甘油三酯葡萄糖指数与冠心病的研究进展
Research Progress on Triglyceride-Glucose Index and Coronary Heart Disease
摘要: 近年来，冠状动脉粥样硬化性心脏病(CAD)的患病率不断攀升，同时，冠心病的发病人群逐渐呈现年轻化趋势，对冠心病的防治已成为一项严峻的公共卫生挑战。胰岛素抵抗(IR)通过代谢紊乱、慢性炎症、损伤血管等机制，显著增加心血管疾病风险，是冠心病的发生发展的重要原因，需要及早干预。在IR的替代指标中，甘油三酯葡萄糖(TyG)指数作为一项简便的生物标志物，已被证实能够可靠反映IR水平。本文旨在阐述TyG指数与CAD相关性的研究现状，为CAD的预防、治疗和预后评估提供参考依据，同时探讨TyG指数在临床应用中的潜在价值与未来研究方向。
Abstract: In recent years, the prevalence of coronary artery disease (CAD) has been steadily increasing, and the affected population is progressively trending toward younger age groups. Consequently, the prevention and treatment of CAD have emerged as a significant public health challenge. Insulin resistance (IR) contributes to an elevated risk of cardiovascular disease through mechanisms involving metabolic disorders, chronic inflammation, and vascular injury. As a critical factor in the initiation and progression of CAD, IR necessitates early intervention. Among the surrogate markers for IR, the triglyceride-glucose (TyG) index, a convenient and cost-effective biomarker, has been demonstrated to reliably reflect IR levels. This article aims to review the current research status on the association between the TyG index and CAD, providing a reference for CAD prevention, treatment, and prognosis assessment. Additionally, the potential clinical applications and future research directions of the TyG index are discussed.
文章引用：邱娟, 朱秀兰. 甘油三酯葡萄糖指数与冠心病的研究进展[J]. 临床个性化医学, 2026, 5(3): 278-286. https://doi.org/10.12677/jcpm.2026.53208

参考文献

[1] 刘明波, 何新叶, 杨晓红, 等. 《中国心血管健康与疾病报告2024》要点解读[J]. 心肺血管病杂志, 2025, 44(9): 899-917.
[2] Ormazabal, V., Nair, S., Elfeky, O., Aguayo, C., Salomon, C. and Zuñiga, F.A. (2018) Association between Insulin Resistance and the Development of Cardiovascular Disease. Cardiovascular Diabetology, 17, Article No. 122. [Google Scholar] [CrossRef] [PubMed]
[3] Chamroonkiadtikun, P., Ananchaisarp, T. and Wanichanon, W. (2020) The Triglyceride-Glucose Index, a Predictor of Type 2 Diabetes Development: A Retrospective Cohort Study. Primary Care Diabetes, 14, 161-167. [Google Scholar] [CrossRef] [PubMed]
[4] Adeva-Andany, M.M., Ameneiros-Rodríguez, E., Fernández-Fernández, C., Domínguez-Montero, A. and Funcasta-Calderón, R. (2019) Insulin Resistance Is Associated with Subclinical Vascular Disease in Humans. World Journal of Diabetes, 10, 63-77. [Google Scholar] [CrossRef] [PubMed]
[5] DeFronzo, R.A., Tobin, J.D. and Andres, R. (1979) Glucose Clamp Technique: A Method for Quantifying Insulin Secretion and Resistance. American Journal of Physiology-Endocrinology and Metabolism, 237, E214-E223. [Google Scholar] [CrossRef] [PubMed]
[6] Matthews, D.R., Hosker, J.P., Rudenski, A.S., Naylor, B.A., Treacher, D.F. and Turner, R.C. (1985) Homeostasis Model Assessment: Insulin Resistance and Beta-Cell Function from Fasting Plasma Glucose and Insulin Concentrations in Man. Diabetologia, 28, 412-419. [Google Scholar] [CrossRef] [PubMed]
[7] Minh, H.V., Tien, H.A., Sinh, C.T., Thang, D.C., Chen, C., Tay, J.C., et al. (2021) Assessment of Preferred Methods to Measure Insulin Resistance in Asian Patients with Hypertension. The Journal of Clinical Hypertension, 23, 529-537. [Google Scholar] [CrossRef] [PubMed]
