Comparison of the correlation between triglyceride‐glucose index and homeostasis model assessment of insulin resistance with subclinical left ventricular dysfunction

AIMS/INTRODUCTION: We aimed to explore the association of the triglyceride-glucose (TyG) index and homeostasis model assessment of insulin resistance (HOMA-IR) with subclinical left ventricular function in the general population. MATERIALS AND METHODS: A total of 2,850 participants with left ventricular ejection fraction ≥50% were recruited from 2017 to 2019 in Danyang. Speckle-tracking echocardiography (Philips CX50) was used to measure global longitudinal strain (GLS). Subclinical left ventricular systolic dysfunction (LVSD) was defined as GLS < 18%. RESULTS: In univariate analyses, higher TyG index and HOMA--IR were significantly associated with reduced GLS, lower E/A ratio and e', and higher E/e' ratio (P < 0.001). After adjustment for confounders, HOMA-IR remained significantly associated with lower GLS (P = 0.002), whereas the TyG index showed stronger correlations with E/e' ratio (P < 0.01). The inclusion of log-transformed HOMA-IR significantly improved model fit in analyses incorporating GLS and TyG index (P = 0.004) but not in those with E/e' ratio and TyG index (P = 0.65). Conversely, the TyG index enhanced model performance for the E/e'-HOMA-IR association (P < 0.001) but not for GLS-HOMA-IR relationships (P = 1). In addition, participants in the highest versus lowest HOMA-IR quartile demonstrated significantly increased odds ratio of subclinical LVSD (OR = 2.22, 95% CI: 1.26-3.92; P = 0.006), while the TyG index showed no significant association with its prevalence (P = 0.98). CONCLUSIONS: In a community-based population, elevated HOMA-IR demonstrated a robust association with subclinical LVSD, whereas the TyG index exhibited a more pronounced correlation with early diastolic dysfunction.