Frontiers in Endocrinology · Oct 8, 2026

Changes in triglyceride-glucose index and progression of coronary artery calcification in asymptomatic adults: a longitudinal cohort study

By Kim MJ, Kim YJ, Kang JH et al.

INTRODUCTION: The triglyceride-glucose (TyG) index is a readily available surrogate marker of insulin resistance; however, the association between changes in TyG index and coronary artery calcification (CAC) progression remains unclear. METHODS: This retrospective cohort study included 14,407 Korean adults without cardiovascular disease who underwent two baseline examinations during 2012-2018 and at least three examinations overall. At each baseline examination, TyG index status was classified as low or high using a predefined cutoff, yielding low-to-low (L-L), low-to-high (L-H), high-to-low (H-L), and high-to-high (H-H) groups. CAC progression was defined as a difference of ≥2.5 between the square root-transformed coronary artery calcium score (CACS) of the follow-up and index examination. Cox proportional hazards and linear mixed-effects models were used to estimate hazard ratios (HRs) and 5-year fold changes, respectively. RESULTS: During a median follow-up of 5.34 years, 4,139 participants experienced CAC progression. Compared with the L-L group, the risk of CAC progression increased across the L-H, H-L, and H-H groups, with adjusted HRs (95% confidence intervals) of 1.07 (0.96-1.19), 1.14 (1.02-1.27), and 1.30 (1.20-1.41), respectively. Associations differed between CAC subgroups (p for interaction <0.001), with more pronounced associations observed among participants with CACS of zero at both the first and index examinations. The 5-year fold change was 11% higher in the L-H group than in the L-L group and 9% lower in the H-L group than in the H-H group. CONCLUSION: Changes in TyG index status were associated with CAC progression, particularly among individuals without detectable CAC. Serial TyG index assessment may aid in cardiovascular risk stratification.

doi.org/10.3389/fendo.2026.1976562 Open access PubMed 42923171 Biomarkers