Abstract
BACKGROUND: Individuals with elevated triglyceride-glucose (TyG) index are prone to metabolic disturbances, which may accelerate the development of atherosclerotic diseases. While the relationship between TyG index and multiple cardiovascular diseases has been established, its association with incident abdominal aortic aneurysm (AAA) remains unclear. Therefore, this study aims to investigate the association between the TyG index and the risk of AAA. METHOD: This prospective study included 428,382 participants with complete TyG index data and without aneurysms at baseline from the UK Biobank. The primary outcome was incident AAA. Multivariate Cox and restricted cubic spline (RCS) regression models were used to evaluate the association between TyG index and AAA. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated. Additionally, sensitivity and subgroup analyses were performed to examine robustness of the results. RESULTS: During a median follow-up of 12.34 (IQR, 11.60-13.05) years, 2,153 (0.50%) new cases of AAA were identified. In adjusted models, an elevated TyG index was significantly linked to a higher risk of AAA, with an adjusted HR (95% CI) of 1.10 (1.05-1.16) per standard deviation (SD) increment. Compared to the lowest TyG quartile, the fully adjusted HRs for the second, third, and fourth quartiles were 1.21 (95% CI:1.04-1.42), 1.25 (95% CI:1.07-1.45), and 1.40 (95% CI:1.20-1.64), respectively. The RCS analysis revealed a linear relationship between the TyG index and the risk of incident AAA. These associations remained robust after adjusting for traditional risk factors and were consistent across subgroups and a series of sensitivity analyses. CONCLUSIONS: An elevated TyG index was independently associated with an increased risk of AAA, underscoring the potential value of the TyG index as a critical risk factor for AAA development.