Li Mengyi, Wang Shiqi, Li Hanbin, Zhong Wen, Cheng Hongxin, Wei Quan, Wang Lu
Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, 610041, PR China.
Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, 610041, PR China.
BMC Cardiovasc Disord. 2025 Sep 26;25(1):675. doi: 10.1186/s12872-025-05115-7.
Metabolic syndrome (MetS) is a cluster of risk factors including increased triglycerides, insulin resistance, and hypertension, posing increasing public health challenges. Both cardiorespiratory fitness (CRF) and the Triglyceride-Glucose (TyG) index have been associated with MetS risk independently. However, their combined predictive value remains unclear. This study aims to assess the combined influence of CRF and TyG index on MetS risk in a survey sample.
Data from 3742 participants in the National Health and Nutrition Examination Survey (NHANES) in year cycle of 1999-2004 were analyzed. Logistic regression and restricted cubic spline (RCS) analyses were used to evaluate the associations of CRF and TyG index with MetS risk. Subgroup analyses by different CRF, TyG, and disease conditions were conducted to explore interaction effects across different populations. Sensitivity analysis was implemented to verify the robustness of the results. Predictive value was assessed using net reclassification improvement (NRI), integrated discrimination improvement (IDI), and area under the curve (AUC) of receiver operating characteristic (ROC) curve.
Logistic regression showed that impaired CRF was associated with a 73% higher risk of MetS (Odds Ratio (OR) 1.73; 95% Confidence Interval (CI), 1.23-2.42), while elevated TyG index was associated with a 6.84-fold increased risk (OR 6.84; 95% CI, 2.71-17.29). The combination of impaired CRF and high TyG index showed the highest risk of MetS (OR 11.99; 95% CI, 3.79-37.98). In sensitivity analysis, the results remained similar. Subgroup and interaction analyses further confirmed these findings, showing consistent results across demographic groups and under various analytical conditions. The combined use of CRF and TyG index significantly enhanced the predictive performance (AUC 0.871; 95% CI, 0.856-0.886) and improved model classification capabilities (NRI 0.393; 95% CI, 0.309-0.476; IDI 0.020; 95% CI, 0.014-0.025).
This study reveals that CRF and TyG index independently predict MetS risk, while their combination demonstrates superior predictive accuracy compared to using either parameter alone. These findings indicate that integrating both CRF and TyG into clinical practice may improve early detection and preventive strategies for MetS.
代谢综合征（MetS）是一组风险因素，包括甘油三酯升高、胰岛素抵抗和高血压，给公共卫生带来了日益严峻的挑战。心肺适能（CRF）和甘油三酯-葡萄糖（TyG）指数均与MetS风险独立相关。然而，它们的联合预测价值仍不明确。本研究旨在评估在一个调查样本中，CRF和TyG指数对MetS风险的综合影响。
分析了1999 - 2004年国家健康和营养检查调查（NHANES）年度周期中3742名参与者的数据。采用逻辑回归和受限立方样条（RCS）分析来评估CRF和TyG指数与MetS风险的关联。通过不同的CRF、TyG和疾病状况进行亚组分析，以探讨不同人群中的交互作用。进行敏感性分析以验证结果的稳健性。使用净重新分类改善（NRI）、综合判别改善（IDI）和受试者工作特征（ROC）曲线下面积（AUC）来评估预测价值。
逻辑回归显示，CRF受损与MetS风险高73%相关（比值比（OR）1.73；95%置信区间（CI），1.23 - 2.42），而TyG指数升高与风险增加6.84倍相关（OR 6.84；95% CI，2.71 - 17.29）。CRF受损和高TyG指数的组合显示出MetS的最高风险（OR 11.99；95% CI，3.79 - 37.98）。在敏感性分析中，结果保持相似。亚组和交互分析进一步证实了这些发现，在不同人口统计学群体和各种分析条件下结果一致。CRF和TyG指数的联合使用显著提高了预测性能（AUC 0.871；95% CI，0.856 - 0.886），并改善了模型分类能力（NRI 0.393；95% CI，0.309 - 0.476；IDI 0.020；95% CI，0.014 - 0.025）。
本研究表明，CRF和TyG指数独立预测MetS风险，而它们的组合相比单独使用任何一个参数具有更高的预测准确性。这些发现表明，将CRF和TyG两者纳入临床实践可能会改善MetS的早期检测和预防策略。
