Higher TyG levels were associated with distinct patterns of subclinical myocardial injury depending on diabetes status. This study in Cardiovascular Diabetology evaluated TyG-related risk profiles in adults without known cardiovascular disease using data from the Atherosclerosis Risk in Communities (ARIC) cohort.

The analysis included 11,478 adults in the cross-sectional evaluation and 8,801 in the prospective cohort. TyG index values were derived from fasting glucose and triglyceride concentrations. Subclinical myocardial injury was defined as high-sensitivity cardiac troponin T (hs-cTnT) ≥14 ng/L.

Cross-sectional findings demonstrated a positive linear association between TyG index and hs-cTnT (r = 0.13; p < 0.001). Logistic regression confirmed this association [(adjusted odds ratio (aOR) = 1.33; p < 0.001]). The association was significant in individuals with diabetes (aOR = 1.64; p = 0.020) but not in those without diabetes (aOR = 0.89; p = 0.374).

During six-year follow-up, a U-shaped association between TyG index and incident hs-cTnT elevation was observed in the overall cohort. Stratified models demonstrated an L-shaped association in individuals without diabetes (aOR = 0.72; p = 0.006) and a J-shaped association in individuals with diabetes (aOR = 2.09; p < 0.001).

These findings indicate that diabetes modifies the relationship between TyG index and subclinical myocardial injury, supporting diabetes-specific interpretation of TyG index in cardiovascular risk assessment.