Abstract
This study aimed to investigate the associations between the triglyceride glucose index (TyG-BRI) and cardiovascular disease (CVD) among middle-aged and elderly individuals. In the REACTION study, a baseline survey was conducted in 2011, which involved the collection of triglyceride levels, fasting blood glucose, height, waist circumference, and other relevant data, from which the TyG-BRI was subsequently calculated. A total of 8,935 participants who met the inclusion criteria were followed up until the conclusion of the study in 2021, during which pertinent data regarding mortality and CVD events were gathered. The study subjects were categorized into quartiles on the basis of TyG-BRI score. To analyze the impact of the TyG-BRI on all-cause mortality and CVD events, a multifactorial Cox proportional hazards model was employed. Additionally, receiver operating characteristic (ROC) curves were generated to assess the ability of the TyG index, BRI, and TyG-BRI to predict cardiovascular events. Among the 7532 participants who completed the follow-up, 474 experienced a CVD event during this period. After multifactor adjustment, a nonlinear correlation was observed between the TyG index, TyG-BRI, and CVD events. When the first quartile (Q1) was used as a reference, the hazard ratios (HRs) with 95% confidence intervals (CIs) for CVD events in the fourth quartile (Q4) were 1.997 (1.361-2.928) and 2.130 (1.535-2.957), respectively. Additionally, in the receiver operating characteristic (ROC) curve analysis, the areas under the curve (AUCs) for the TyG index, BRI, and TyG-BRI concerning the risk of CVD events were 0.614 (0.588, 0.640), 0.609 (0.584, 0.633), and 0.626 (0.601, 0.651), respectively. In middle-aged and elderly individuals, both the TyG index and the TyG-BRI serve as independent risk factors for cardiovascular disease. Notably, the TyG-BRI has a stronger ability to predict the risk of cardiovascular events than does the TyG index.