Xiao Jing, Li Ying, Gao Xiyu, Yan Bao'e, Chen Fangyao, Zhang Chunyan, Wang Congxia, Han Tuo, Zhang Yan
Department of Cardiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, China.
Department of Cardiology, Affiliated Hospital of Yan'an University, Yan'an, 716000, China.
Sci Rep. 2025 May 9;15(1):16157. doi: 10.1038/s41598-025-00129-9.
The triglyceride-glucose (TyG) index is regarded as a surrogate marker of systemic insulin resistance (IR). Studies have substantiated the impact of IR on cardiovascular diseases. Nonetheless, the prognostic value of the TyG index in critical patients with heart failure (HF) with intensive care unit (ICU) admission remains unclear. This study aims to assess the association between the TyG index and all-cause mortality in critically ill patients with HF. Patients with HF requiring ICU admission were identified from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database and subsequently stratified into quartiles based on their TyG index. The primary outcome was 30-day all-cause mortality, and the secondary outcome was 1-year all-cause mortality. The relationship between the TyG index and all-cause mortality in HF patients was analyzed using multivariable Cox proportional hazards models and restricted cubic splines. A total of 1220 patients (62.4% men) were enrolled, with a mean age of 70.6 years. The 30-day and one-year all-cause mortality rate were 15.7% and 34.6%, respectively. Multivariable Cox regression revealed that TyG index was significantly associated with an elevated risk of 30-day all-cause mortality (adjusted HR, 1.360; 95% CI, 1.093-1.694; P = 0.006), but not with one-year mortality (adjusted HR 1.046; 95% CI 0.895-1.222, P = 0.574). Restricted cubic splines showed a progressively increasing risk of 30-day mortality was linearly related to an elevated TyG index. Subgroup analyses indicated a more prominent association between TyG index and 30-day mortality in patients with age ≤ 65, female or BMI > 30 kg/m. In critically ill patients with HF, the TyG index is significantly associated with short-term all-cause mortality. Our results highlight that the TyG index can be useful in identifying HF patients at high risk of all-cause mortality and require close follow-up after discharge.
甘油三酯-葡萄糖（TyG）指数被视为全身胰岛素抵抗（IR）的替代标志物。研究已证实IR对心血管疾病的影响。尽管如此，TyG指数在入住重症监护病房（ICU）的心力衰竭（HF）重症患者中的预后价值仍不明确。本研究旨在评估TyG指数与重症HF患者全因死亡率之间的关联。从重症监护医学信息集市IV（MIMIC-IV）数据库中确定需要入住ICU的HF患者，随后根据其TyG指数分为四分位数。主要结局是30天全因死亡率，次要结局是1年全因死亡率。使用多变量Cox比例风险模型和受限立方样条分析TyG指数与HF患者全因死亡率之间的关系。共纳入1220例患者（62.4%为男性），平均年龄70.6岁。30天和1年全因死亡率分别为15.7%和34.6%。多变量Cox回归显示，TyG指数与30天全因死亡率风险升高显著相关（调整后HR，1.360；95%CI，1.093-1.694；P = 0.006），但与1年死亡率无关（调整后HR 1.046；95%CI 0.895-1.222，P = 0.574）。受限立方样条显示，30天死亡率风险逐渐增加与TyG指数升高呈线性相关。亚组分析表明，在年龄≤65岁、女性或BMI>30 kg/m²的患者中，TyG指数与30天死亡率之间的关联更为显著。在重症HF患者中，TyG指数与短期全因死亡率显著相关。我们的结果强调，TyG指数可用于识别全因死亡率高风险的HF患者，出院后需要密切随访。
