Hu Xiao, Xu Jing, Gu Yang
Department of Cardiology, The Affiliated Huaian No.1 People's Hospital of Nanjing Medical University, 6 Beijing Road West, Huaian, Jiangsu, 223300, China.
Department of Respiratory and Critical Care Medicine, The Affiliated Huaian No.1 People's Hospital of Nanjing Medical University, Huaian, Jiangsu, China.
Diabetol Metab Syndr. 2025 Jul 2;17(1):209. doi: 10.1186/s13098-025-01791-9.
The predictive value of the triglyceride-glucose (TyG) index in patients with obstructive sleep apnea (OSA) remains unclear. Therefore, we aimed to investigate the associations between the TyG index and all-cause and non-cardiovascular (non-CV) mortality in an OSA cohort, focusing on age differences.
This study enrolled 10,274 patients with OSA from the National Health and Nutrition Examination Survey (2005-2008 and 2015-2018). Mortality outcomes were ascertained by linking to National Death Index records through December 31, 2019. Multivariate Cox proportional hazards regression models with restricted cubic splines and interaction tests with age were employed to evaluate the association between the TyG index and all-cause and non-CV mortality. Kaplan-Meier analysis was used to evaluate mortality differences.
During a mean follow-up of 88 months, 1027 all-cause deaths occurred, of which non-CV deaths accounted for 77.8% of the total mortality burden. After fully adjusting for potential confounders, our study explored a U-shaped association between the TyG index and all-cause/non-CV mortality (both non-linear p < 0.001), with inflection points at 9.27 and 9.2. Age yielded a statistically significant interaction between the TyG index and mortality. The TyG index was linearly associated with higher risks of all-cause [Hazard Ratio (HR) 1.30, 95% Confidence Interval (CI): 1.09-1.55, p = 0.004] and non-CV mortality (HR 1.33, 95% CI: 1.08-1.62, p = 0.006) in participants aged < 65, but not in participants age ≥ 65. Kaplan-Meier curves indicated that the patients with the higher TyG index had a significantly lower survival probability (All-cause mortality: p for log-rank test < 0.001; non-CV mortality: p for log-rank test = 0.001).
This study identified a U-shaped association between the TyG index and all-cause and non-CV mortality in an OSA population, with a statistically significant interaction with age. A linear relationship was detected between the TyG index and mortality in those aged < 65, while a non-linear association was established in those aged ≥ 65.
甘油三酯-葡萄糖（TyG）指数在阻塞性睡眠呼吸暂停（OSA）患者中的预测价值尚不清楚。因此，我们旨在研究OSA队列中TyG指数与全因死亡率和非心血管（非CV）死亡率之间的关联，并重点关注年龄差异。
本研究纳入了来自国家健康与营养检查调查（2005 - 2008年和2015 - 2018年）的10274例OSA患者。通过与截至2019年12月31日的国家死亡指数记录进行关联来确定死亡结局。采用带有受限立方样条的多变量Cox比例风险回归模型以及与年龄的交互作用检验来评估TyG指数与全因死亡率和非CV死亡率之间的关联。采用Kaplan - Meier分析来评估死亡率差异。
在平均88个月的随访期间，发生了1027例全因死亡，其中非CV死亡占总死亡负担的77.8%。在对潜在混杂因素进行充分调整后，我们的研究发现TyG指数与全因/非CV死亡率之间呈U型关联（两者均为非线性，p < 0.001），拐点分别为9.27和9.2。年龄在TyG指数与死亡率之间产生了具有统计学意义的交互作用。在年龄<65岁的参与者中，TyG指数与全因死亡率[风险比（HR）1.30，95%置信区间（CI）：1.09 - 1.55，p = 0.004]和非CV死亡率（HR 1.33，95% CI：1.08 - 1.62，p = 0.006）呈线性相关，但在年龄≥65岁的参与者中并非如此。Kaplan - Meier曲线表明，TyG指数较高的患者生存概率显著较低（全因死亡率：对数秩检验p < 0.001；非CV死亡率：对数秩检验p = 0.001）。
本研究发现OSA人群中TyG指数与全因死亡率和非CV死亡率之间呈U型关联，且与年龄存在具有统计学意义的交互作用。在年龄<65岁的人群中，TyG指数与死亡率呈线性关系，而在年龄≥65岁的人群中则呈非线性关联。
