The association between Angina and Triglyceride-Glucose Index among non-Diabetic Patients: A NHANES Cross-Sectional study: 2001-2020

Abstract Background A current alternative test of insulin resistance that has been considered a predictor of metabolic syndrome and cardiovascular disease (CVD) is the triglyceride-glucose (TyG) index. However, it is unknown if the TyG index may estimate the risk and incidence of angina in the non-diabetic population. This research examines the correlation between the TyG index and angina in non-diabetic individuals. Methods Data from the National Health and Nutrition Examination Survey (NHANES) were used in this study from 2001 to 2020; non-diabetic individuals aged 18 years or older were our targeted sample. We divided the sample regarding the angina as follows: no angina, no exertional chest pain, possible angina, and definitive angina. As well, the categories of TyG index were < = 8.22, 8.23–8.60, 8.61–9.01, and 9.02+. The analysis was conducted using a 4-year weight at fasting (WTSAF4YR) according to NHANES analysis criteria. The receiver operating characteristic (ROC) analysis was utilized to determine the sensitivity and specificity of the TyG index for estimating the endpoints of interest (angina). Univariate and multivariate logistic regression were performed to determine the factors correlated with the study outcomes, and the analysis was performed using IBM, SPSS Version 28.0. Results We involved 6,762 non-diabetic individuals, including 49 individuals who had possible angina, and 487 individuals had definitive angina, in addition 1,690 individuals with TyG above 9.02. We addressed a statistically difference between TyG and gender, as 55.9% of participants with high TyG (> 9.02) were males. The Pearson chi-square test showed no statistically significant difference between angina subgroups and TyG index categories, p-value: 0.065. In addition, six regression models confirmed that higher values of TyG index were not associated with the presence of no exertional chest pain, definitive angina, or possible angina. In addition, the TYG test had low diagnostic accuracy for identifying patients with angina (Sensitivity: 52.8%, Specificity: 52.83% AUC; 52.82%, P-value < 0.05). Conclusion The TyG index cannot be utilized as an alternate predictive marker for angina in the non-diabetic population since it has no correlation to angina risk factors.