wu, P.-Y.; Hsu, W.-H.; Lee, M.-Y. Comparison of the Effects of Fasting Glucose, Hemoglobin A1c, and Triglyceride–Glucose Index on Cardiovascular Events in Type 2 Diabetes Mellitus. Nutrients 2019, 11, 2838. https://doi.org/10.3390/nu11112838

AMA Style

Su W-Y, Chen S-C, Huang Y-T, Huang J-C, Wu P-Y, Hsu W-H, Lee M-Y. Comparison of the Effects of Fasting Glucose, Hemoglobin A1c, and Triglyceride–Glucose Index on Cardiovascular Events in Type 2 Diabetes Mellitus. Nutrients. 2019; 11(11):2838. https://doi.org/10.3390/nu11112838

Chicago/Turabian Style

Su, Wei-Yu, Szu-Chia Chen, Yu-Ting Huang, Jiun-Chi Huang, Pei-Yu Wu, Wei-Hao Hsu, and Mei-Yueh Lee. 2019. "Comparison of the Effects of Fasting Glucose, Hemoglobin A1c, and Triglyceride–Glucose Index on Cardiovascular Events in Type 2 Diabetes Mellitus" Nutrients 11, no. 11: 2838. https://doi.org/10.3390/nu11112838

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