Links between blood fat and sugar measures and death risk from all causes and heart disease in people with early to moderate heart, kidney, and metabolism problems
A significant positive association exists between the -waist circumference index and all-cause mortality, with a hazard ratio of 1.50.
The TyG-waist-to-height ratio index is associated with all-cause mortality, showing a hazard ratio of 1.45.
The TyG-waist-to-height ratio index has the strongest correlation with cardiovascular mortality, with a hazard ratio of 1.85.
An L-shaped relationship is identified between TyG-related indices and all-cause mortality in individuals with syndrome.
TyG-related indices correlate more strongly with all-cause mortality in individuals with CKM syndrome stages 1 and 3.
Simplified
BACKGROUND: Cardiovascular-Kidney-Metabolic () syndrome typically commences with the interaction of insulin resistance (IR), excessive or dysfunctional obesity, and the consequent systemic inflammatory response and oxidative stress. The relationship between the triglyceride-glucose () index and TyG-related indices that may simply assess IR and obesity, as well as the mortality risk in the CKM syndrome population, remains ambiguous.
METHODS: This study included 6,383 participants from the National Health and Nutrition Examination Survey (NHANES) 2009-2018. The TyG index, TyG-waist-to-height ratio (TyG-WHtR), TyG-waist circumference (TyG-WC), and TyG-body mass index (TyG-BMI) were developed. Cox proportional hazards models, smooth curve fitting, and two-stage Cox proportional hazards models were employed to examine the association of TyG and TyG-related indices with all-cause and cardiovascular mortality in the CKM syndrome population. Subgroup analyses and interaction tests were conducted to evaluate the risk within various demographics.
RESULTS: In survey-weighted multifactorial regression analyses, a significant positive association existed between TyG, TyG-related indices, and both all-cause mortality and cardiovascular mortality, except for the TyG index, which did not demonstrate a significant link with all-cause mortality. Of these indices, the TyG-WC index exhibited the strongest correlation with all-cause mortality, with a hazard ratio (HR) of 1.50 and a 95% confidence interval (CI) of 1.18-1.92, followed by the TyG-WHtR index (HR: 1.45, 95%CI 1.13-1.85). The TyG-WHtR index demonstrated the strongest correlation with cardiovascular mortality (HR: 1.85, 95% CI 1.19-2.86), followed by the TyG-WC index(HR: 1.83, 95%CI 1.21-2.78). An L-shaped association was identified between TyG-WHtR, TyG-BMI, and all-cause mortality in CKM syndrome during the examination of nonlinear relationships (both P for log-likelihood ratio < 0.05). The TyG-WHtR, TyG-WC, and TyG-BMI indices exhibited a more pronounced correlation with all-cause mortality in those with CKM syndrome stages 1 and 3 (P value < 0.05, P for interaction < 0.05).
CONCLUSION: Our study emphasizes the association between TyG and TyG-related indices and mortality in individuals with CKM syndrome stages 0-3. Individuals with CKM syndrome stages 1 and 3 should be more vigilant to abnormal alterations in TyG-related indices.
Key numbers
1.50
Increase in All-Cause Mortality Risk
Hazard Ratio for -WC index per standard deviation increase.
1.85
Increase in Cardiovascular Mortality Risk
Hazard Ratio for -WHtR index per standard deviation increase.
2.78
Risk Elevation for -WC T3
Hazard Ratio for all-cause mortality in -WC T3 vs. T1.
Full Text
We can’t show the full text here under this license.
