Journal of the American Heart Association
September 24, 2026 · via Europe PMC
Insulin Resistance Indices and Genetic Predisposition in Relation to the Risk of Incident and Recurrent Coronary Artery Disease.
Ding Y, Yang Z, Ge T, He J, Wang Z, Zhou D, Zhu Y, He D.
AI summary — for doctors, generated from the abstract only
In a large UK study, simple blood-test-based insulin resistance markers predicted both first-time and recurrent coronary artery disease, with their effect on first-time disease being notably stronger in people who also had higher genetic risk for the condition.
What was studied
An analysis of UK Biobank data examining four triglyceride-glucose (TyG)-based insulin resistance indices (calculated from routine blood tests and body measurements) and a genetic risk score for coronary artery disease, assessing their associations with incident (first-time) coronary artery disease in 408,759 participants without baseline disease and recurrent disease in 12,895 participants with pre-existing coronary artery disease, using Cox proportional hazards models.
Key findings
- 27,378 of 408,759 participants (6.7%) without baseline coronary artery disease developed incident disease, and 7,620 of 12,895 (59.1%) with pre-existing disease experienced recurrence during follow-up.
- Comparing highest versus lowest quartile, all four insulin resistance indices were significantly associated with incident coronary artery disease (hazard ratios ranging from 1.57 to 1.96) and with recurrent disease (hazard ratios ranging from 1.18 to 1.26), though associations were notably stronger for incident than recurrent disease.
- There were significant interactions between insulin resistance indices and genetic risk specifically for incident disease, with stronger associations seen in participants with medium or high genetic risk scores, but no significant interaction was found for recurrent disease.
Clinical relevance
These findings suggest that simple, routinely available insulin resistance markers could help identify people at higher risk for developing coronary artery disease for the first time, especially when combined with genetic risk information, which could support more personalized cardiovascular risk assessment and prevention strategies, though the markers appear somewhat less informative for predicting recurrence in those who already have the disease.
Who should care
Limitations
This is an observational cohort study, so causation cannot be firmly established; the UK Biobank population may not fully represent other ethnic or socioeconomic groups, limiting generalizability.
Simple blood-test-based measures of insulin resistance predicted future heart disease risk, and this prediction was even stronger in people who also carried higher genetic risk for coronary artery disease, suggesting value in combining these two types of information.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Background
Insulin resistance contributes to the pathogenesis of coronary artery disease (CAD), yet its association with recurrent CAD and the potential role of genetic susceptibility remain unclear.
Methods
We analyzed data from the UK Biobank. Four triglyceride-glucose (TyG)-based indices were calculated to assess insulin resistance, including TyG, TyG-body mass index, TyG-waist circumference, and TyG-waist-to-height ratio. The polygenic risk score for CAD was categorized into tertiles, representing low, medium, and high genetic risk. Cox proportional hazards models were used to evaluate the associations of TyG-based indices and polygenic risk score with the risk of incident and recurrent CAD.
Results
During follow-up, 27 378 of 408 759 (6.7%) participants without baseline CAD developed incident CAD, and 7620 of 12 895 (59.1%) participants with preexisting CAD experienced recurrent CAD. When comparing the highest versus lowest quartile (Q4 versus Q1), the hazard ratios (HRs) and 95% CIs for incident CAD were 1.57 (1.51-1.63) for TyG, 1.79 (1.72-1.86) for TyG-body mass index, 1.95 (1.86-2.04) for TyG-waist circumference, and 1.96 (1.88-2.05) for TyG-waist-to-height ratio. The corresponding HRs for recurrent CAD were 1.18 (95% CI, 1.10-1.26), 1.20 (95% CI, 1.12-1.28), 1.23 (95% CI, 1.15-1.32), and 1.26 (95% CI, 1.17-1.34), respectively. We observed significant interactions between TyG-based indices and genetic risk for incident CAD, with stronger associations among participants with medium/high polygenic risk score. However, no significant interactions were detected for recurrent CAD.
Conclusions
Elevated TyG-based indices were associated with a higher risk of incident and recurrent CAD. Interactions between TyG-based indices and polygenic risk score were observed for incident but not recurrent CAD.
DOI
10.1161/jaha.126.049158
PMID
42786634
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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