Association of triglyceride-glucose related indices with cardiovascular diseases in individuals with low handgrip strength: a prospective cohort study of UK biobank.

Per 1-SD increase in TyG-related indices was significantly associated with higher CVD incidence in individuals with low handgrip strength.

• Adjusted HRs per 1-SD increase: TyG 1.08, TyG-BMI 1.13, TyG-WC 1.15, TyG-WHtR 1.15
• All associations were statistically significant (all p < 0.001)
• Associations were assessed using multivariable Cox proportional hazards models
• Study population included 18,341 participants with low HGS from the UK Biobank

Over a median follow-up of 13.4 years, 2,666 CVD cases occurred among individuals with low handgrip strength.

• Cohort comprised 18,341 participants with low HGS
• Mean age of participants was 59.2 years
• 61.2% of the cohort was female
• Median follow-up duration was 13.4 years

TyG-related indices showed significant interaction effects for CVD and CHD across multiple subgroups.

• Significant interaction effects were identified across subgroups including age, disease status, and medication use
• Subgroup analyses were performed to identify effect modifiers
• Both CVD and CHD endpoints demonstrated significant subgroup interactions

Dyslipidemia, inflammation, and insulin resistance mediated the associations between TyG-related indices and CVD in individuals with low handgrip strength.

• Mediation analyses were conducted to identify pathways linking TyG-related indices to CVD outcomes
• Three mediating pathways were identified: dyslipidemia, inflammation, and insulin resistance
• The mediation analysis results support a mechanistic link between insulin resistance markers and CVD risk in this population

TyG index combined with adiposity measures (TyG-BMI, TyG-WC, TyG-WHtR) showed stronger associations with CVD than TyG alone.

• TyG alone had an adjusted HR of 1.08 per 1-SD increase
• TyG-BMI, TyG-WC, and TyG-WHtR had adjusted HRs of 1.13, 1.15, and 1.15 respectively
• Combinations with adiposity measures (BMI, waist circumference, waist-to-height ratio) enhanced predictive value compared to TyG index alone

Low handgrip strength was identified as a population in which TyG-related indices offer value for early CVD risk identification and preventive strategies.

• The prognostic value of TyG-related indices in low HGS populations was previously unknown
• Low HGS predicts CVD risk, potentially via insulin resistance
• The study suggests TyG-related indices can be used for early risk identification and development of preventive strategies in this population