Zhao Yi-Chang, Wu Shi-Qi, Li Jia-Kai, Sun Zhi-Hua, Zhang Bi-Kui, Fu Rao, Yan Miao
Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan Province, People's Republic of China.
International Research Center for Precision Medicine, Transformative Technology and Software Services, Changsha, Hunan Province, China.
Cardiovasc Diabetol. 2025 Aug 4;24(1):318. doi: 10.1186/s12933-025-02880-9.
The triglyceride-glucose (TyG) index is a validated surrogate for insulin resistance, while frailty reflects cumulative physiological decline. The combined impact of TyG-Frailty Index (TyGFI) has not been adequately explored. This study aimed to investigate the association between TyGFI and the risk of cardiovascular disease (CVD) and stroke.
A total of 5448 participants from the China Health and Retirement Longitudinal Study (CHARLS) and 1139 participants from the U.S. National Health and Nutrition Examination Survey (NHANES) were included. Multivariable logistic regression models were used to estimate associations with CVD and stroke, adjusting for demographic, clinical, and lifestyle covariates. Restricted cubic spline (RCS) and subgroup analyses were employed to examine dose-response relationships and interaction effects.
Higher TyGFI levels were associated with older age, adverse metabolic parameters, and increased prevalence of hypertension, diabetes, and dyslipidemia. In fully adjusted models, the highest TyGFI quartile was significantly associated with increased risks of CVD (CHARLS: OR 15.09, 95% CI 9.65-23.60; NHANES: OR 4.98, 95% CI 2.04-12.19) and stroke (CHARLS: OR 21.12, 95% CI 6.44-69.23; NHANES: OR 12.98, 95% CI 2.58-65.17), with consistent dose-response trends confirmed by RCS analyses. Subgroup analyses further demonstrated the robustness of these associations across diverse demographic and clinical strata.
TyGFI is a strong and independent predictor of CVD and stroke in two nationally representative cohorts. By integrating metabolic and functional risk dimensions, TyGFI provides a more comprehensive risk stratification tool, with significant implications for early identification and prevention of cardiovascular events in aging populations.
甘油三酯-葡萄糖（TyG）指数是胰岛素抵抗的有效替代指标，而衰弱反映了累积的生理衰退。TyG-衰弱指数（TyGFI）的综合影响尚未得到充分研究。本研究旨在探讨TyGFI与心血管疾病（CVD）和中风风险之间的关联。
纳入了来自中国健康与养老追踪调查（CHARLS）的5448名参与者和来自美国国家健康与营养检查调查（NHANES）的1139名参与者。使用多变量逻辑回归模型来估计与CVD和中风的关联，并对人口统计学、临床和生活方式协变量进行了调整。采用限制立方样条（RCS）和亚组分析来检验剂量反应关系和交互作用。
较高的TyGFI水平与年龄较大、不良代谢参数以及高血压、糖尿病和血脂异常患病率增加有关。在完全调整模型中，最高的TyGFI四分位数与CVD风险增加显著相关（CHARLS：比值比[OR]15.09，95%置信区间[CI]9.65-23.60；NHANES：OR 4.98，95%CI 2.04-12.19）和中风风险增加显著相关（CHARLS：OR 21.12，95%CI 6.44-69.23；NHANES：OR 12.98，95%CI 2.58-65.17），RCS分析证实了一致的剂量反应趋势。亚组分析进一步证明了这些关联在不同人口统计学和临床分层中的稳健性。
TyGFI是两个全国代表性队列中CVD和中风的强有力且独立的预测指标。通过整合代谢和功能风险维度，TyGFI提供了一种更全面的风险分层工具，对老年人群心血管事件的早期识别和预防具有重要意义。
