Abstract

The Association of the Triglyceride-glucose index with the risk of Atrial Fibrillation

Author(s): Shanshan Shi, Yanjun Song, Kefei Dou

The Triglyceride-Glucose (TyG) index is a recognized surrogate for insulin resistance, yet its relationship with Atrial Fibrillation (AF) remains incompletely defined, with prior studies yielding conflicting results. In a recent UK Biobank study, Shi et al. investigated the association between baseline TyG index and long-term AF risk in 409,705 participants without prior arrhythmias. Over a mean follow-up of 13.9 years, 26,092 AF cases occurred. Participants were stratified by TyG tertiles (T1: Low, T2: Middle, T3: High). Multivariable Cox regression revealed a U-shaped association: Compared to T2, T1 (HR: 1.22, 95% CI: 1.17-1.27) and T3 (HR: 1.09, 95% CI: 1.05-1.14) groups showed elevated AF risk, independent of demographics, lifestyle, comorbidities, and polygenic risk score for AF. Restricted cubic spline analysis confirmed a significant non-linear relationship (P<0.001). This non-linear relationship remained consistent across subgroups stratified by type 2 diabetes status, heart valve disease, and genetic susceptibility to AF. The findings suggest that both low and high TyG index values are independent risk factors for AF, highlighting the potential of this simple metric for improving AF risk stratification in clinical practice.