Title:Relationship between Triglyceride-Glucose Index and Disease Activity and
Subclinical Atherosclerosis in Rheumatoid Arthritis
Volume: 20
Issue: 2
Author(s): Seham Abdallah Elazab*, Wagenat Effat Elsayed, Nosaiba Mohammed Alrahim, Marwa Abdallah Elsaid, Samah Mohamed Akab, Alshimaa Ahmed Ezzat Mohammed Enayet, Maha Salah Eldin Mohamed, Sherien Abdallah Elazab, Marwa Mostafa Sonbol and Radwa Mohamed Fath Allah
Affiliation:
- Rheumatology and Rehabilitation Department, Al-Azhar University, Cairo, Egypt
Keywords:
Rheumatoid arthritis, triglyceride-glucose index, subclinical atherosclerosis, autoimmune disease, insulin resistance (IR), disease.
Abstract:
Background: In rheumatoid arthritis (RA), insulin resistance (IR) is related to inflammatory
markers, disease activity, and progression of atherosclerotic changes. Triglyceride-glucose
(TyG) index is a relatively new indicator of IR.
Aims: The present study aimed to investigate the relationship between TyG index, disease activity
and subclinical atherosclerosis (SCA) in RA patients.
Methods: The present case-control study included 100 RA patients and 50 age- and sex-matched
healthy controls. All participants were subjected to careful history taking through clinical examination
and standard laboratory assessment. The TyG index was calculated as TyG index = ln (Fasting
triglyceride (mg/dL) × fasting glucose (mg/dL))/2. Carotid intima-media thickness (CIMT)
measurement was done using B-mode ultrasound.
Results: Patients had significantly higher TyG index as compared to controls. Patients with high
disease activity had significantly higher frequency of extraarticular manifestations (39.6% versus
51.6%, p = 0.028), higher Larsen score (3.8 ± 1.3 versus 2.8 ± 1.2, p < 0.001), higher anti-cyclic
citrullinated peptide (anti-CCP) levels (median (IQR): 243.1 (205.0-408.0) U/ml versus 99.0
(78.0-332.5), p < 0.001), higher TyG index (4.8 ± 0.22 versus 4.67 ± 0.24, p = 0.006), and higher
CIMT (0.87 ± 0.22 versus 0.77 ± 0.17 mm, p = 0.018). Patients with SCA had higher BMI (34.6 ±
6.2 versus 30.5 ± 5.3 Kg/m2, p < 0.001), higher Larsen score (3.7 ± 1.4 versus 3.1 ± 1.3, p =
0.028) and higher TyG index (4.89 ± 0.23 versus 4.64 ± 0.19, p < 0.001). Binary logistic regression
analysis identified patients’ age (OR (95% CI): 0.94 (0.89-0.99), p = 0.018), Larsen score
(OR (95% CI): 1.93 (1.32-2.82), p = <0.001), anti-CCP (OR (95%): 1.04 (1.02-1.07), p = 0.032),
and TyG index (OR (95% CI): 22.67 (2.14-240.4), p = 0.01) as significant predictors of high disease
activity in multivariate analysis.
Conclusion: IR estimated by the TyG index is related to disease activity and SCA in RA patients.
