Xu Heping, Xie Jinyuan, Niu Huan, Cai Xiongwei, He Ping
Department of Emergency Medicine, Hainan General Hospital/Hainan Affiliated Hospital of Hainan Medical University, No. 19, Xiuhua Road, Xiuying District, Haikou City, Hainan Province, 570311, China.
BMC Cardiovasc Disord. 2025 May 9;25(1):359. doi: 10.1186/s12872-025-04804-7.
The triglyceride‒glucose body mass index (TyG-BMI) has been recognized as a significant predictor of cardiovascular disease risk and plays a crucial role in assessing insulin resistance. However, the correlation between the TyG-BMI and clinical outcomes in patients with sepsis and acute heart failure (AHF) has not been sufficiently explored. This study aimed to investigate the associations between TyG-BMI and clinical outcomes in patients with sepsis and AHF.
We conducted a retrospective analysis of ICU-admitted patients via data from the MIMIC-IV database. Multivariable logistic regression, sensitivity analysis, and restricted cubic spline (RCS) models were used to assess the relationship between TyG-BMI and all-cause mortality. K‒M survival analysis and Boruta analysis were employed to evaluate the predictive value of the TyG-BMI. Subgroup analyses considered the effects of age, sex, ethnicity, and comorbidities.
Among the 1,729 patients, a higher TyG-BMI was associated with lower all-cause mortality at 90 and 180 days. Each standard deviation increase in the TyG-BMI was linked to 0.2% and 0.3% reductions in 90-day and 180-day all-cause mortality, respectively. Kaplan‒Meier analysis revealed significantly lower all-cause mortality in patients with higher TyG-BMIs (P < 0.0001). The RCS model revealed a nonlinear relationship between the TyG-BMI and mortality. Boruta analysis identified the TyG-BMI as an important clinical feature. Sensitivity analyses revealed that the association remained significant after patients with myocardial infarction, malignancies, or missing data were excluded. The subgroup analysis revealed that for the 90-day and 180-day mortality rates, significant interactions were found only in the subgroup of patients with kidney diseases (P < 0.05).
The TyG-BMI may have potential value in predicting mortality in ICU patients with sepsis and AHF, supporting early risk assessment and clinical intervention. This study provides critical insights into patient prognosis.
甘油三酯-葡萄糖体质指数（TyG-BMI）已被公认为心血管疾病风险的重要预测指标，在评估胰岛素抵抗方面起着关键作用。然而，TyG-BMI与脓毒症和急性心力衰竭（AHF）患者临床结局之间的相关性尚未得到充分研究。本研究旨在探讨TyG-BMI与脓毒症和AHF患者临床结局之间的关联。
我们通过MIMIC-IV数据库的数据对入住重症监护病房（ICU）的患者进行了回顾性分析。采用多变量逻辑回归、敏感性分析和限制性立方样条（RCS）模型来评估TyG-BMI与全因死亡率之间的关系。采用K-M生存分析和Boruta分析来评估TyG-BMI的预测价值。亚组分析考虑了年龄、性别、种族和合并症的影响。
在1729例患者中，较高的TyG-BMI与90天和180天较低的全因死亡率相关。TyG-BMI每增加一个标准差，90天和180天全因死亡率分别降低0.2%和0.3%。Kaplan-Meier分析显示，TyG-BMI较高的患者全因死亡率显著较低（P<0.0001）。RCS模型显示TyG-BMI与死亡率之间存在非线性关系。Boruta分析将TyG-BMI确定为一项重要的临床特征。敏感性分析显示，排除心肌梗死、恶性肿瘤或数据缺失的患者后，该关联仍然显著。亚组分析显示，对于90天和180天死亡率，仅在肾病患者亚组中发现显著的交互作用（P<0.05）。
TyG-BMI在预测脓毒症和AHF的ICU患者死亡率方面可能具有潜在价值，有助于早期风险评估和临床干预。本研究为患者预后提供了重要见解。
