The TYG index as a potential predictor of subclinical vascular disease after the menopause

Eleni Armeni (GR), Kimon Stamatelopoulos (GR), Maria Kazani (GR), Georgios Georgiopoulos (GR), Konstantinos Tampakis (GR), Demetrios Rizos (GR), Areti Augoulea (GR), Georgios Kaparos (GR), Andreas Alexandrou (GR), Irene Lambrinoudaki (GR)

[Armeni] 2nd Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, Aretaieio Hospital, Athens, [Stamatelopoulos] Department of Therapeutics, National and Kapodistrian University of Athens, Alexandra Hospital, Athens, [Kazani] Department of Therapeutics, National and Kapodistrian University of Athens, Alexandra Hospital, Athens, [Georgiopoulos] Department of Therapeutics, National and Kapodistrian University of Athens, Alexandra Hospital, Athens, [Tampakis] Department of Therapeutics, National and Kapodistrian University of Athens, Alexandra Hospital, Athens, [Rizos] Hormonal and Biochemical Laboratory, National and Kapodistrian University of Athens, Aretaieio Hospital, Athens, [Augoulea] 2nd Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, Aretaieio Hospital, Athens, [Kaparos] Hormonal and Biochemical Laboratory, National and Kapodistrian University of Athens, Aretaieio Hospital, Athens, [Alexandrou] 2nd Department of Obstetrics and Gy

Context: Obese postmenopausal women present with a clustering of co-existing metabolic risk factors and are easily stratified in cardiovascular risk-categories, whereas lean women are more difficult to be risk-stratified. Objective: To examine the association of the metabolic syndrome (MetS) and the triglyceride-glucose index (TyG-Index), a novel marker of insulin resistance, with subclinical atherosclerosis and arterial stiffness in a cohort of postmenopausal women, stratified according to their body mass index. Methods: We evaluated the association between indices of vascular function/structure and the MetS and TyG-index, independently in lean and overweight/obese postmenopausal women. Patients: 473 informed-consenting, non-diabetic postmenopausal women, without overt cardiovascular disease Interventions: 1) Sonographical assessment of carotid/femoral intima-media thickness (IMT) and pulse wave velocity (PWV). 2) Fasting venous blood samples for biochemical and hormonal assessment. Main outcome measures: Predictive ability of TyG-index vs MetS with respect to cardiovascular risk-classification in lean vs overweight/obese postmenopausal women. Results: The TyG-Index correlated with PWV (r=0.157, p-value=0.013) and carotid IMT (r=0.155, p-value=0.012), only in lean women. Subclinical atherosclerosis was predicted by MetS in the overweight/obese group (OR=2.517, p-value=0.033), and by the TyG-Index in the lean group (OR=3.119, p-value<0.001). Applying a TyG-Index cut-off value of 8.0 in the lean subgroup, women with TyG index>8 had higher prevalence of subclinical atherosclerosis vs women with TyG-index levels ≤8 (44.1% vs 29.4%, p-value=0.043). Conclusions: The MetS serves as a better predictor of subclinical atherosclerosis in overweight/obese women, while the TyG-Index is associated with carotid atherosclerosis and arterial stiffness mainly in lean postmenopausal women.