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Pu Y, Feng Y, Zhao W. The association between triglyceride -glucose index and stress urinary incontinence in adult American women: A population-based study. Neurourol Urodyn 2024. [PMID: 39032097 DOI: 10.1002/nau.25552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2024] [Revised: 07/02/2024] [Accepted: 07/06/2024] [Indexed: 07/22/2024]
Abstract
PURPOSE This investigation seeks to determine the triglyceride glucose (TyG) index's link to stress urinary incontinence (SUI) in American females of adult age. METHODS The investigation relied on data acquired via the National Health and Nutrition Examination Survey (NHANES) conducted over the period from 2011 to 2018. The independent relationship between TyG index and SUI was tested using multivariate logistic regression analysis. We applied a smooth curve fitting approach to analyze the interrelation of them. In addition, subgroup analysis was conducted and interaction experiments were conducted. RESULTS Among 4459 female participants aged 20 and above, TyG index and SUI demonstrated a favorable correlation. Model 3 indicated that with every single-unit rise in the TyG index, the incidence of SUI increases by 18% [1.18 (1.01, 1.38)]. In contrast to individuals in the lowest tertile, subjects within the highest tertile of the TyG index exhibited a 68% increase in SUI incidence [1.68 (95% CI: 1.26, 2.23), 0.0004]. By using smooth curve fitting, a nonlinear positive evidence of an interconnection of the TyG index to SUI was identified. CONCLUSIONS Women exhibiting increased TyG index levels are at a heightened risk of SUI. TyG index displays a stronger correlation than that observed with BMI. According to our findings, the TyG index is viewed as a potential tool for identifying SUI in women, and monitoring the value of TyG index may be helpful for predicting the occurrence of SUI.
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Affiliation(s)
- YangPeng Pu
- School of Medical and Life Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - YouGang Feng
- Sichuan Province, Suining Central Hospital, Suining, China
| | - WenCai Zhao
- School of Medical and Life Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu, China
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Adams-Huet B, Jialal I. An Increasing Triglyceride-Glucose Index Is Associated with a Pro-Inflammatory and Pro-Oxidant Phenotype. J Clin Med 2024; 13:3941. [PMID: 38999506 PMCID: PMC11242814 DOI: 10.3390/jcm13133941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Revised: 06/21/2024] [Accepted: 07/02/2024] [Indexed: 07/14/2024] Open
Abstract
Background/Objectives: Insulin resistance is crucial in the pathogenesis of Metabolic Syndrome (MetS), type 2 diabetes mellitus (T2DM) and premature atherosclerotic cardiovascular disease (ASCVD). The triglyceride-glucose index (TyG index), a validated measure of insulin resistance, also predicts MetS, T2DM, the severity of albuminuria and ASCVD. There are scant data providing mechanistic insights into these sequalae. Accordingly, we investigated the relationship between the TyG index and biomarkers of inflammation, oxidative stress, free fatty acid (FFA) levels and adipokine dysregulation in a cohort comprising both controls and patients with nascent MetS. Methods: Participants (n = 102) included 59 patients with MetS and 43 controls. People with diabetes, ASCVD, smoking and macro-inflammation were excluded. Fasting blood was obtained for both plasma and monocyte isolation. Results: Receiver Operating Characteristic (ROC) curve analysis revealed that the TyG index was an excellent predictor of MetS with an area under the curve of 0.87, and it correlated with both hepatic and adipose tissue insulin resistance. Both serum RBP-4 levels and non-HDL cholesterol increased significantly over tertiles of the TyG index. Based on the TyG index tertiles and/or correlations, oxidized LDL, nitrotyrosine, C-reactive protein, endotoxin, chemerin, interleukin-6 levels and monocyte toll-like receptor (TLR)-4 and TLR-2 and their cellular signaling were significantly associated with the TyG index. Conclusions: Increased non-HDL-C and, most importantly, a pro-inflammatory and pro-oxidant state could be advanced as potential mechanisms explaining the increased risk for T2DM and ASCVD with an increasing TyG index.
