Association of the triglyceride-glucose index with all-cause and cardiovascular mortality in patients with cardiometabolic syndrome: a national cohort study
Authors' conclusion
The TyG index demonstrated a U-shaped correlation with all-cause and cardiovascular mortality in individuals with CMS. The thresholds of 9.104 and 8.758 for all-cause and cardiovascular mortality, respectively, may be used as intervention targets to reduce the risk of premature death and cardiovascular disease.
Study context
- Population
- Individuals with cardiometabolic syndrome (CMS), 2001–2018 National Health and Nutrition Examination Survey
- Participants
- 5,754 individuals
- Exposure
- Triglyceride-glucose (TyG) index
- Outcome
- All-cause and CV mortality
- Follow-up
- Median 107 months
Methodological detailsnational cohort, NHANES 2001-2018, multivariate Cox proportional hazards regression, restricted cubic splines, two-piecewise Cox model
- National cohort
- NHANES 2001-2018
- Multivariate Cox proportional hazards regression
- Restricted cubic splines
- Two-piecewise Cox model
Main finding
As reported in the abstract
TyG index, per one-unit increaseHazard ratio (95% CI)P value
All-cause mortality; adjusted for confounders
1.16(1.03–1.31)
P = 0.017CV mortality; adjusted for confounders
1.39(1.14–1.71)
P = 0.001Per one-unit increase, as printed
- All-cause deaths
- 1201
- CVD-related deaths
- 398
Observational data: associations, not effects.
Further findings
TyG index below threshold
| HR (95% CI) | P value | ||
|---|---|---|---|
| TyG index below thresholdAll-cause mortality | 0.58 (0.38–0.90) | P = 0.015 | |
| TyG index below thresholdCV mortality | 0.39 (0.12–1.27) | P = 0.119 | |
| 0.10.31310Hazard ratio (log scale) |
TyG index above threshold
| HR (95% CI) | P value | ||
|---|---|---|---|
| TyG index exceeding thresholdAll-cause mortality | 1.35 (1.17–1.55) | P < 0.001 | |
| TyG index exceeding thresholdCV mortality | 1.54 (1.25–1.90) | P < 0.001 | |
| 0.512Hazard ratio (log scale) |
Non-linear association (restricted cubic splines)
Threshold
- U-shaped association, all-cause mortality (P for nonlinear < 0.001)
- 9.104
- U-shaped association, CV mortality (P for nonlinear = 0.044)
- 8.758
Higher (≥ threshold) vs lower TyG index, by age
- Significantly associated with increased mortality only among individuals aged under 55
Original publication
Association of the triglyceride-glucose index with all-cause and cardiovascular mortality in patients with cardiometabolic syndrome: a national cohort study. Cardiovasc Diabetol. Published 24 February 2024. doi:10.
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