Elevated TyG index was associated with higher risk of cardiovascular involvement in SLE patients, with each one-unit increase associated with an adjusted HR of 1.36 for both overall cardiovascular involvement and inflammatory/lupus-related manifestations, supporting the TyG index as 'an accessible marker of cardiometabolic risk in SLE.'
Cardiovascular involvement occurred in approximately one quarter of SLE patients over the 21-year study period.
Elevated TyG index was associated with progressively lower event-free survival across quartiles.
Each one-unit increase in TyG index was independently associated with a 36% higher risk of overall cardiovascular involvement after multivariable adjustment.
Each one-unit increase in TyG index was independently associated with a 36% higher risk of inflammatory or lupus-related cardiovascular manifestations after multivariable adjustment.
An approximately linear dose-response association was observed between TyG index and both overall cardiovascular involvement and inflammatory/lupus-related cardiovascular manifestations.
The association between higher TyG index and MACE risk was less robust and should be interpreted cautiously due to limited events.
This research suggests that a simple blood test calculation called the triglyceride-glucose (TyG) index — derived from routine fasting triglyceride and blood sugar measurements — may help identify which patients with systemic lupus erythematosus (SLE) are at greater risk of developing heart and cardiovascular problems. In a study of nearly 1,000 SLE patients followed over up to 21 years, about one in four patients developed some form of cardiovascular involvement. Patients with higher TyG index values at baseline were significantly more likely to develop these complications over time, and the risk increased in an approximately linear fashion — meaning there was no clear threshold below which higher TyG stopped mattering. The association was particularly strong and consistent for cardiovascular problems directly related to lupus inflammation, such as myocarditis or pericarditis. For every one-unit increase in the TyG index, the risk of these events was approximately 36% higher even after adjusting for other known risk factors. The link with traditional atherosclerotic cardiovascular events (heart attacks, strokes) was suggested by the data but was less certain, partly because there were relatively few such events, and the results changed depending on how the analysis was conducted. This research suggests that the TyG index — which is inexpensive and can be calculated from blood tests already routinely ordered — could serve as a useful, accessible tool for monitoring cardiometabolic risk in people with SLE. Because SLE patients already face elevated cardiovascular risk compared to the general population, identifying accessible biomarkers to stratify that risk further could have practical value in clinical monitoring, though further prospective studies would be needed to confirm these findings and determine whether acting on TyG values improves outcomes.
Deng Z, Zheng J, Ye Y, Chen F, Liu H, Wang X, et al.. (2026). Long-term association of the triglyceride-glucose index with cardiovascular involvement in systemic lupus erythematosus: a retrospective cohort study.. Lupus science & medicine. https://doi.org/10.1136/lupus-2026-002141