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ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Cardiovascular Endocrinology
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1515559
Association of insulin resistance-related indicators with cardiovascular disease in Chinese people with different glycemic states
Provisionally accepted
Zihao Zhang 
Lan Tan *- Qingdao Municipal Hospital, Qingdao University Medical College, Qingdao, China
This study compares the association of eight insulin resistance (IR)-related markers (triglyceride-glucose index (TyG), TyG-body mass index (TyG-BMI), TyG-waist circumference (TyG-WC), TyG-waist-to-height ratio (TyG-WHtR), triglycerides-to-high-density lipoprotein cholesterol ratio (TG/HDL), lipid accumulation product (LAP), visceral adiposity index (VAI), and estimated glucose disposal rate (eGDR)) with cardiovascular disease (CVD).Methods: Spearman's coefficients were used for correlations between IR-related markers. Predictive capacities were evaluated using receiver operating characteristic (ROC) curve analysis, Akaike Information Criterion, and Bayesian Information Criterion were calculated. Multivariable-adjusted Cox regression models and restricted cubic spline (RCS) analysis were performed to explore associations between IR-related markers and CVD.In Pearson correlation analysis, TyG-WC and TyG-WHtR had a correlation coefficient of 0.95, while TG/HDL ratio and VAI had a correlation coefficient of 0.97.Regarding predictive capacity across different glycemic states, eGDR showed the best performance among the 8 IR-related markers, particularly in predicting stroke.According to Cox regression analysis, with each unit increase in TyG, TyG-BMI, TyG-WC, and TyG-WHtR, the risk of heart disease increased by 24.1%, 0.4%, 0.1%, and 17.56%, respectively; and the risk of stroke increased by 69.3%, 0.6%, 0.2%, and 36.5%, respectively. Additionally, TG/HDL ratio, VAI, and LAP exhibited nonlinear associations with heart disease and stroke risk. For each unit increase in eGDR, the risks of heart disease and stroke decreased by 21% and 14.2%, respectively Conclusion: eGDR is the most effective marker for predicting CVD, especially stroke, across all glycemic states. Modified TyG indices provide better predictive value than TyG alone.
Keywords: Stroke, Heart disease, Insulin Resistance, cardiovascular, Glucose
Received: 23 Oct 2024; Accepted: 02 Apr 2025.
Copyright: © 2025 Zhang and Tan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Lan Tan, Qingdao Municipal Hospital, Qingdao University Medical College, Qingdao, China
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