PDF(Pubmed)
Abstract：
BACKGROUND: Although triglyceride-glucose (TyG) index is a reliable indicator of insulin resistance and cardiometabolic disease, its effectiveness in predicting mortality risk has not been adequately validated. We aimed to investigate the association between the TyG-related indices and all-cause and cause-specific mortality in the general population.
METHODS: A total of 27,642 individuals were included from the National Health and Nutrition Examination Survey (NHANES) between 1999 and 2018. Three indicators were constructed, including the TyG index, TyG combined with waist-to-height ratio (TyG-WHtR), and TyG combined with waist circumference (TyG-WC). Mortality data was acquired through the linkage of NHANES data with National Death Index records. Weighted Cox proportional hazards models were used to estimate the independent association between the TyG-related indices and mortality. Nonlinear associations were explored using restricted cubic splines.
RESULTS: Multivariable adjusted models showed a progressive increase in all-cause and cause-specific mortality across quartiles of the TyG-related indices. Compared with the lowest quartile of the TyG index, the highest quartile had adjusted hazard ratios of 1.26 (95% CI 1.04-1.52) for all-cause mortality, 1.38 (1.04-1.74) for cardiovascular mortality, and 1.23 (1.01-1.50) for non-cardiovascular mortality, respectively. For the TyG-WHtR index, the corresponding hazard ratios were 1.60 (1.25-2.05), 1.86 (1.26-2.50), and 1.48 (1.10-1.99), respectively. For the TyG-WC index, the corresponding hazard ratios were 1.42 (1.11-1.75), 1.48 (1.04-1.96), and 1.38 (1.05-1.72), respectively. The associations between the three TyG-related indices and all-cause, cardiovascular and non-cardiovascular mortality were J-shaped. Interaction tests revealed significant effect modification by age, low-density lipoprotein cholesterol (LDL-C) level, and statin use (all P values < 0.05).
CONCLUSIONS: The TyG-related indices were independent predictors of all-cause and cause-specific mortality in the general population. Young individuals should be particularly vigilant, whereas low LDL-C levels and statin use are potentially protective.
METHODS: A total of 27,642 individuals were included from the National Health and Nutrition Examination Survey (NHANES) between 1999 and 2018. Three indicators were constructed, including the TyG index, TyG combined with waist-to-height ratio (TyG-WHtR), and TyG combined with waist circumference (TyG-WC). Mortality data was acquired through the linkage of NHANES data with National Death Index records. Weighted Cox proportional hazards models were used to estimate the independent association between the TyG-related indices and mortality. Nonlinear associations were explored using restricted cubic splines.
RESULTS: Multivariable adjusted models showed a progressive increase in all-cause and cause-specific mortality across quartiles of the TyG-related indices. Compared with the lowest quartile of the TyG index, the highest quartile had adjusted hazard ratios of 1.26 (95% CI 1.04-1.52) for all-cause mortality, 1.38 (1.04-1.74) for cardiovascular mortality, and 1.23 (1.01-1.50) for non-cardiovascular mortality, respectively. For the TyG-WHtR index, the corresponding hazard ratios were 1.60 (1.25-2.05), 1.86 (1.26-2.50), and 1.48 (1.10-1.99), respectively. For the TyG-WC index, the corresponding hazard ratios were 1.42 (1.11-1.75), 1.48 (1.04-1.96), and 1.38 (1.05-1.72), respectively. The associations between the three TyG-related indices and all-cause, cardiovascular and non-cardiovascular mortality were J-shaped. Interaction tests revealed significant effect modification by age, low-density lipoprotein cholesterol (LDL-C) level, and statin use (all P values < 0.05).
CONCLUSIONS: The TyG-related indices were independent predictors of all-cause and cause-specific mortality in the general population. Young individuals should be particularly vigilant, whereas low LDL-C levels and statin use are potentially protective.
摘要：
背景：尽管甘油三酸酯-葡萄糖（TyG）指数是胰岛素抵抗和心脏代谢疾病的可靠指标，其预测死亡风险的有效性尚未得到充分验证.我们旨在调查普通人群中TyG相关指数与全因死亡率和特定原因死亡率之间的关系。
方法：从1999年至2018年的国家健康和营养检查调查（NHANES）中纳入了27,642名个体。构建了三个指标，包括TyG指数，TyG结合腰围与身高比（TyG-WHtR），和TyG结合腰围（TyG-WC）。死亡率数据是通过将NHANES数据与国家死亡指数记录联系起来获得的。使用加权Cox比例风险模型来估计TyG相关指数与死亡率之间的独立关联。使用受限三次样条探索了非线性关联。
结果：多变量调整模型显示，在TyG相关指数的四分位数中，全因死亡率和特定原因死亡率逐渐增加。与TyG指数的最低四分位数相比，最高四分位数调整后的全因死亡率风险比为1.26（95％CI1.04-1.52），1.38（1.04-1.74）心血管死亡率，和1.23（1.01-1.50）的非心血管死亡率，分别。对于TyG-WHtR索引，相应的危险比为1.60(1.25-2.05)，1.86(1.26-2.50),和1.48（1.10-1.99），分别。对于TyG-WC指数，相应的危险比为1.42(1.11-1.75)，1.48(1.04-1.96),和1.38（1.05-1.72），分别。三个与TyG相关的指数与所有原因之间的关联，心血管和非心血管死亡率呈J形.相互作用测试表明，随着年龄的变化，低密度脂蛋白胆固醇（LDL-C）水平，和他汀类药物的使用（所有P值<0.05）。
结论：在普通人群中，TyG相关指数是全因死亡率和特定原因死亡率的独立预测因子。年轻人应该特别警惕，而低LDL-C水平和他汀类药物的使用具有潜在的保护作用.
方法：从1999年至2018年的国家健康和营养检查调查（NHANES）中纳入了27,642名个体。构建了三个指标，包括TyG指数，TyG结合腰围与身高比（TyG-WHtR），和TyG结合腰围（TyG-WC）。死亡率数据是通过将NHANES数据与国家死亡指数记录联系起来获得的。使用加权Cox比例风险模型来估计TyG相关指数与死亡率之间的独立关联。使用受限三次样条探索了非线性关联。
结果：多变量调整模型显示，在TyG相关指数的四分位数中，全因死亡率和特定原因死亡率逐渐增加。与TyG指数的最低四分位数相比，最高四分位数调整后的全因死亡率风险比为1.26（95％CI1.04-1.52），1.38（1.04-1.74）心血管死亡率，和1.23（1.01-1.50）的非心血管死亡率，分别。对于TyG-WHtR索引，相应的危险比为1.60(1.25-2.05)，1.86(1.26-2.50),和1.48（1.10-1.99），分别。对于TyG-WC指数，相应的危险比为1.42(1.11-1.75)，1.48(1.04-1.96),和1.38（1.05-1.72），分别。三个与TyG相关的指数与所有原因之间的关联，心血管和非心血管死亡率呈J形.相互作用测试表明，随着年龄的变化，低密度脂蛋白胆固醇（LDL-C）水平，和他汀类药物的使用（所有P值<0.05）。
结论：在普通人群中，TyG相关指数是全因死亡率和特定原因死亡率的独立预测因子。年轻人应该特别警惕，而低LDL-C水平和他汀类药物的使用具有潜在的保护作用.