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Affiliation(s)
| | - Ishwarlal Jialal
- UC Davis School of Medicine, 2616 Hepworth Drive, Davis, CA 95618, USA
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Zhang W, Zhang C, Lu D, Nie J, Hu Z, Xian C, He M. The mediation effect of Systemic Immunity Inflammation Index between urinary metals and TOFAT among adults in the NHANES dataset. Sci Rep 2024; 14:14940. [PMID: 38942999 PMCID: PMC11213905 DOI: 10.1038/s41598-024-65925-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 06/25/2024] [Indexed: 06/30/2024] Open
Abstract
Systemic Immune Inflammatory Index (SII) is a novel indicator of inflammation. However, no studies have reported the effect of SII on the association between metals and total fat (TOFAT). We aim to investigate the mediated effect of SII on the relationship between urinary metals and TOFAT in a US adult population. This cross-sectional study was conducted among adults with complete information on SII, urine metal concentrations, and TOFAT from the 2011-2018 National Health and Nutrition Examination Survey (NHANES). Multifactorial logistic regression and restricted cubic splines were used to explore the association between urine metal levels and TOFAT. Furthermore, serial mediation analyses were used to investigate the mediating effect of SII on metals and TOFAT. A total of 3324 subjects were included in this study. After adjusting for confounders, arsenic (As), cadmium (Cd), cobalt (Co), cesium (Cs), inorganic mercury (Hg), molybdenum (Mo), manganese (Mn), lead (Pb), antimony (Sb), and thallium(Tl) had negative decreased trends of odds ratios for TOFAT (all P for trend < 0.05). In the total population, we found that Cd, Co, and Tu were positively associated with SII (β = 29.70, 79.37, and 31.08), whereas As and Hg had a negative association with SII. The mediation analysis showed that SII mediated the association of Co with TOFAT, with the β of the mediating effect being 0.9% (95%CI: 0.3%, 1.6%). Our findings suggested that exposure to As, Cd, and Hg would directly decrease the level of TOFAT. However, Co would increase TOFAT, completely mediated by SII, mainly exerted in females rather than males.
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Affiliation(s)
- Weipeng Zhang
- The Affiliated Panyu Central Hospital of Guangzhou Medical University, Guangzhou, 511400, Guangdong, China.
| | - Cong Zhang
- Department of Pharmacy, Guangdong Second Provincial General Hospital, Guangzhou, 510317, Guangdong, China
| | - Dengqiu Lu
- The Affiliated Panyu Central Hospital of Guangzhou Medical University, Guangzhou, 511400, Guangdong, China
| | - Junfeng Nie
- The Affiliated Panyu Central Hospital of Guangzhou Medical University, Guangzhou, 511400, Guangdong, China
| | - Zhumin Hu
- The Affiliated Panyu Central Hospital of Guangzhou Medical University, Guangzhou, 511400, Guangdong, China
| | - Cuiyao Xian
- The Affiliated Panyu Central Hospital of Guangzhou Medical University, Guangzhou, 511400, Guangdong, China
| | - Minxing He
- The Affiliated Panyu Central Hospital of Guangzhou Medical University, Guangzhou, 511400, Guangdong, China
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Li X, Wang L, Zhou H, Xu H. Association between triglyceride-glucose index and chronic kidney disease: results from NHANES 1999-2020. Int Urol Nephrol 2024:10.1007/s11255-024-04103-8. [PMID: 38856937 DOI: 10.1007/s11255-024-04103-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 05/29/2024] [Indexed: 06/11/2024]
Abstract
AIMS Examining the connection between the triglyceride-glucose (TyG) index and chronic kidney disease (CKD) was the aim of this investigation. METHODS Data from the National Health and Nutrition Examination Survey (NHANES) covering the years 1999-2020 were analyzed in this study. The TyG index was calculated as Ln (triglycerides (mg/dl) * fasting glucose (mg/dl)/2). The two criteria used to diagnose CKD were low estimated glomerular filtration rate (eGFR) (eGFR < 60 mL/min/1.73m2) or albuminuria (urine albumin-to-creatinine ratio (ACR) ≥ 30 mg/g). To look into the independent associations between TyG index levels with CKD, albuminuria, and low-eGFR, weighted multivariable logistic regression and generalized additive models were employed. To assess and contrast the diagnostic ability, receiver operating characteristic (ROC) curves were employed. RESULTS Out of 18,078 total participants recruited, 48.54% were male. 8.48 + 0.68 was the mean value of the TyG index. CKD, albuminuria, and low-eGFR were common, with respective prevalences of 17.06%, 11.26%, and 8.03%, respectively. The TyG index and CKD were observed to positively correlate (OR = 4.03; 95% CI 1.81, 8.96). In US adults between the ages of 41 and 60, a J-shaped connection was found between the two. Furthermore, a higher TyG index is associated with a higher prevalence of albuminuria (OR = 6.11; 95% CI 2.64, 14.14). Subgroup analyses and interaction tests revealed that different stratifications did not significantly affect the relationship between TyG index and CKD, albuminuria, and low-eGFR. Comparing the TyG index to other indicators [lipid accumulation product (LAP), Visceral adiposity index (VAI), and the triglyceride glucose-body mass index (TyG-BMI)], it may be more accurate and discriminative in predicting CKD and albuminuria. CONCLUSION When predicting CKD and albuminuria, the TyG index may be a more useful marker when compared to other markers (LAP, VAI, and TyG-BMI index). In addition, in American adults aged 41-60, the TyG index shows a J-shaped relationship with CKD. As a result, when assessing the kidney health of US adults, we must pay close attention to the significance of the TyG index.
