Abstract:

Objective To investigate the association between the triglyceride-glucose index and platelet-lymphocyte ratio combined index (TyG-logPLR) and incident atherosclerotic coronary heart disease (CHD). Methods This was a retrospective study. A total of 1 222 patients with angina who underwent coronary angiography for the first time at Cangzhou People’s Hospital from January 2023 to September 2025 were enrolled. Based on the presence or absence of CHD, patients were divided into a CHD group (n=566) and a non-CHD group (n=656). Logistic regression was used to analyze the association between TyG-logPLR at different levels and incident CHD. Restricted cubic spline regression was applied to assess the dose-response relationship between TyG-logPLR and incident CHD. Subgroup analyses were conducted to further explore the association between TyG-logPLR and incident CHD. Results Compared with the non-CHD group, the CHD group had significantly higher age, proportions of men, hypertension history, diabetes history, smoking history, and alcohol consumptionhistory, leukocytecount, absolute monocyte count, absolute neutrophil count, low-density lipoprotein cholesterol, triglycerides, serum creatinine, glycated hemoglobin, fasting blood glucose, TyG, and TyG-logPLR levels (P<0.05), while absolute lymphocyte count and high-density lipoprotein cholesterol levels were significantly lower (P<0.05). Logistic regression showed that, with TyG-logPLR as a continuous variable and without adjustment for confounders, the odds ratio was 1.17, with a 95% confidence interval of 1.11-1.24. After adjustment for confounders including age, sex, history of hypertension, history of diabetes, absolute monocyte count, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, serum creatinine, glycated hemoglobin, smoking history, and alcohol consumption history, each 1-unit increase in TyG-logPLR was associated with an 11% increase in the risk of incident CHD. When TyG-logPLR was analyzed as a categorical variable, using Q1 as the reference group and without adjustment for confounders, the odds ratio for Q3 was 2.31, with a 95% confidence interval of 1.67-3.20. After adjustment for confounders, each 1-unit increase in TyG-logPLR in the Q3 group was associated with a 71% increase in the risk of incident CHD. Restricted cubic spline analysis showed a nonlinear relationship between TyG-logPLR and incident CHD in the univariate logistic regression model (P-non-linear=0.023). After multivariable logistic regression adjustment, TyG-logPLR still showed a nonlinear dose-response relationship with the risk of incident CHD (P-non-linear=0.019). Subgroup analysis confirmed that the association between TyG-logPLR and CHD was consistent across most subgroups. Conclusion TyG-logPLR is an independent risk factor for the development of CHD.

Key words: coronary disease, triglyceride-glucose index, platelet-to-lymphocyte ratio, combined index