Usefulness of Triglyceride-glucose index for detecting prevalent atrial fibrillation in a type 2 diabetic population

Objectives Atrial fibrillation (AF) is the most common arrhythmias, which significantly jeopardizes global cardiovascular health through the complicated heart failure and stroke. Published studies have demonstrated the impact of insulin resistance on the genesis of AF. Hence, monitoring insulin resistance may be a possible way to improve the detection of early-stage AF. Accordingly, our work aimed to investigate the association between TyG, a surrogate of insulin resistance, and the prevalent AF, and to evaluate the potential of TyG to refine the detection of prevalent AF in a diabetic population. Methods This cross-sectional study was derived from the National Metabolic Management Center Program and included 3244 diabetic patients between September 2017 and December 2020. TyG was calculated as ln[fasting TG (mg/ dL)x FPG (mg/dL)/2]. AF was diagnosed according to electrocardiography and subjects' self-reports. Results The prevalence of AF was 6.57%. In the fully adjusted model, each SD elevation of TyG cast a 40.6% additional risk for prevalent AF. In the quartile analysis, the top quartile showed a 2.120 times risk of prevalent AF compared with the bottom quartile. Smooth curve fitting demonstrated that the association was linear in the full range of TyG, and subgroup analysis suggested that the association was robust in several common subpopulations of AF. Furthermore, ROC results displayed an improvement for the detection of prevalent AF when adding TyG into conventional cardiovascular risk factors (0.812vs.0.825, P = 0.019), and continuous net reclassification index (0.227, 95% CI: 0.088-0.365, P = 0.001) and integrated discrimination index (0.007, 95% CI: 0.001-0.012, P = 0.026) also showed the improvement achieved by TyG. Conclusion Our data supported a linear and robust correlation between TyG and the prevalent AF in a diabetic population. Moreover, our results implicated the potential usefulness of TyG to refine the detection of prevalent AF in a diabetic population.