Guo Shao-Han, Xu Jian, Gong Ya-Qin, Hu Wen-Bin, Li Chong, Lu Ke
Department of Orthopedics, Affiliated Kunshan Hospital of Jiangsu University, Suzhou, Jiangsu, China.
Kunshan Biomedical Big Data Innovation Application Laboratory, Suzhou, Jiangsu, China.
Front Endocrinol (Lausanne). 2025 Apr 30;16:1574238. doi: 10.3389/fendo.2025.1574238. eCollection 2025.
Osteoporotic fractures (OPFs) pose a considerable global health burden and are linked with an elevated mortality risk. The triglyceride-glucose index (TyG-I) is a recognized marker of insulin resistance across various populations. The association between all-cause mortality (ACM) and the TyG-I has been widely investigated in a variety of clinical settings. The potential sex-specific differences in this association among OPF patients remain uncertain.
In this retrospective cohort study, 2,307 patients ≥ 50 years old admitted to the hospital between January 2018 and August 2023 for surgical treatment of OPFs were included. The TyG-I was determined using fasting triglyceride and glucose levels measured at admission. The association between ACM and the TyG-I was evaluated by Cox proportional hazards regression, adjusting for possible confounding variables. Analyses were categorized by sex, and subgroup analyses evaluated possible interaction effects. The ACM rates among TyG-I tertiles were compared Kaplan-Meier curves.
This research study analyzed 2,307 patients, of whom 247 (10.71%) died from any cause during the follow-up period. In females, a linear association of the TyG-I with ACM was observed even after adjusting for confounders, with each unit increase in the TyG-I correlating with a 37% increased risk of death (HR: 1.37, 95% CI: 1.06-1.77, = 0.02). However, in males, there was a non-linear correlation, where patients in the uppermost TyG-I tertile showed a substantially decreased mortality risk relative to those in the lowest tertile (HR: 0.53, 95% CI: 0.30-0.92, 0.02). TyG-I indicated a statistically significant relation with sex ( for interaction = 0.01).
In patients diagnosed with OPFs, distinct sex-specific variations were observed in the relationship between ACM and the TyG-I. Among female patients, each unit increase in the TyG-I was linked to a 37% greater risk of mortality. Conversely, male patients within the highest TyG-I tertile indicated a lower mortality risk than those in the lowest tertile. Further research is required to confirm these sex-specific associations.
骨质疏松性骨折（OPF）给全球带来了相当大的健康负担，且与死亡风险升高有关。甘油三酯-葡萄糖指数（TyG-I）是各类人群中公认的胰岛素抵抗标志物。全因死亡率（ACM）与TyG-I之间的关联已在多种临床环境中得到广泛研究。OPF患者中这种关联潜在的性别差异仍不明确。
在这项回顾性队列研究中，纳入了2018年1月至2023年8月期间因OPF手术治疗而入院的2307例年龄≥50岁的患者。TyG-I通过入院时测量的空腹甘油三酯和血糖水平来确定。通过Cox比例风险回归评估ACM与TyG-I之间的关联，并对可能的混杂变量进行调整。分析按性别分类，亚组分析评估可能的交互作用。通过Kaplan-Meier曲线比较TyG-I三分位数组之间的ACM发生率。
本研究分析了2307例患者，其中247例（10.71%）在随访期间因任何原因死亡。在女性中，即使在调整混杂因素后，也观察到TyG-I与ACM呈线性关联，TyG-I每增加一个单位，死亡风险增加37%（HR：1.37，95%CI：1.06 - 1.77，P = 0.02）。然而，在男性中，存在非线性相关性，TyG-I最高三分位数组的患者相对于最低三分位数组的患者，死亡风险大幅降低（HR：0.53，95%CI：0.30 - 0.92，P = 0.02）。TyG-I与性别存在统计学显著关系（交互作用P = 0.01）。
在诊断为OPF的患者中，观察到ACM与TyG-I之间的关系存在明显的性别差异。在女性患者中，TyG-I每增加一个单位，死亡风险增加37%。相反，TyG-I最高三分位数组的男性患者死亡风险低于最低三分位数组的男性患者。需要进一步研究来证实这些性别特异性关联。
