Association Between Triglyceride-Glucose Index and Mild Cognitive Impairment in the Elderly

doi:10.3870/j.issn.1672-0741.25.08.005

Abstract

Abstract: Objective T o investigate the association between the triglyceride-glucose(TyG)index and mild cognitive impairment(MCI)in older adults. Methods Older adults aged ≥ 60 years who underwent health examinations in the Shuiguohu Community of Wuhan,Hubei Province,from September 2023 to September 2024 were enrolled.According to the inclusion and exclusion criteria,487 participants were ultimately included.General demographic characteristics and laboratory data were collected,and body mass index(BMI)and the TyG index were calculated.The participants were divided into an MCI group and a normal cognition group on the basis of the Montreal Cognitive Assessment(MoCA)score.Between-group comparisons were performed via independent-samples t tests,Wilcoxon rank-sum tests,and Fisher’s exact tests.After adjustment for confounders,including age,sex,and BMI,binary logistic regression was used to analyze the association between the TyG index and MCI,and subgroup analyses were conducted according to combined categories of age and BMI.Restricted cubic spline(RCS)regression was applied to evaluate the dose-response relationship between the TyG index and MCI. Results Among the 487 participants,203 were classified into the MCI group,and 284 into the normal group.Compared with that in the normal group,the TyG index was significantly increased in the MCI group(P<0.05).After adjustment for confounding factors,binary logistic regression revealed that the TyG index was positively associated with MCI(P= 0.036).RCS regression indicated a linear increasing trend in MCI risk with increasing TyG index values(P_overall= 0.038,P_non-linear> 0.05).Subgroup analysis on the basis of combined age and BMI data revealed that an elevated TyG index was significantly positively associated with MCI risk among individuals aged ≥70 years with a BMI ≥ 24 kg/m². Conclusion Elevated TyG index is associated with an increased risk of MCI,suggesting that the TyG index may serve as a potential indicator for the early identification of MCI.

Key words: mild cognitive impairment, triglyceride-glucose index, insulin resistance, elderly, cross-sectional study

CLC Number:

R749.16

Wu Qingqing, Chong Yufei, Li Zhengliang et al. Association Between Triglyceride-Glucose Index and Mild Cognitive Impairment in the Elderly[J]. Acta Medicinae Universitatis Scientiae et Technologiae Huazhong, 2026, 55(1): 116-121.

