The novel triglyceride‒glucose-weighted adjusted waist index as a supplementary diagnostic tool for heart failure: evidence of improved reclassification beyond traditional TyG-related indices from a cross-sectional study
Authors' conclusion
In the general population, the TyG-WWI is strongly, independently, and dose-dependently associated with heart failure (HF) risk. Notably, its diagnostic performance for HFs surpasses that of traditional TyG-related indices, and it has incremental value as a supplementary parameter to existing TyG-derived metrics. These findings support the use of the TyG-WWI as a promising tool for HF risk stratification with practical clinical utility. However, further validation in large-scale prospective cohorts is warranted to confirm its long-term predictive value and generalizability across diverse populations.
Study context
- Population
- General population, National Health and Nutrition Examination Survey (NHANES) 1999–2018; mean age 49.5 years, 48.34% males704 with heart failure (HF)
- Participants
- 22,575 participants
- Exposure
- TyG-WWI vs TyG, TyG-WC, TyG-WHtR and traditional HF factors for HF
- Outcome
- Association of TyG-WWI with HF
Methodological detailsNHANES 1999–2018, multivariable logistic regression, restricted cubic splines, ROC analysis with DeLong's test, net reclassification improvement (NRI), multiple imputation sensitivity analyses
- NHANES 1999–2018
- Multivariable logistic regression
- Restricted cubic splines
- ROC analysis with DeLong's test
- NRI
- Multiple imputation sensitivity analyses
Main finding
As reported in the abstract
OR per SD increase in TyG-WWI, fully adjusted
1.52
95% CI 1.27–1.81
Observational data: associations, not effects.
Further findings
Discrimination for HF diagnosis (AUC)
- TyG-WWI AUC
- 0.697 (95% CI 0.678-0.715)
- TyG AUC
- 0.616
- TyG-WC AUC
- 0.665
- TyG-WHtR AUC
- 0.673
- BMI AUC
- 0.592
- Waist circumference AUC
- 0.654
- Fasting blood glucose AUC
- 0.524
- DeLong P, all, after Bonferroni correction
- DeLong-P < 0.001
- TyG-WWI superior discriminative performance
NRI of TyG-WWI
- vs TyG
- 11.41%
- vs TyG-WC
- 4.20%
- vs TyG-WHtR
- 2.99%
Subgroups
- Association more pronounced in men, patients not using β-blockers, and nondiabetic individuals
Sensitivity analyses
- Sensitivity analyses reinforced the robustness of the findings
Original publication
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