[8] Simental-Mendía, L.E., Rodríguez-Morán, M. and Guerrero-Romero, F. (2008) The Product of Fasting Glucose and Triglycerides as Surrogate for Identifying Insulin Resistance in Apparently Healthy Subjects. Metabolic Syndrome and Related Disorders, 6, 299-304. [Google Scholar] [CrossRef] [PubMed]
[9] Zhou, H., Shi, Y. and Zhou, X. (2025) Comparison of Nine Insulin Resistance Surrogates for Predicting Cardiovascular Disease: A Cohort Study. Diabetology & Metabolic Syndrome, 17, Article No. 365. [Google Scholar] [CrossRef] 
[10] Guerrero-Romero, F., Simental-Mendía, L.E., González-Ortiz, M., Martínez-Abundis, E., Ramos-Zavala, M.G., Hernández-González, S.O., et al. (2010) The Product of Triglycerides and Glucose, a Simple Measure of Insulin Sensitivity. Comparison with the Euglycemic-Hyperinsulinemic Clamp. The Journal of Clinical Endocrinology & Metabolism, 95, 3347-3351. [Google Scholar] [CrossRef] [PubMed]
[11] Vasques, A.C.J., Novaes, F.S., de Oliveira, M.d.S., Matos Souza, J.R., Yamanaka, A., Pareja, J.C., et al. (2011) Tyg Index Performs Better than HOMA in a Brazilian Population: A Hyperglycemic Clamp Validated Study. Diabetes Research and Clinical Practice, 93, e98-e100. [Google Scholar] [CrossRef] [PubMed]
[12] Sánchez‐Íñigo, L., Navarro‐González, D., Fernández‐Montero, A., Pastrana‐Delgado, J. and Martínez, J.A. (2016) The TyG Index May Predict the Development of Cardiovascular Events. European Journal of Clinical Investigation, 46, 189-197. [Google Scholar] [CrossRef] [PubMed]
[13] Jin, J., Cao, Y., Wu, L., You, X., Guo, Y., Wu, N., et al. (2018) Triglyceride Glucose Index for Predicting Cardiovascular Outcomes in Patients with Coronary Artery Disease. Journal of Thoracic Disease, 10, 6137-6146. [Google Scholar] [CrossRef] [PubMed]
[14] Tao, L., Xu, J., Wang, T., Hua, F. and Li, J. (2022) Triglyceride-Glucose Index as a Marker in Cardiovascular Diseases: Landscape and Limitations. Cardiovascular Diabetology, 21, Article No. 68. [Google Scholar] [CrossRef] [PubMed]
[15] Miao, M., Zhou, G., Bao, A., Sun, Y., Du, H., Song, L., et al. (2022) Triglyceride-Glucose Index and Common Carotid Artery Intima-Media Thickness in Patients with Ischemic Stroke. Cardiovascular Diabetology, 21, Article No. 43. [Google Scholar] [CrossRef] [PubMed]
[16] Wang, M., Mei, L., Jin, A., Cai, X., Jing, J., Wang, S., et al. (2022) Association between Triglyceride Glucose Index and Atherosclerotic Plaques and Burden: Findings from a Community-Based Study. Cardiovascular Diabetology, 21, Article No. 204. [Google Scholar] [CrossRef] [PubMed]
[17] Li, J., Dong, Z., Wu, H., Liu, Y., Chen, Y., Li, S., et al. (2023) The Triglyceride-Glucose Index Is Associated with Atherosclerosis in Patients with Symptomatic Coronary Artery Disease, Regardless of Diabetes Mellitus and Hyperlipidaemia. Cardiovascular Diabetology, 22, Article No. 224. [Google Scholar] [CrossRef] [PubMed]
[18] Braunwald, E. (2009) Noninvasive Detection of Vulnerable Coronary Plaques: Locking the Barn Door before the Horse Is Stolen. Journal of the American College of Cardiology, 54, 58-59. [Google Scholar] [CrossRef] [PubMed]
