Triglyceride-glucose (TyG) index is an index to evaluate insulin resistance (IR) and obesity-related metabolic diseases, which is closely related to the high risk of cardiovascular disease (CVD). However, TyG index may be different from the high risk of CVD in middle-aged obese people of different genders.

To investigate the relationship between TyG index and the high risk of CVD in middle-aged obese people of different genders, and to evaluate its role in the prevention and treatment of CVD.

A total of 30 425 middle-aged obese residents were selected from 10 early screening and comprehensive intervention projects of high-risk CVD population in Anhui Province and investigated by investigators who were trained and qualified, using the preliminary screening questionnaire and basic information registration form designed by the National Cardiovascular Center. The main survey contents included gender, age, hypertension, dyslipidemia, diabetes, smoking and alcohol consumption, etc, and perform a CVD high-risk assessment. The included residents were divided into the male group (n=11 566) and female group (n=18 859). The male group was divided into T₁ (7.417-8.870) (n=2 892), T₂ (8.871-9.204) (n=2 891), T₃ (9.205-9.578) (n=2 892) and T₄ (9.579-11.435) (n=2 891) subgroups, the female group was divided into F₁ (7.579-8.876) (n=4 715), F₂ (8.877-9.183) (n=4 720), F₃ (9.184-9.526) (n=4 710) and F₄ (9.527-11.647) (n=4 714) subgroups according to the quartiles of TyG index. Binary Logistic regression analysis was used to explore the relationship between TyG index and the high risk of CVD, and Z-test was used to compare the differences in effect values among subgroups.

The high risk rate of CVD was 28.4% (3 280/11 566) in the male group and 26.0% (4 909/18 859) in the female group. Binary Logistic regression analysis showed that TyG index T₂ (F₂), T₃ (F₃), T₄ (F₄) in male group (female group) were correlated with the high risk of CVD (P<0.05), and the correlation with the high risk of CVD increased with the gradual increase of TyG index. In the male group, the risk of developing high risk of CVD in the T₄ subgroup compared to T₁ was OR (95%CI) =1.827 (1.622, 2.058) ; In the female group, the risk of developing high risk of CVD in the F₄ subgroup compared to F₁ was OR (95%CI) =1.552 (1.410, 1.708). There were significant differences in the TyG index and risk of developing high risk of CVD between the T₄ and F₄ subgroups in both male and female groups (P<0.05). After further adjustment for total cholesterol and other indicators (model 2), the correlation between T₂ (F₂), T₃ (F₃), T₄ (F₄) and the risk of developing high risk of CVD was attenuated. However, in both male and female groups, T₂ (F₂), T₃ (F₃) and T₄ (F₄) were all correlated with the high risk of CVD (P<0.05), and the correlation increased with the gradual increase of TyG index level. In the male group, the risk of developing high risk of CVD in the T₄ subgroup compared to T₁ subgroup was OR (95%CI) =1.804 (1.584, 2.055), in the female group, the risk of developing high risk of CVD in the F₄ subgroup compared to F₁ subgroup was OR (95%CI) =1.496 (1.345, 1.665) ; There were significant differences in the risk of developing high risk of CVD between the T₄ and F₄ subgroup in both male and female groups (P<0.05) .

Middle-aged obese men with high TyG index are more prone to develop high risk for CVD, and more attention should be paid to the TyG index level of the population.