POS0406 ASSOCIATIONS BETWEEN THE TRIGLYCERIDE-GLUCOSE INDEX AND THE RISKS OF INCIDENT DIABETES AND CARDIOVASCULAR DISEASES IN INDIVIDUALS WITH OSTEOARTHRITIS: A LARGE-SCALE PROSPECTIVE COHORT STUDY

Abstract

Background:

The triglyceride-glucose (TyG) index is an emerging surrogate indicator of insulin resistance (IR). Although several studies have reported the association between TyG index and increased risks of diabetes and cardiovascular disease (CVD) in general population, its relationship with diabetes and CVD risk among individuals with osteoarthritis (OA) remains unclear.

Objectives:

This study aimed to investigate the associations between baseline TyG index and the risks of incident diabetes and CVD in individuals with OA.

Methods:

A total of 44,294 participants with OA at baseline were included in this study from the UK Biobank prospective cohort. The TyG index was calculated as Ln [fasting triglyceride (TG) (mg/dL) × FBG (fasting blood glucose) (mg/dL)/2], and participants were categorized into quartiles. Incident diabetes and major CVD events (including coronary heart disease [CHD], stroke and CVD mortality) were identified through medical and death records. Multivariable Cox regression models, Kaplan-Meier (KM) curves, and restricted cubic splines (RCS) were used to evaluate the association between TyG index and the risk of incident diabetes (n = 44,294) and CVD (n = 33,767) among OA participants in the UK Biobank. The predictive value of the TyG index was estimated using the area under the curve (AUC) and the receiver operating characteristic (ROC) curve. Sensitive analyses were performed to check the robustness of the main findings.

Results:

During a median follow-up of 14.78 years, 40,986 (92.53%) individuals developed diabetes, and 17,153 (50.80%) developed CVD. Multivariable adjusted models showed a significant trend toward an increasing risk of diabetes and CVD in participants with OA across quartiles of the TyG index. Compared with the lowest quartile of the TyG index, the highest quartile had adjusted hazard ratios (HR) of 3.97 (95% CI 3.49–4.53) for diabetes, 1.11 (95% CI 1.06–1.16) for CVD, 1.16 (95% CI 1.04–1.29) for CHD, and 1.35 (95% CI 1.29-1.41) for CVD mortality, respectively. This effect was more prominent among young adults (age<60, P for interaction <0.05) and females (P for interaction <0.05). The RCS curves demonstrated a linear dose-response relationship between TyG and the risk of diabetes, CVD, CHD, and stroke, while revealing a non-linear trend between the TyG index and CVD mortality (P for nonlinearity=0.02). The predictive value of the TyG index on diabetes (AUC: 0.79, 95%CI: 0.78-0.79) and CVD (AUC: 0.70, 95%CI: 0.70-0.71) were similar, among which the diagnostic efficiency for CVD mortality (AUC: 0.74, 95%CI: 0.73-0.75) was the highest. Sensitivity analysis consistently demonstrated a significant association between the TyG index and the risk of both diabetes and CVD in the OA population.

Conclusion:

Individuals with OA exhibiting an elevated baseline TyG index are at higher risk of developing both diabetes and CVD, with a particularly heightened risk of CVD-related mortality.

REFERENCES:

NIL. Table 1. Longitudinal associations between the TyG index (quartile) and diabetes and cardiovascular disease in participants with osteoarthritis in UK Biobank cohort Abbreviations: TyG, triglyceride-glucose; HR, hazard ratio; CI, confidence intervals Model 1: unadjusted model Model 2: adjusted for age, sex, race, education level (lower or higher), region (England, Scotland, and Wales), and Townsend Deprivation Index Model 3: further adjusted for smoking status (never, previous or current), alcohol drinker status(never, previous or current), regular physical activity (yes or no), body mass index (kg/m²), systolic blood pressure (mmHg), low-density lipoprotein cholesterol (mmol/L), use of lipid-lowering medication（yes or no） Figure 1Kaplan-Meier (KM) analysis of future diabetes and cardiovascular disease（CVD） risk in participants with osteoarthritis according to TyG index (quartile).A: Diabetes risk in participants with osteoarthritis with different quartiles of the TyG index.B: Cardiovascular diseases (CVD) risk in participants with osteoarthritis with different quartiles of the TyG index.

Acknowledgements:

NIL.

Disclosure of Interests:

None declared. © The Authors 2025. This abstract is an open access article published in Annals of Rheumatic Diseases under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Neither EULAR nor the publisher make any representation as to the accuracy of the content. The authors are solely responsible for the content in their abstract including accuracy of the facts, statements, results, conclusion, citing resources etc.