Association between the triglyceride-glucose index and cognitive impairment in China: a community population-based cross-sectional study

ABSTRACT

Introduction

Insulin resistance (IR) is a feature of metabolic syndrome and plays an important role in cognitive impairment (CI). The triglyceride-glucose (TyG) index is a convenient and cost-effective surrogate for assessing IR. This study aimed to assess the association between the TyG index and CI.

Methods

This community population-based cross-sectional study used a cluster-sampling methodology. All participants underwent the education-based Mini-Mental State Examination (MMSE), and those with CI were identified using standard thresholds. The fasting blood triglyceride and glucose levels were measured in the morning, and the TyG index was calculated as ln (½ fasting triglyceride level [mg/dL] × fasting blood glucose level [mg/dL]). Multivariable logistic regression and subgroup analysis were used to assess the relationship between the TyG index and CI.

Results

This study included 1484 subjects, of which 93 (6.27%) met the CI criteria. Multivariable logistic regression showed that CI incidence increased by 64% per unit increase in the TyG index (odds ratio [OR] = 1.64, 95% confidence interval [CI]: 1.02–2.63, p = 0.042). CI risk was 2.64-fold higher in the highest TyG index quartile compared to the lowest TyG index quartile (OR = 2.64, 95% CI: 1.19–5.85, p = 0.016). Finally, interaction analysis showed that sex, age, hypertension, and diabetes did not significantly affect the association between the TyG index and CI.

Conclusion

The present study suggested that an elevated TyG index was associated with a higher CI risk. Subjects with a higher TyG index should manage and treat at an early stage to alleviate the cognitive decline.

KEYWORDS:

• cognitive impairment
• insulin resistance
• triglyceride-glucose index
• cross-sectional study
• association
• ‌Alzheimer's disease
• ‌dementia
• Body mass index

Acknowledgements

We are thankful for the cooperation of all participants in our study.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Author contributions

YM took part in the survey, did the statistical analysis and wrote the manuscript. LD, SW, LG, and NH participated in the questionnaire survey, sample collection, and biochemical assessment. SS designed this study and participated in the questionnaire survey and sample collection. WP, YZ, YY, RZ, YW, FG and JW took part in the survey and collected samples. QQ provided technical guidance in all stages of the study. All authors have read and approved the final manuscript.

Statement of ethics

The studies involving human participants were reviewed and approved by Medical Ethics Committee of the First Affiliated Hospital of Xi’an Jiaotong University on December 9, 2019 (XJTU1AF2019LSL-018).

Data availability statement

The data that support the findings of this study are available from the corresponding author, Qiumin Qu, upon reasonable request.

Additional information

Funding

This work was supported by the Clinical Research Award of the First Affiliated Hospital of Xi’an Jiaotong University [No. XJTU1AF-CRF-2018-004] and the Key Research and Development Programs of Shaanxi Province [No. 2018ZDXM-SF-052].

Notes on contributors

Yimeng Ma

Yimeng Ma, is a Master student at Department of Neurology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China.

Shan Wei

Shan Wei, is a MD student at Department of Neurology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China.

Liangjun Dang

Liangjun Dang, is a MD student at Department of Neurology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China.

Ling Gao

Ling Gao, is a MD at Department of Neurology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China.

Suhang Shang

Suhang Shang, is a PhD at Department of Neurology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China.

Ningwei Hu

Ningwei Hu, is a MD student at Department of Neurology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China.

Wei Peng

Wei Peng, is a PhD student at Department of Neurology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China.

Yi Zhao

Yi Zhao, is a MD student at Department of Neurology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China.

Ye Yuan

Ye Yuan, is a PhD student at Department of Neurology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China.

Rong Zhou

Rong Zhou, is a Master student at Department of Neurology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China.

Yanyu Wang

Yanyu Wang, is a MD student at Department of Neurology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China.

Fan Gao

Fan Gao, is a Master at clinical research center, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China.

Jin Wang

Jin Wang, is a professor at the department of Neurology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China.

Qiumin Qu

Qiumin Qu, is a professor at the department of Neurology and center for Brain Science, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China.