Zheng Xin, Zhang Wenjing, Yang Feng, Wang Leigang, Yu Bing, Liang Bin
Department of Cardiovascular Medicine, Second Hospital of Shanxi Medical University, Taiyuan, 030001, China.
Department of Cardiovascular Medicine, Yangquan First People's Hospital, Yangquan, 045000, China.
Cardiovasc Diabetol. 2025 Aug 21;24(1):344. doi: 10.1186/s12933-025-02902-6.
Metabolic Syndrome (MetS) significantly increases the risk of cardiovascular disease (CVD), with central obesity and insulin resistance as major contributors. The TyG-ABSI index is a newly proposed composite measure that combines the TyG index and ABSI, aiming to assess both insulin resistance and central obesity simultaneously. Previous studies have shown that TyG-ABSI has potential in predicting cardiovascular mortality, but its applicability in MetS populations remains unclear. This study aims to explore the association between TyG-ABSI and cardiovascular events in individuals with MetS and compare its predictive value with the traditional TyG index in this specific population.
Participants from the National Health and Nutrition Examination Survey (NHANES) between 2001 and 2018 were selected, with all data weighted for sample design, clustering, and stratification to ensure national representativeness. Associations between TyG-ABSI and other TyG indices with cardiovascular mortality and all-cause mortality were assessed using weighted Cox proportional hazards models; CVD prevalence was analyzed using weighted logistic regression models. Additional analyses included Kaplan-Meier survival curves and restricted cubic spline regression. Model performance was compared between TyG-ABSI, TyG, and its derived indices using ROC curves, NRI, IDI, and DCA. E-value, subgroup analyses, and competing risks models were conducted to assess robustness.
This study analyzed data from 12,813 individuals with metabolic syndrome in the NHANES cohort to systematically compare the performance of TyG-ABSI and other TyG-related indices in assessing CVD and mortality. The results revealed significant associations between TyG-ABSI and CVD, cardiovascular mortality, and all-cause mortality. Specifically, for each 1-unit increase in TyG-ABSI, the risk of CVD increased by 28%, cardiovascular mortality by 25%, and all-cause mortality by 28%. These associations showed a dose-response relationship in stratified analyses based on tertiles, and TyG-ABSI outperformed the traditional TyG index in overall analysis. Compared to other TyG-related indices, TyG-ABSI demonstrated superior predictive performance in metrics such as the ROC curve, NRI, and DCA. Further analyses, including competing risks models, E-value estimation, and RCS modeling, confirmed the robustness of these associations. Subgroup analyses also supported the stability of TyG-ABSI, with limited interaction effects.
Our study highlights the value of TyG-ABSI in assessing cardiovascular disease and mortality risk in populations with MetS, providing new evidence for medical practice and public health interventions.
代谢综合征（MetS）显著增加心血管疾病（CVD）风险，中心性肥胖和胰岛素抵抗是主要促成因素。TyG-ABSI指数是一种新提出的综合指标，它结合了TyG指数和ABSI，旨在同时评估胰岛素抵抗和中心性肥胖。先前的研究表明TyG-ABSI在预测心血管死亡率方面具有潜力，但其在MetS人群中的适用性仍不明确。本研究旨在探讨TyG-ABSI与MetS个体心血管事件之间的关联，并在这一特定人群中将其预测价值与传统TyG指数进行比较。
选取2001年至2018年美国国家健康与营养检查调查（NHANES）的参与者，所有数据针对样本设计、聚类和分层进行加权，以确保具有全国代表性。使用加权Cox比例风险模型评估TyG-ABSI和其他TyG指数与心血管死亡率和全因死亡率之间的关联；使用加权逻辑回归模型分析CVD患病率。额外的分析包括Kaplan-Meier生存曲线和受限立方样条回归。使用ROC曲线、NRI、IDI和DCA比较TyG-ABSI、TyG及其衍生指数之间的模型性能。进行E值、亚组分析和竞争风险模型以评估稳健性。
本研究分析了NHANES队列中12813名患有代谢综合征个体的数据，以系统比较TyG-ABSI和其他TyG相关指数在评估CVD和死亡率方面的性能。结果显示TyG-ABSI与CVD、心血管死亡率和全因死亡率之间存在显著关联。具体而言，TyG-ABSI每增加1个单位，CVD风险增加28%，心血管死亡率增加25%，全因死亡率增加28%。在基于三分位数的分层分析中，这些关联呈现剂量反应关系，并且在总体分析中TyG-ABSI优于传统TyG指数。与其他TyG相关指数相比，TyG-ABSI在ROC曲线、NRI和DCA等指标上表现出更好的预测性能。包括竞争风险模型、E值估计和RCS建模在内的进一步分析证实了这些关联的稳健性。亚组分析也支持TyG-ABSI的稳定性，交互作用有限。
我们的研究突出了TyG-ABSI在评估MetS人群心血管疾病和死亡风险方面的价值，为医学实践和公共卫生干预提供了新证据。