[19] Zhang, Y., Shi, R., Jiang, Y., Gao, Y., Jiang, Y., Wang, J., et al. (2025) The Association between the Triglyceride-glucose Index and Vulnerable Plaques in Patients with Type 2 Diabetes Mellitus: Insights from Coronary Computed Tomography Angiography. Cardiovascular Diabetology, 24, Article No. 169. [Google Scholar] [CrossRef] [PubMed]
[20] Guo, Y., Cui, L., Guo, J., Jin, C., Xiu, L., Gao, Y., et al. (2025) The Triglyceride-Glucose Index Is Associated with Coronary Plaque Features and Clinical Outcomes in Patients with ST-Segment Elevation Myocardial Infarction. Frontiers in Endocrinology (Lausanne), 16, Article ID: 1665292. [Google Scholar] [CrossRef] 
[21] Huo, G., Zheng, J., Cao, J., Zhang, L., Yao, Z., Zeng, Y., et al. (2025) Association between Triglyceride-Glucose Index and Carotid Plaque Stability in Different Glycemic Status: A Single‐Center Retrospective Study. Journal of the American Heart Association, 14, e037970. [Google Scholar] [CrossRef] [PubMed]
[22] Adams-Huet, B. and Jialal, I. (2024) An Increasing Triglyceride-Glucose Index Is Associated with a Pro-Inflammatory and Pro-Oxidant Phenotype. Journal of Clinical Medicine, 13, Article No. 3941. [Google Scholar] [CrossRef] [PubMed]
[23] Li, Y., Yi, M., Wang, X., Zhang, Y., Xiao, K., Si, J., et al. (2024) Association between Triglyceride-Glucose Index and Endothelial Dysfunction. Endocrine, 85, 717-723. [Google Scholar] [CrossRef] [PubMed]
[24] Gounden, V., Devaraj, S. and Jialal, I. (2024) The Role of the Triglyceride-Glucose Index as a Biomarker of Cardio-Metabolic Syndromes. Lipids in Health and Disease, 23, Article No. 416. [Google Scholar] [CrossRef] [PubMed]
[25] Liu, L., Wu, Z., Zhuang, Y., Zhang, Y., Cui, H., Lu, F., et al. (2022) Association of Triglyceride-Glucose Index and Traditional Risk Factors with Cardiovascular Disease among Non-Diabetic Population: A 10-Year Prospective Cohort Study. Cardiovascular Diabetology, 21, Article No. 256. [Google Scholar] [CrossRef] [PubMed]
[26] Pan, W., Ren, Y., Yang, F., Wang, M., Li, X. and Yin, D. (2023) Triglyceride Glucose Index Is Associated with Obstructive Coronary Artery Disease in Hypertensive Patients. Cardiovascular Diabetology, 22, Article No. 9. [Google Scholar] [CrossRef] [PubMed]
[27] Cole, J.H., Miller, J.I., Sperling, L.S. and Weintraub, W.S. (2003) Long-Term Follow-Up of Coronary Artery Disease Presenting in Young Adults. Journal of the American College of Cardiology, 41, 521-528. [Google Scholar] [CrossRef] [PubMed]
[28] Hou, Q., Qi, Q., Han, Q., Yu, J., Wu, J., Yang, H., et al. (2024) Association of the Triglyceride-Glucose Index with Early-Onset Atherosclerotic Cardiovascular Disease Events and All-Cause Mortality: A Prospective Cohort Study. Cardiovascular Diabetology, 23, Article No. 149. [Google Scholar] [CrossRef] [PubMed]
[29] Shali, S., Luo, L., Yao, K., Sun, X., Wu, H., Zhang, S., et al. (2023) Triglyceride-Glucose Index Is Associated with Severe Obstructive Coronary Artery Disease and Atherosclerotic Target Lesion Failure among Young Adults. Cardiovascular Diabetology, 22, Article No. 283. [Google Scholar] [CrossRef] [PubMed]
