Liu Chang, Liang Dan, Xiang Guoan, Zhao Xuanbo, Xiao Kun, Xie Lixin
School of Medicine, Nankai University, Tianjin, China.
College of Pulmonary and Critical Care Medicine, 8th Medical Center of Chinese PLA General Hospital, Beijing, China.
Sci Rep. 2025 Jan 22;15(1):2745. doi: 10.1038/s41598-025-86612-9.
Although the triglyceride-glucose (TyG) index has been established as a valuable predictor for cardiovascular disease (CVD) and cardiovascular mortality, there is limited research exploring its association with all-cause or CVD mortality specifically in adults with diabetes aged < 65 years without cardiovascular disease. This study aimed to investigate the relationship between the TyG index and both all-cause and CVD mortality in this population within the United States. Our study recruited 1778 adults with diabetes aged < 65 years without cardiovascular disease from the National Health and Nutrition Examination Survey (NHANES) 2003-2018. Mortality outcomes were determined by linking to National Death Index (NDI) records up to December 31, 2019. Cox regression modeling was employed to examine the association between the TyG index and mortality in this population. The nonlinear relationship between the TyG index and mortality was assessed using restricted cubic splines (RCS). Additionally, subgroup analyses and interaction tests were conducted to explore potential effect modifiers. A total of 1788 participants were included in the final cohort, with an average age of 49.61 ± 0.32 years. During a median follow-up of 7.92 years, the occurrence of 150 all-cause deaths and 33 CVD-related deaths were recorded. To investigate the independent association between the TyG index and the risks of all-cause and CVD mortality, three Cox regression models were developed. In Model 1, a significant positive association was observed between the TyG index and the risk of all-cause mortality (HR 1.38, 95% CI 1.09-1.74). This association persisted in the minimally adjusted model (HR 1.44, 95% CI 1.13-1.83), which was adjusted for age, gender and race. Even after full adjustment, this positive association remained significant (HR 1.91, 95% CI 1.36-2.70). We also found that the relationship between the TyG index and all-cause mortality was linear. Subgroup analyses revealed no significant interactions between the TyG index and the stratification variables. However, we did not observe a significant association between the TyG index and CVD mortality in this population. Our results suggested that a significantly positive association between the TyG index and all-cause mortality. The positive association between the TyG index and all-cause mortality was linear. We did not observe a significant association between the TyG index and CVD mortality.
尽管甘油三酯-葡萄糖（TyG）指数已被确立为心血管疾病（CVD）和心血管疾病死亡率的重要预测指标，但专门针对年龄＜65岁且无心血管疾病的糖尿病成年人中该指数与全因死亡率或CVD死亡率之间关联的研究却很有限。本研究旨在调查美国该人群中TyG指数与全因死亡率及CVD死亡率之间的关系。我们的研究从2003 - 2018年国家健康与营养检查调查（NHANES）中招募了1778名年龄＜65岁且无心血管疾病的糖尿病成年人。通过与截至2019年12月31日的国家死亡指数（NDI）记录相链接来确定死亡结局。采用Cox回归模型来检验该人群中TyG指数与死亡率之间的关联。使用受限立方样条（RCS）评估TyG指数与死亡率之间的非线性关系。此外，进行亚组分析和交互作用检验以探索潜在的效应修饰因素。最终队列共纳入1788名参与者，平均年龄为49.61±0.32岁。在中位随访7.92年期间，记录到150例全因死亡和33例CVD相关死亡。为了研究TyG指数与全因死亡率及CVD死亡率风险之间的独立关联，建立了三个Cox回归模型。在模型1中，观察到TyG指数与全因死亡率风险之间存在显著正相关（风险比[HR] 1.38，95%置信区间[CI] 1.09 - 1.74）。在对年龄、性别和种族进行调整的最小调整模型中，这种关联仍然存在（HR 1.44，95% CI 1.13 - 1.83）。即使在完全调整后，这种正相关仍然显著（HR 1.91，95% CI 1.36 - 2.70）。我们还发现TyG指数与全因死亡率之间的关系是线性的。亚组分析显示TyG指数与分层变量之间无显著交互作用。然而，我们在该人群中未观察到TyG指数与CVD死亡率之间存在显著关联。我们的结果表明TyG指数与全因死亡率之间存在显著正相关。TyG指数与全因死亡率之间的正相关是线性的。我们未观察到TyG指数与CVD死亡率之间存在显著关联。
