{
  "abstract": "Objective To investigate whether the triglyceride-glucose (TyG) index and the triglyceride-to-high-density lipoprotein cholesterol (TG/HDL-C) ratio, as clinical surrogates of insulin resistance, predict the risk of anxiety, and to examine the potential mediating role of plasma proteins.Design Prospective cohort study.Setting Community-based population cohort in the United Kingdom.Participants A total of 412 767 participants aged 40–69 years without anxiety at baseline and with available data on TyG index and TG/HDL-C ratio were included. Among them, 43 991 participants had proteomic data with 2923 unique plasma proteins measured.Primary and secondary outcome measures The primary outcome was the incidence of first-episode anxiety. The main exposures were TyG index and TG/HDL-C ratio. Mediation analysis was conducted to assess the contribution of plasma proteins.Results During a median follow-up of 13.8 years, 21 616 cases of first-episode anxiety were identified. Higher quintiles of TyG index and TG/HDL-C ratio were significantly associated with increased anxiety risk (p trend <0.001). Each one SD increase in TyG index and TG/HDL-C ratio was associated with an 8% and 9% higher risk of anxiety, respectively. Mediation analysis showed that 36 proteins jointly explained 64.0% and 74.9% of the associations of TyG index and TG/HDL-C ratio with anxiety, respectively, with asialoglycoprotein receptor 1 (ASGR1) and protease serine 8 (PRSS8) identified as key mediators.Conclusions Elevated baseline TyG index and TG/HDL-C ratio are associated with an increased risk of anxiety, and this association may be mediated by ASGR1 and PRSS8.",
  "authors": [
    {
      "affiliations": [
        "Department of Rehabilitation Medicine, Ningbo No 2 Hospital, Ningbo, People's Republic of China"
      ],
      "name": "Huiming Ren"
    },
    {
      "affiliations": [
        "Department of Rehabilitation Medicine, Ningbo No 2 Hospital, Ningbo, People's Republic of China"
      ],
      "name": "Tian Zhao"
    },
    {
      "affiliations": [
        "Department of Neurology, Ningbo Medical Center Lihuili Hospital, Ningbo, People's Republic of China"
      ],
      "name": "Zhongyue Lv"
    },
    {
      "affiliations": [
        "Department of Neurology, Ningbo Medical Center Lihuili Hospital, Ningbo, People's Republic of China"
      ],
      "name": "Guoming Xie"
    },
    {
      "affiliations": [
        "The Sixth People's Hospital of Kunshan, Kunshan, People's Republic of China",
        "Jiangsu Key Laboratory of Preventive and Translational Medicine for Major Chronic Non-communicable Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, School of Public Health, Suzhou Medical College of Soochow University, Suzhou, People's Republic of China"
      ],
      "name": "Hongpeng Sun"
    }
  ],
  "title": "Prospective association of the triglyceride-glucose index and triglyceride to high-density lipoprotein cholesterol ratio with anxiety risk in a community-based cohort: a UK Biobank study",
  "uid": "e8d58e0d-68ee-529a-8c39-e247f3d683c4"
}