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Affiliation(s)
- Xiaowan Li
- Department of Critical Care Medicine, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, China
| | - Lanyu Wang
- Department of Urology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, China
| | - Hongyi Zhou
- Department of Urology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, China
| | - Hongyang Xu
- Department of Critical Care Medicine, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, China.
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Feng X, Wu S, Ke B, Liang Y. Elevated TyG index associated with increased prevalence of gallstones in a United States cross-sectional study. Front Public Health 2024; 12:1351884. [PMID: 38883189 PMCID: PMC11177685 DOI: 10.3389/fpubh.2024.1351884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 05/17/2024] [Indexed: 06/18/2024] Open
Abstract
Objective This study aimed to investigate the correlation between the triglyceride-glucose (TyG) index and the incidence of cholelithiasis. Research approach In this investigation, a cross-sectional analysis was undertaken utilizing data from the US National Health and Nutrition Examination Survey (NHANES) spanning the years 2017 to 2020. The TyG index served as an independent predictor, while gallstone prevalence was considered the dependent variable of interest. We employed a multivariate logistic regression model to evaluate the interplay between these independent and dependent variables. To assess the presence of potential non-linear associations, sensitivity analysis was executed, utilizing inverse probability weighted validation, smooth curve fitting, and threshold effect analysis. In cases where non-linear relationships were observed, likelihood ratios were utilized to pinpoint potential inflection points. Ultimately, subgroup analyses were conducted to identify specific populations demonstrating heightened susceptibility to gallstone prevalence. Results Encompassing 838 patients who self-reported gallstones, a total of 7,794 participants were included in the analytical cohort. A statistically significant disparity in the TyG index was observed when all individuals were categorized into gallstone patients and non-patients (p < 0.05). Logistic regression findings indicated a positive correlation between the TyG index and gallstone disease prevalence (OR = 1.28, 95% CI: 1.12, 1.47), with a strengthening association as the TyG index increased (p trend <0.01). The results were corroborated by the use of inverse probability weighting. Additionally, a non-linear connection between the TyG index and gallstone prevalence was identified (log-likelihood ratio p < 0.01), with the optimal inflection point for TyG calculated at 8.96. In subgroup analysis, the positive relationship between the TyG index and gallstone prevalence was notably pronounced among black Americans under the age of 40 and female participants. Conclusion Alterations in the TyG index may potentially correlate with shifts in the prevalence of gallstones among adult populations in the United States. Elevated TyG index values may coincide with an augmented likelihood of gallstone occurrence.
