Department of Cardiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, China.
Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China.
Cardiovasc Diabetol. 2024 Jan 28;23(1):43. doi: 10.1186/s12933-024-02120-6.
The prognostic value of triglyceride-glucose (TyG) index in general type 2 diabetes mellitus (T2DM) patients is still unclear. Therefore, we aimed to determine the associations between TyG and all-cause/cause-specific death in a T2DM cohort and explore whether such associations would be modified by age.
A total of 3,376 patients with T2DM from the National Health and Nutrition Examination Survey (NHANES) 1999-2018 were selected and divided into the younger group (< 65 yrs) and the older group (≥ 65 yrs). Baseline TyG was calculated and cause-specific mortality status [cardiovascular (CV), cancer, and non-CV] was determined by the NHANES Public-Use Linked Mortality Files through 31 December 2019. Multivariate Cox and restricted cubic spline (RCS) regression models were used to evaluate the association between TyG and all-cause/cause-specific mortality. Interaction between TyG and age to mortality was also evaluated. Sensitivity analyses were performed in patients without cardiovascular disease, chronic kidney disease, or insulin treatment.
During a median follow-up of 107 months, 805 all-cause deaths occurred, of which 250 and 144 were attributed to CV and cancer deaths. There was a significant age interaction to the association between TyG and all-cause/non-CV mortality. After fully adjusting for potential confounding factors, higher TyG was associated with an increased risk of all-cause [TyG per unit increase Hazard Ratio (HR) 1.33, 95% Confidence Interval (CI) 1.06-1.66, p = 0.014] and non-CV mortality (TyG per unit increase HR 1.54, 95% CI 1.18-2.01, p = 0.002) only in the younger group, but not in the older group. There was no significant association between TyG and CV/cancer death in the total cohort and two age subgroups. Similar results were found in RCS and sensitivity analyses.
In a national sample of patients with T2DM in the United States, we found that the association between TyG and all-cause/non-CV death was modified by age. Higher TyG was only associated with an increased risk of all-cause/non-CV only in T2DM patients younger than 65 years old, but not in older patients.
甘油三酯-葡萄糖（TyG）指数在普通 2 型糖尿病（T2DM）患者中的预后价值尚不清楚。因此，我们旨在确定 T2DM 患者中 TyG 与全因/病因特异性死亡之间的关系，并探讨这种关联是否会因年龄而改变。
本研究从 1999 年至 2018 年的国家健康和营养检查调查（NHANES）中选择了 3376 名 T2DM 患者，并分为年轻组（<65 岁）和老年组（≥65 岁）。计算基线 TyG，通过 NHANES 公共使用链接死亡率文件确定病因特异性死亡率状况[心血管（CV）、癌症和非 CV]，截至 2019 年 12 月 31 日。使用多变量 Cox 和限制性立方样条（RCS）回归模型评估 TyG 与全因/病因特异性死亡率之间的关系。还评估了 TyG 与死亡率之间的年龄交互作用。在没有心血管疾病、慢性肾脏病或胰岛素治疗的患者中进行了敏感性分析。
在中位随访 107 个月期间，发生了 805 例全因死亡，其中 250 例和 144 例归因于 CV 和癌症死亡。TyG 与全因/非 CV 死亡率之间存在显著的年龄交互作用。在充分调整潜在混杂因素后，TyG 升高与全因[TyG 每单位增加的危险比（HR）1.33，95%置信区间（CI）1.06-1.66，p=0.014]和非 CV 死亡率（TyG 每单位增加的 HR 1.54，95%CI 1.18-2.01，p=0.002）增加相关仅在年轻组，而在老年组则没有。在总队列和两个年龄亚组中，TyG 与 CV/癌症死亡之间均无显著关联。RCS 和敏感性分析也得到了类似的结果。
在美国 T2DM 患者的全国样本中，我们发现 TyG 与全因/非 CV 死亡之间的关联受年龄影响。在年龄<65 岁的 T2DM 患者中，TyG 升高仅与全因/非 CV 死亡风险增加相关，而在年龄较大的患者中则没有。
