Different associations of atherogenic index of plasma, triglyceride glucose index, and hemoglobin A1C levels with the risk of coronary artery calcification progression according to established diabetes

• Published in: Cardiovascular diabetology 2024-11, Vol.23 (1), p.418-9, Article 418
• Main Authors: Won, Ki-Bum, Choi, Su-Yeon, Chun, Eun Ju, Park, Sung Hak, Sung, Jidong, Jung, Hae Ok, Chang, Hyuk-Jae
• Format: Article
• Language: English
• Subjects: Adult; Atherogenic index of plasma; Biomarkers - blood; Blood Glucose - analysis; Blood Glucose - metabolism; Coronary Angiography; Coronary artery calcium score; Coronary Artery Disease - blood; Coronary Artery Disease - diagnosis; Coronary Artery Disease - diagnostic imaging; Coronary Artery Disease - epidemiology; Diabetes mellitus; Diabetes Mellitus - blood; Diabetes Mellitus - diagnosis; Diabetes Mellitus - epidemiology; Disease Progression; Female; Glycated Hemoglobin - analysis; Glycated Hemoglobin - metabolism; Hemoglobin A1C; Humans; Male; Middle Aged; Prognosis; Republic of Korea - epidemiology; Risk Assessment; Risk Factors; Time Factors; Triglyceride glucose index; Triglycerides - blood; Vascular Calcification - blood; Vascular Calcification - diagnosis; Vascular Calcification - diagnostic imaging; Vascular Calcification - epidemiology
• ISSN: 1475-2840; 1475-2840
• DOI: 10.1186/s12933-024-02508-4

Both insulin resistance and hyperglycemia are important risk factors for atherosclerosis. While the characteristics of atherosclerosis are obviously different according to established diabetes, little has been known regarding the risk of coronary artery calcification (CAC) progression related to the biomarkers of atherogenic index of plasma (AIP), triglyceride glucose (TyG) index, and hemoglobin A1C (HbA1C) in conditions with and without diabetes. We analyzed 12,326 asymptomatic Korean adults (mean age 51.7 ± 8.5 years; 84.2% males; 15.8% with diabetes) over a median follow-up period of 3.0 years. AIP was defined as the base-10 logarithm of the ratio of triglyceride concentration (mmol/L) to high-density lipoprotein cholesterol (mmol/L). The TyG index was calculated as ln (fasting triglycerides [mg/dL] × fasting glucose [mg/ dL]/2). CAC progression was defined using the SQRT method, as a difference of ≥ 2.5 between the square roots (√) of baseline and follow-up coronary artery calcium scores (CACS) (Δ√transformed CACS). Logistic regression models adjusted for interscan periods were used to estimate the odds ratio (OR). The levels of AIP, TyG index, and HbA1C were significantly higher in diabetics than in non-diabetics. CAC progression was more frequently observed in diabetics (46.9%) than in non-diabetics (28.0%). After adjusting for age, sex, hypertension, hyperlipidemia, obesity, current smoking status, serum creatinine levels, baseline CACS, and interscan period, AIP (per-0.1 unit increase) was associated with CAC progression in only non-diabetics (OR: 1.04, 95% confidence interval [CI]: 1.02 - 1.06; P