Lipids & metabolic liver disease
Association between triglyceride-glucose index and related indicators with heart failure–related mortality in individuals with early-stage cardiovascular-kidney-metabolic syndrome
Authors' conclusion
In individuals with early-stage CKM syndrome, TyG-related indices-particularly those incorporating central adiposity-are independently associated with HF-related mortality. These findings highlight the prognostic relevance of insulin resistance-related metabolic burden in the early stages of CKM syndrome.
Study context
- Population
- National Health and Nutrition Examination Survey (NHANES) 2005–2018 participants with cardiovascular-kidney-metabolic (CKM) stages 0–2 and without clinical CVD at baseline
- Participants
- 14,830 participants
- Exposure
- Higher vs lower triglyceride-glucose (TyG)-related indices
- Outcome
- HF-related mortality, via linkage to the National Death Index
Methodological detailsNHANES 2005-2018, Cox proportional hazards and Fine-Gray competing risk models, machine learning covariate selection (Boruta and SHAP)
- NHANES 2005-2018
- Cox proportional hazards and Fine-Gray competing risk models
- Machine learning covariate selection (Boruta and SHAP)
Main finding
As reported in the abstract
Each 1-SD increase in TyG-WC: higher risk of heart failure (HF)-related mortality (all P < 0.05)
2.27-fold
Each 1-SD increase in TyG-WHtR: higher risk of HF-related mortality (all P < 0.05)
2.94-fold
Observational data: associations, not effects.
Further findings
Discriminatory ability of TyG-WHtR (strongest)
- AUC
- 0.641 (95% CI 0.601-0.680)
Mediation by HbA1c
- Proportion of associations mediated by HbA1c (approximately)
- 15%-30%
Subgroup, competing risk and sensitivity analyses
- Associations generally consistent across clinically relevant subgroups and robust in competing risk and sensitivity analyses
Original publication
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