[30] Su, J., Li, Z., Huang, M., Wang, Y., Yang, T., Ma, M., et al. (2022) Triglyceride Glucose Index for the Detection of the Severity of Coronary Artery Disease in Different Glucose Metabolic States in Patients with Coronary Heart Disease: A RCSCD-TCM Study in China. Cardiovascular Diabetology, 21, Article No. 96. [Google Scholar] [CrossRef] [PubMed]
[31] Xiong, S., Chen, Q., Long, Y., Su, H., Luo, Y., Liu, H., et al. (2023) Association of the Triglyceride-Glucose Index with Coronary Artery Disease Complexity in Patients with Acute Coronary Syndrome. Cardiovascular Diabetology, 22, Article No. 56. [Google Scholar] [CrossRef] [PubMed]
[32] Xu, Z., Chen, P., Wang, L., Yan, J., Yan, X. and Li, D. (2024) Relationship between TyG Index and the Degree of Coronary Artery Lesions in Patients with H-Type Hypertension. Cardiovascular Diabetology, 23, Article No. 23. [Google Scholar] [CrossRef] [PubMed]
[33] Jiao, Y., Su, Y., Shen, J., Hou, X., Li, Y., Wang, J., et al. (2022) Evaluation of the Long-Term Prognostic Ability of Triglyceride-Glucose Index for Elderly Acute Coronary Syndrome Patients: A Cohort Study. Cardiovascular Diabetology, 21, Article No. 3. [Google Scholar] [CrossRef] [PubMed]
[34] Wu, Z., Liu, L., Wang, W., Cui, H., Zhang, Y., Xu, J., et al. (2022) Triglyceride-Glucose Index in the Prediction of Adverse Cardiovascular Events in Patients with Premature Coronary Artery Disease: A Retrospective Cohort Study. Cardiovascular Diabetology, 21, Article No. 142. [Google Scholar] [CrossRef] [PubMed]
[35] Hao, B., Lyu, L., Xu, J., Zhu, X., Xu, C., Gao, W., et al. (2024) The Relationship between Triglyceride-Glucose Index and Prospective Key Clinical Outcomes in Patients Hospitalised for Coronary Artery Disease. Cardiovascular Diabetology, 23, Article No. 40. [Google Scholar] [CrossRef] [PubMed]
[36] Luo, E., Wang, D., Yan, G., Qiao, Y., Liu, B., Hou, J., et al. (2019) High Triglyceride-Glucose Index Is Associated with Poor Prognosis in Patients with Acute ST-Elevation Myocardial Infarction after Percutaneous Coronary Intervention. Cardiovascular Diabetology, 18, Article No. 150. [Google Scholar] [CrossRef] [PubMed]
[37] Hu, S., Yan, H., Sun, Y., Wang, D., Zeng, H. and Cui, G. (2025) Triglyceride Glucose Index in Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention Predicts Cardiovascular Events: A Cohort Study. Cardiovascular Diabetology, 24, Article No. 380. [Google Scholar] [CrossRef] 
[38] Guo, X., Shen, R., Yan, S., Su, Y. and Ma, L. (2023) Triglyceride-glucose Index for Predicting Repeat Revascularization and In-Stent Restenosis in Patients with Chronic Coronary Syndrome Undergoing Percutaneous Coronary Intervention. Cardiovascular Diabetology, 22, Article No. 43. [Google Scholar] [CrossRef] [PubMed]
[39] Zhu, Y., Liu, K., Chen, M., Liu, Y., Gao, A., Hu, C., et al. (2021) Triglyceride-Glucose Index Is Associated with In-Stent Restenosis in Patients with Acute Coronary Syndrome after Percutaneous Coronary Intervention with Drug-Eluting Stents. Cardiovascular Diabetology, 20, Article No. 137. [Google Scholar] [CrossRef] [PubMed]
