Association of changes in trajectory of triglyceride-glucose index with left ventricular hypertrophy in childhood

Objective: To explore the association between triglyceride-glucose index (TyG) trajectory changes and left ventricular hypertrophy (LVH) in childhood.

Methods: A total of 1 515 students from grades 1-5 were selected as subjects in a public primary school in Huantai County, Zibo City, Shandong Province by convenient cluster sampling method from November 2017. Follow-up surveys were conducted every 2 years (2019, 2021, 2023), which involved questionnaire survey, physical examination, cardiac ultrasound and blood biochemical examination. The correlation between changes in TyG and left ventricular structural indicators between 2017 and 2023 was analyzed using a multiple linear regression. The group based trajectory modelling was used to fit the childhood TyG change trajectory model, and divided into high, medium and low level trajectory groups. Additionally, multivariate logistic regression was employed to analyze the relationship between TyG trajectory and LVH in children.

Results: A total of 1 111 subjects with an average age of (8.3±1.5) years were included, including 582 (52.4%) boys. There were 391 (35.2%), 596 (53.6%) and 124 (11.2%) children in TyG low, medium and high level trajectory groups, respectively. TyG, left ventricular mass (LVM), left ventricular mass index (LVMI), left ventricular end-diastolic dimension (LVDD), left ventricular posterior wall thickness (LVPWT) and interventricular septal thickness (IVST) in TyG high level trajectory group were all higher than those in low and medium level trajectory groups (all P<0.05). Compared with the TyG normal-normal group, the LVM, LVMI, LVDD in the TyG normal-high group, LVM in the TyG high-normal group and LVM, LVMI, LVDD, LVPWT and IVST in the TyG high-high group were all increased (all P<0.05). Compared with the TyG low level trajectory group, the risk of LVH was increased in the total population [OR (95%CI): 3.69 (1.79-7.61)] and boys [OR (95%CI): 5.48 (1.95-15.44)].

Conclusions: High TyG in childhood increases the risk of LVH. If the TyG can be controlled to normal levels early, the risk of LVH can be effectively reduced.