ArticleBiomolecules & biomedicine2026
Triglyceride-glucose index is independently associated with left ventricular outflow tract obstruction in hypertrophic cardiomyopathy.
Article in Biomolecules & biomedicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Insulin resistance and metabolic dysregulation are increasingly recognized as contributors to myocardial remodeling and phenotypic heterogeneity in hypertrophic cardiomyopathy (HCM). While the triglyceride-glucose (TyG) index offers a simple surrogate marker of insulin resistance, its relationship with left ventricular outflow tract (LVOT) obstruction in HCM patients remains underexplored. This study aimed to investigate the association between the TyG index and LVOT obstruction in a retrospective observational cohort of 124 adult HCM patients. LVOT obstruction was defined as a resting or provoked gradient of ≥30 mmHg. Clinical, laboratory, and echocardiographic data were systematically evaluated. The TyG index was computed from fasting triglyceride and glucose levels. Multivariable logistic regression analysis, with the TyG index scaled per 0.1-unit increment, was used to assess independent associations. Receiver operating characteristic (ROC) curve analysis determined discriminatory performance. Patients with obstructive HCM exhibited significantly higher TyG index values compared to those without obstruction (9.07 ± 0.25 vs. 8.76 ± 0.21, p<0.001). The TyG index maintained an independent association with LVOT obstruction after adjusting for relevant clinical and echocardiographic covariates (per 0.1-unit increase: OR 1.84, 95% CI 1.40-2.42, p<0.001). Furthermore, the TyG index demonstrated moderate correlations with both resting (r=0.519, p<0.001) and provoked (r=0.557, p<0.001) LVOT gradients. ROC analysis indicated good discriminatory performance (AUC: 0.826, 95% CI: 0.752-0.901), with a cut-off value of 8.75 yielding 87.9% sensitivity and 47.0% specificity. In conclusion, the TyG index was independently associated with LVOT obstruction in HCM patients, with higher values observed in those with the obstructive phenotype. This suggests a potential link between metabolic status and disease manifestation in HCM. Given its cost-effectiveness and accessibility, the TyG index may offer valuable complementary clinical insights. However, this association requires cautious interpretation, and prospective studies are essential to establish its clinical and prognostic utility.
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