Beyond metabolic syndrome: the relationship of mets-ir, tyg index, and epicardial adipose tissue with subclinical atherosclerosis in different vascular beds

Objective: This study aimed to evaluate the relationship between metabolic insulin resistance indicators (METS-IR and TyG index) and the amount of epicardial adipose tissue (EAT), with subclinical atherosclerosis markers such as coronary artery calcium (CAC) and carotid intima-media thickness (IMT). Methods: Retrospective data from 108 patients evaluated for suspected coronary artery disease were analyzed. METS-IR and TyG scores were calculated using laboratory and anthropometric data. EAT thickness and volume were measured by computed tomography. CAC score and carotid IMT were assessed using standard methods. Correlations and multivariate regression analyses were used to examine associations, and ROC analysis was performed to evaluate diagnostic performance. Results: Epicardial fat thickness (AUC=0.802) and volume (AUC=0.781) showed high discriminative power in predicting the presence of CAC. A threshold value of 5.9 mm for EAT thickness provided 75% sensitivity and 71% specificity. The METS-IR score was independently associated with both CAC (AUC=0.670) and carotid IMT, while the TyG index showed only a weak association with CAC (AUC=0.661). In multivariate analyses, EAT measurements and METS-IR scores were significantly associated with subclinical atherosclerosis markers, independent of conventional risk factors. Conclusion: METS-IR, TyG, and particularly epicardial fat measurements appear to be potential biomarkers for the early detection of subclinical atherosclerosis. Integration of these parameters into individualized cardiovascular risk assessments should be supported by further studies.