Triglyceride-Glucose Index May Be a Marker for Atherosclerosis in Psoriatic Arthritis

The triglyceride-glucose (TyG) index may be a marker for atherosclerosis in psoriatic arthritis (PsA), according to results of a cross-sectional study published in Rheumatology.

Patients with PsA who visited the Peking University First Hospital in China between 2018 and 2021 were eligible for inclusion in the study. All patients underwent clinical evaluations and carotid ultrasonography. Carotid atherosclerosis status and carotid artery plaque levels were related to TyG index scores.

A total of 165 patients with PsA were included in the study, with a mean age of 48.3±13.1 years; 60.0% were men. Patients had a body mass index (BMI) of 24.9±3.5 and a duration of arthritis of 4.5 years (IQR, 1.2-10.5 years).

Stratified by tertiles of TyG index scores, the lowest (<8.35; n=54), intermediate (8.35-8.81; n=55), and highest (³8.82; n=56) score groups differed significantly by age, BMI, dyslipidemia, hypertension, swollen joint count, and statin use (all P £.028).

Researchers noted significantly higher TyG score among patients with vs without coronary atherosclerosis (mean, 8.82 vs 8.54; P =.002) and coronary artery plaque (mean, 8.88 vs 8.55; P =.001).

Patients in the highest vs lowest tertile of TyG index scores were at increased risk for carotid atherosclerosis (adjusted odds ratio [aOR], 5.10; 95% CI, 1.54-16.93; P =.029) and carotid artery plaque (aOR, 17.89; 95% CI, 2.88-111.11; P =.008). In addition, individuals in the intermediate vs lower tertile were also at higher risk for carotid artery plaque (aOR, 10.32; 95% CI, 1.74-61.40; P =.008).

Using TyG index as a continuous variable, risk for carotid atherosclerosis (aOR, 2.69; 95% CI, 1.02-7.11; P =.046) and carotid artery plaque (aOR, 3.61; 95% CI, 1.15-11.38; P =.028) was higher with every 1-unit increase in TyG index score.

In subgroup analyses, subclinical atherosclerotic events were observed to be more common among individuals without a history of smoking and with hyperuricemia or dyslipidemia (all P <.05).

Incorporating the TyG index into predictive models that included age, sex, comorbidities, smoking, BMI, low-density lipoprotein cholesterol, and/or Disease Activity Index in Psoriatic Arthritis (DAPSA) score improved the prediction of carotid atherosclerosis (C-statistic, 0.828 vs 0.707-0.810) and carotid artery plaque (C-statistic, 0.795 vs 0.702-0.773), respectively.

The study authors concluded, “[T]he TyG index may be useful for detecting carotid atherosclerosis, although external validation is still needed. With the advantages of being simple, accessible and reliable, TyG index could be a useful tool for cardiovascular risk assessment for [patients with] PsA in daily practice, especially for primary hospitals and communities.”