Huang Yong, Wei Ziling, Wang Linfeng, Zhang Gaojie, Yang Guo, Yu Jiang, Wu Qingyu, Liu Jiayu
Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
School of Psychiatry, The First Clinical College of Chongqing Medical University, Chongqing, China.
J Am Nutr Assoc. 2025 Sep-Oct;44(7):599-608. doi: 10.1080/27697061.2025.2475876. Epub 2025 Mar 20.
This study sought to clarify the relationship between triglyceride-glucose (TyG)-related obesity indices and all-cause and cardiovascular mortality in patients with hyperuricemia (HUA).
A total of 4207 patients with HUA from the National Health and Nutrition Examination Survey (NHANES) database were included in this study. Various methods were employed, including weighted multivariate-adjusted Cox regression models, Kaplan-Meier curves, restricted cubic spline, and receiver operating curves.
A nonlinear relationship was identified between TyG-related obesity indices and all-cause mortality, while a linear positive relationship was observed for cardiovascular mortality. Among the indices, TyG-ABSI (a body shape index) demonstrated the strongest predictive ability, with areas under the curve for all-cause mortality at 3, 5, and 10 years being 0.638, 0.632, and 0.650, respectively, and for cardiovascular mortality at 3, 5, and 10 years being 0.699, 0.673, and 0.671, respectively. Threshold analysis revealed the potential inflection point (k) of the nonlinear relationship. Subgroup analyses indicated interactions with age, diabetes, or cardiovascular disease. Additionally, serum uric acid was found to partially mediate the association between TyG-derived indices and follow-up time. The results of the sensitivity analysis were consistent with those of the original analysis.
TyG-ABSI, which exhibited the best predictive ability, may serve as a valuable biomarker for the long-term follow-up of individuals with HUA.
本研究旨在阐明高尿酸血症(HUA)患者中甘油三酯-葡萄糖(TyG)相关肥胖指数与全因死亡率和心血管死亡率之间的关系。
本研究纳入了国家健康与营养检查调查(NHANES)数据库中的4207例HUA患者。采用了多种方法,包括加权多变量调整Cox回归模型、Kaplan-Meier曲线、限制性立方样条和受试者工作曲线。
TyG相关肥胖指数与全因死亡率之间存在非线性关系,而与心血管死亡率呈线性正相关。在这些指数中,TyG-ABSI(一种体型指数)表现出最强的预测能力,全因死亡率在3年、5年和10年时的曲线下面积分别为0.638、0.632和0.650,心血管死亡率在3年、5年和10年时的曲线下面积分别为0.699、0.673和0.671。阈值分析揭示了非线性关系的潜在拐点(k)。亚组分析表明与年龄、糖尿病或心血管疾病存在相互作用。此外,发现血清尿酸部分介导了TyG衍生指数与随访时间之间的关联。敏感性分析结果与原分析结果一致。
TyG-ABSI具有最佳的预测能力,可能是HUA患者长期随访的有价值生物标志物。