Qiu Jiajun, Li Jin'e, Xu Shan, Fang Lixuan, Zou Yang, Zhou Hongtao, Feng Jiaying, Zan Yujie, Lu Yu, Zhou Ying, Liu Jianping
Department of Endocrinology and Metabolism of the Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, No. 1, Minde Road, Nanchang, 330006, Jiangxi, China.
Institute for the Study of Endocrinology and Metabolism in Jiangxi Province, Nanchang City, 330006, Jiangxi Province, China.
Cardiovasc Diabetol. 2026 Jan 18;25(1):40. doi: 10.1186/s12933-025-03069-w.
Atherosclerotic cardiovascular disease (ASCVD) is a leading global cause of mortality, and reliable risk assessment tools are critical for prevention. While TyG-related parameters are used for ASCVD risk stratification, the association between the novel TyG-ABSI and ASCVD in the general population requires further characterization, and its potential improvement in discrimination over traditional TyG parameters has not been fully elucidated.
We analyzed data from the National Health and Nutrition Examination Survey (NHANES, 1999–2018), a nationally representative cross-sectional study including 22,466 participants. ASCVD was defined by self-reported physician diagnosis of coronary heart disease (CHD), angina pectoris (AP), myocardial infarction (MI), or stroke. TyG-ABSI and traditional TyG parameters were calculated using standardized laboratory and anthropometric data. Statistical analyses included weighted logistic regression (to assess associations), restricted cubic spline analysis (to explore dose–response relationships), subgroup analyses (to test effect modification), receiver operating characteristic (ROC) curves (to evaluate discrimination ability), and net reclassification improvement (NRI) and integrated discrimination improvement (IDI) (to quantify improvement in reclassification and risk separation). Sensitivity analyses were conducted to verify robustness.
In fully adjusted models, TyG-ABSI was significantly associated with ASCVD (odds ratio [OR] per standard deviation [SD] increase: 1.15, 95% confidence interval [CI]: 1.09–1.22) and its subtypes (CHD: OR = 1.14, 95%CI: 1.05–1.24; AP: OR = 1.10, 95%CI: 1.01–1.21; MI: OR = 1.15, 95%CI: 1.06–1.25), with a significant linear dose–response relationship observed for ASCVD and all subtypes (all p-trend < 0.05). TyG-ABSI yielded the highest ROC area under the curve (AUC) across all outcomes (ASCVD: 0.69; CHD: 0.70; AP: 0.69; MI: 0.70; stroke: 0.65). Furthermore, TyG-ABSI demonstrated modest but significant improvement in discrimination over traditional TyG parameters for both ASCVD and its subtypes, as evidenced by significant NRI and IDI metrics. Specifically for ASCVD, it correctly reclassified an additional 7.88% (vs TyG-WHtR) to 16.36% (vs TyG-BMI) of patients based on NRI. The association between TyG-ABSI and ASCVD was robust across demographic, lifestyle, and clinical subgroups, as well as in sensitivity analyses.
This study indicates a significant positive correlation between TyG-ABSI and ASCVD in the general population. Moreover, TyG-ABSI demonstrates modest improvement in discrimination compared to traditional TyG parameters, identifying additional high-risk individuals via reclassification. These findings suggest that TyG-ABSI holds promise as a candidate marker for optimizing ASCVD risk stratification in clinical practice, though future prospective validation is warranted.
The online version contains supplementary material available at 10.1186/s12933-025-03069-w.
动脉粥样硬化性心血管疾病（ASCVD）是全球主要的死亡原因，可靠的风险评估工具对预防至关重要。虽然与甘油三酯-葡萄糖（TyG）相关的参数用于ASCVD风险分层，但新型TyG-体脂率指数（TyG-ABSI）与一般人群中ASCVD之间的关联需要进一步明确，其在区分能力上相对于传统TyG参数的潜在改善尚未完全阐明。
我们分析了美国国家健康与营养检查调查（NHANES，1999 - 2018年）的数据，这是一项具有全国代表性的横断面研究，包括22466名参与者。ASCVD由自我报告的医生诊断的冠心病（CHD）、心绞痛（AP）、心肌梗死（MI）或中风定义。使用标准化的实验室和人体测量数据计算TyG-ABSI和传统TyG参数。统计分析包括加权逻辑回归（以评估关联）、受限立方样条分析（以探索剂量反应关系）、亚组分析（以检验效应修饰）、受试者工作特征（ROC）曲线（以评估区分能力）以及净重新分类改善（NRI）和综合区分改善（IDI）（以量化重新分类和风险分离的改善情况）。进行敏感性分析以验证稳健性。
在完全调整的模型中，TyG-ABSI与ASCVD（每增加一个标准差[SD]的优势比[OR]：1.15，95%置信区间[CI]：1.09 - 1.22）及其亚型（CHD：OR = 1.14，95%CI：1.05 - 1.24；AP：OR = 1.10，95%CI：1.01 - 1.21；MI：OR = 1.15，95%CI：1.06 - 1.25）显著相关，观察到ASCVD及其所有亚型存在显著的线性剂量反应关系（所有p趋势<0.05）。TyG-ABSI在所有结局中产生了最高的曲线下ROC面积（AUC）（ASCVD：0.69；CHD：0.70；AP：0.69；MI：0.70；中风：0.65）。此外，TyG-ABSI在区分ASCVD及其亚型方面相对于传统TyG参数有适度但显著的改善，显著的NRI和IDI指标证明了这一点。具体对于ASCVD，基于NRI，它将另外7.88%（相对于TyG-腰围身高比[TyG-WHtR]）至16.36%（相对于TyG-体重指数[TyG-BMI]）的患者正确重新分类。TyG-ABSI与ASCVD之间的关联在人口统计学、生活方式和临床亚组以及敏感性分析中均具有稳健性。
本研究表明一般人群中TyG-ABSI与ASCVD之间存在显著正相关。此外，与传统TyG参数相比，TyG-ABSI在区分能力上有适度改善，通过重新分类识别出更多高危个体。这些发现表明TyG-ABSI有望作为临床实践中优化ASCVD风险分层的候选标志物，不过未来需要进行前瞻性验证。
在线版本包含可在10.1186/s12933-025-03069-w获取的补充材料。
