Association between the triglyceride-glucose index and abdominal aortic calcification in adults: A cross-sectional study

Background and aims The triglyceride-glucose (TyG) index is a reliable marker of insulin resistance, which is a substantial risk factor for cardiovascular diseases. Abdominal aortic calcification (AAC) is significantly associated with subclinical atherosclerotic diseases. The present study investigated the relationship between the TyG index and extensive AAC in middle-aged and elderly populations in the United States (US). Methods and results We performed cross-sectional analyses of data from 1419 participants from the National Health and Nutrition Examination Survey 2013–2014. AAC was detected using dual-energy X-ray absorptiometry on Hologic Discovery model A densitometer, and quantified using the Kauppila score system. Extensive AAC was defined as a Kauppila score ≥5. Multivariable logistic regression models were used to determine the association between AAC and the TyG index. The restricted cubic spline model was used for the dose–response analysis. Extensive AAC was detected in 196 (13.8%) participants. The odds of extensive AAC increased by 41% per unit increase in the TyG index (adjusted odds ratios [OR] = 1.41, 95% confidence interval [CI]: 1.04–1.91). The multivariable-adjusted OR and 95% CI of the highest TyG index tertile compared with the lowest tertile was 1.80 (95% CI: 1.11–2.94). Extensive AAC showed a more robust association with the TyG index than with triglycerides or glycemia. The subgroup analyses indicated that the association was consistent irrespective of age, sex, hypertension, diabetes, hypercholesteremia and smoking status. Conclusion The TyG index was independently associated with the presence of extensive AAC in the study population. Further studies are required to confirm this relationship.