References

[1] 龚婧仪,种玉飞,段璨,等.近红外脑功能成像在轻度认知障碍诊断与康复中的应用进展[J].中华物理医学与康复杂志,2024,46(6):556-560.
Gong J Y,Chong Y F,Duan C,et al.Research progress on the application of near-infrared brain functional imaging in the diagnosis and rehabilitation of mild cognitive impairment[J].Chinese Journal of Physical Medicine and Rehabilitation,2024,46(6):556-560.
[2] Jia L,Du Y,Chu L,et al.Prevalence,risk factors,and management of dementia and mild cognitive impairment in adults aged 60 years or older in China:A cross-sectional study[J].Lancet Public Health,2020,5(12):e661-e671.
[3] Lacour A,Espinosa A,Louwersheimer E,et al.Genome-wide significant risk factors for Alzheimer’s disease:Role in progression to dementia due to Alzheimer’s disease among subjects with mild cognitive impairment[J].Mol Psychiatry,2017,22(1):153-160.
[4] Zhou M,Wang H,Zeng X,et al.Mortality,morbidity,and risk factors in China and its provinces,1990-2017:A systematic analysis for the Global Burden of Disease Study 2017[J].Lancet,2019,394(10204):1145-1158.
[5] Kellar D,Craft S.Brain insulin resistance in Alzheimer’s disease and related disorders:Mechanisms and therapeutic approaches[J].Lancet Neurol,2020,19(9):758-766.
[6] Sánchez-García A,Rodríguez-Gutiérrez R,Mancilas-Adame L,et al.Diagnostic accuracy of the triglyceride and glucose index for insulin resistance:A systematic review[J].Int J Endocrinol,2020,2020:4678526.
[7] Sun J,Xie Z,Wu Y,et al.Association of the triglyceride-glucose index with risk of alzheimer’s disease:A prospective cohort study[J].Am J Prev Med,2023,65(6):1042-1049.
[8] Hong S,Han K,Park C Y.The insulin resistance by triglyceride glucose index and risk for dementia:Population-based study[J].Alzheimers Res Ther,2021,13(1):9.
[9] Rhea E M,Leclerc M,Yassine H N,et al.State of the science on brain insulin resistance and cognitive decline due to Alzheimer’s disease[J].Aging Dis,2024,15(4):1688-1725.
[10] Sen T,Saha P,Jiang T,et al.Sulfhydration of AKT triggers Tau-phosphorylation by activating glycogen synthase kinase 3β in Alzheimer’s disease[J].Proc Natl Acad Sci USA,2020,117(8):4418-4427.
[11] Pan Y,Chen W,Yan H,et al.Glycemic traits and Alzheimer’s disease:A Mendelian randomization study[J].Aging,2020,12(22):22688-22699.
[12] Alizargar J,Bai C H,Hsieh N C,et al.Use of the triglyceride-glucose index(TyG)in cardiovascular disease patients[J].Cardiovasc Diabetol,2020,19(1):8.
[13] Kim Y M,Kim J H,Park J S,et al.Association between triglyceride-glucose index and gastric carcinogenesis:A health checkup cohort study[J].Gastric Cancer,2022,25(1):33-41.
[14] Albert M S,DeKosky S T,Dickson D,et al.The diagnosis of mild cognitive impairment due to Alzheimer’s disease:Recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease[J].Alzheimers Dement,2011,7(3):270-279.
[15] 中国痴呆与认知障碍诊治指南写作组.2018中国痴呆与认知障碍诊治指南(五):轻度认知障碍的诊断与治疗[J].中华医学杂志,2018,98(17):1294-1301.
Writing Group of Chinese Guidelines for diagnosis and treatment of dementia and cognitive disorders.2018 Chinese guidelines for diagnosis and treatment of dementia and cognitive disorders(Part 5):Diagnosis and treatment of mild cognitive impairment[J].Natl Med J China,2018,98(17):1294-1301.
[16] Chen K L,Xu Y,Chu A Q,et al.Validation of the Chinese version of montreal cognitive assessment basic for screening mild cognitive impairment[J].J Am Geriatr Soc,2016,64(12):e285-e290.
[17] Simental-Mendía L E,Rodríguez-Morán M,Guerrero-Romero F.The product of fasting glucose and triglycerides as surrogate for identifying insulin resistance in apparently healthy subjects[J].Metab Syndr Relat Disord,2008,6(4):299-304.
[18] Riley R D,Collins G S,Hattle M,et al.Calculating the power of a planned individual participant data meta-analysis of randomised trials to examine a treatment-covariate interaction with a time-to-event outcome[J].Res Synth Methods,2023,14(5):718-730.
[19] Kapasi A,Decarli C,Schneider J A.Impact of multiple pathologies on the threshold for clinically overt dementia[J].Acta Neuropathol,2017,134(2):171-186.
[20] Hou Y,Dan X,Babbar M,et al.Ageing as a risk factor for neurodegenerative disease[J].Nat Rev Neurol,2019,15(10):565-581.
[21] Feng Z,Fang C,Ma Y,et al.Obesity-induced blood-brain barrier dysfunction:Phenotypes and mechanisms[J].J Neuroinflammation,2024,21(1):110.
[22] Yang W,Liu Y,Xu Q Q,et al.Sulforaphene ameliorates neuroinflammation and hyperphosphorylated tau protein via regulating the PI3K/Akt/GSK-3β pathway in experimental models of Alzheimer’s disease[J].Oxid Med Cell Longev,2020,2020:4754195.
[23] Von Eckardstein A,Nordestgaard B G,Remaley A T,et al.High-density lipoprotein revisited:Biological functions and clinical relevance[J].Eur Heart J,2023,44(16):1394-1407.
[24] Tong X W,Zhang Y T,Yu Z W,et al.Triglyceride glucose index is related with the risk of mild cognitive impairment in type 2 diabetes[J].Diabetes Metab Syndr Obes,2022,15:3577-3587.
[25] Park S Y,Gautier J F,Chon S.Assessment of insulin secretion and insulin resistance in human[J].Diabetes Metab J,2021,45(5):641-654.