[40] Ye, Z., Xu, Y., Tang, L., Wu, M., Wu, B., Zhu, T., et al. (2023) Predicting Long-Term Prognosis after Percutaneous Coronary Intervention in Patients with New Onset ST-Elevation Myocardial Infarction: Development and External Validation of a Nomogram Model. Cardiovascular Diabetology, 22, Article No. 87. [Google Scholar] [CrossRef] [PubMed]
[41] Feng, Q., Jiang, M., Peng, X., He, H., Jia, D., Feng, J., et al. (2024) Adjustment of the ACEF Score by the Triglyceride Glucose Index Improves the Prediction of Clinical Outcomes in Patients Undergoing Percutaneous Coronary Intervention. Cardiovascular Diabetology, 23, Article No. 440. [Google Scholar] [CrossRef] [PubMed]
[42] Sun, Y., Sun, P. and Liu, D. (2025) Association of Triglyceride-Glucose Index and Estimated Glucose Disposal Rate with Outcomes in Patients with Acute Myocardial Infarction: Cumulative Effect and Mediation Analysis. PLOS ONE, 20, e0328150. [Google Scholar] [CrossRef] [PubMed]
[43] Che, B., Zhong, C., Zhang, R., Pu, L., Zhao, T., Zhang, Y., et al. (2023) Triglyceride-Glucose Index and Triglyceride to High-Density Lipoprotein Cholesterol Ratio as Potential Cardiovascular Disease Risk Factors: An Analysis of UK Biobank Data. Cardiovascular Diabetology, 22, Article No. 34. [Google Scholar] [CrossRef] [PubMed]
[44] He, H., Xie, Y., Chen, Q., Li, Y., Li, X., Mu, Y., et al. (2024) The Additive Effect of the Triglyceride-Glucose Index and Estimated Glucose Disposal Rate on Long-Term Mortality among Individuals with and without Diabetes: A Population-Based Study. Cardiovascular Diabetology, 23, Article No. 307. [Google Scholar] [CrossRef] [PubMed]
[45] Ruan, X., Ling, Y., Chen, J., Xiang, Y., Ruan, H., Zhang, W., et al. (2025) Joint Effects of Triglyceride Glucose Index and Its Obesity-Related Derivatives with Estimated Glucose Disposal Rate on Cardiometabolic Multimorbidity in Middle-Aged and Older Chinese Adults: A Nationwide Cohort Study. Cardiovascular Diabetology, 24, Article No. 382. [Google Scholar] [CrossRef] 
[46] Miao, Y., Wang, Y. and Wan, Q. (2025) Association between TyG Index with Obesity Indicators and Coronary Heart Disease: A Cohort Study. Scientific Reports, 15, Article No. 8920. [Google Scholar] [CrossRef] [PubMed]
[47] Shan, Y., Lin, M., Gu, F., Li, D., Zhu, Q., Chen, Z., et al. (2025) The Prognostic Association of Triglyceride-Glucose Index and Its Derived Indicators with Stable Coronary Artery Disease Patients Undergoing Percutaneous Coronary Intervention. Frontiers in Endocrinology (Lausanne), 16, Article ID: 1465376. [Google Scholar] [CrossRef] [PubMed]
[48] Lai, J., Zhang, X., He, Y. and Liang, S. (2025) Triglyceride-Glucose Index and the Risk of Major Adverse Cardiovascular Events in Patients with Coronary Artery Disease: A Systematic Review and Meta-Analysis. Medicine (Baltimore), 104, e42562. [Google Scholar] [CrossRef] 
[49] Hao, Q.Y., Gao, J.W., Zeng, Y.H., et al. (2025) Roles of Triglyceride-Glucose Index in Aortic Valve Calcification Progression: A Prospective and Mendelian Randomization Analysis. Clinical Radiology, 84, Article ID: 106860. [Google Scholar] [CrossRef] [PubMed]