A correlation study on triglyceride-glucose index and extensive neovascularization within carotid artery plaques.

Objective: This study aims to investigate the correlation between the triglyceride-glucose (TyG) index and intraplaque neovascularization (IPN), evaluate the predictive efficacy of the TyG index for massive IPN, and provide novel serological markers for the early clinical identification of vulnerable plaques.

Methods: A total of 308 patients enrolled between May 2019 and December 2024 were included. IPN (0-3) was graded by Contrast-enhanced ultrasound (CEUS) and dichotomized (Grade I: none/minimal neovascularization, Grade II: extensive neovascularization). The association between the TyG and Grade II and its predictive performance were evaluated.

Results: The proportion of IPN Grade II significantly increased with ascending TyG quartiles (Q1: 37.66% vs. Q4: 85.71%, P < 0.001). After adjusting for confounders, the risk of Grade II in the Q4 group was 7.32 times higher than in the Q1 group (95% CI: 2.81-19.05). Restricted cubic spline analysis revealed an exponential increase in risk when TyG > 8.28. Subgroup analysis demonstrated a stronger association between TyG and IPN Grade II in hypertensive populations. Furthermore, the TyG index yielded an area under the curve of 0.72, with a sensitivity of 81% and specificity of 60% at the optimal cutoff value of 8.645.

Conclusion: This study demonstrates that the TyG index is significantly and independently associated with extensive IPN in carotid plaques. This finding suggests the TyG index has potential as a supplementary serological marker in the assessment of plaque vulnerability.