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Affiliation(s)
- Xueyi Feng
- Department of General Surgery, Lu'an Hospital Affiliated of Anhui Medical University (Lu'an City People's Hospital), Lu'an, Anhui, China
| | - Shenwei Wu
- Department of General Surgery, Lu'an Hospital Affiliated of Anhui Medical University (Lu'an City People's Hospital), Lu'an, Anhui, China
| | - Bin Ke
- Department of Gastrointestinal Surgery, The Second People's Hospital of Wuhu City (Affiliated Wuhu Hospital of East China Normal University), Wuhu, China
| | - Yongkang Liang
- Department of General Surgery, Lu'an Hospital Affiliated of Anhui Medical University (Lu'an City People's Hospital), Lu'an, Anhui, China
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Saadon SR, Allwsh TA. Lipocalin-2 as a marker of inflammation, bone density, and triglyceride-glucose index for new-onset arthritis patients in Mosul, Iraq. Qatar Med J 2024; 2024:23. [PMID: 38765271 PMCID: PMC11097680 DOI: 10.5339/qmj.2024.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 04/17/2024] [Indexed: 05/21/2024] Open
Abstract
OBJECTIVE Lipocalin-2 is an acute phase-associated adipokine that can serve as an inflammatory and biomarker indicator of cartilage deterioration in osteoarthritis. However, its role in the musculoskeletal system remains not fully understood. Hence, this study aimed to evaluate lipocalin-2 and its relationship with markers of inflammation (Interferon-gamma, ESR, and CRP), bone density (vitamin D3 and calcium), and the triglyceride-glucose index in new-onset arthritis patients in Mosul, Iraq. METHODS This study included 125 participants aged 20 to 65, divided into two groups. The Arthritis Patient Group comprised 70 participants (37 females and 33 males) attending the Bone Diseases Consultation Unit at the Ibn Sina Teaching Hospital in Mosul, Iraq. The Control Group comprised 31 females and 24 males. Ethical approval was obtained from the Iraqi Ministry of Health - Nineveh Health (No. 2022095). Commercial ELISA kits were used to measure serum lipocalin-2, Interferon-gamma, ESR, and CRP as inflammation markers, vitamin D3, and calcium as bone density markers. Moreover, the Triglyceride Glucose (TYG) Index was evaluated. RESULTS The findings revealed a significant increase in lipocalin-2 levels in males compared to females, with LCN-2 increasing with age. Arthritis patients showed a significant increase (72%) in lipocalin-2 levels. Inflammatory indicators (erythrocyte sedimentation rate, C-reactive protein, interferon-gamma) displayed significant increases (46%, 1200%, and 581%, respectively). Glucose (23%), triglycerides (71%), and TYG index (21%) also exhibited significant increases. Meanwhile, bone density indicators (vitamin D3 and calcium) found a significant decrease (53% and 20%, respectively) in arthritis patients. Linear correlation coefficient (R) analysis revealed a significant positive relationship between lipocalin-2 and indicators of inflammation, glucose, TG, and TYG index. CONCLUSION This study's findings suggest that LCN-2 serum levels were higher in patients with new-onset arthritis than in controls in Mosul, and LCN-2 serum increased in males compared with females and getting older serum LCN-2 increased for the patients and control groups. Furthermore, a significant correlation was found between the Triglyceride Glucose Index, which measures metabolic disorders, and serum LCN-2 levels and inflammatory indicators in new-onset arthritis patients in Mosul, Iraq.
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Affiliation(s)
- Safa Rabea Saadon
- Department of Chemistry, Collage of Science, University of Mosul, Mosul, Iraq *
| | - Thikra Ali Allwsh
- Department of Chemistry, Collage of Science, University of Mosul, Mosul, Iraq *
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Pan JY, Chen Y, Lin ZH, Lv B, Chen L, Feng SY. Association Between Triglyceride-Glucose Index and Hearing Threshold Shifts of Adults in the United States: National Health and Nutrition Examination Survey, 2015-2016. J Multidiscip Healthc 2024; 17:1791-1801. [PMID: 38686130 PMCID: PMC11056606 DOI: 10.2147/jmdh.s454678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 04/10/2024] [Indexed: 05/02/2024] Open
Abstract
Objective Sensorineural Hearing Loss (SNHL) is a representative human sensory impairment, few studies have paid attention to the correlation between the Triglyceride-Glucose (TyG) index and SNHL to date. We conducted this analysis to elucidate the correlation between the TyG index and pure tone hearing thresholds among US adults. Methods Our analysis included 1226 adults (age range: 20 to 69 years old) from the 2015-2016 National Health and Nutrition Examination Survey (NHANES) data. TyG index was scored into three quartiles. Weighted univariate analysis, weighted multivariate linear regression analyses as well as smooth curve fittings evaluated the associations between TyG index and pure tone hearing thresholds. Results In the multiple regression analysis, the second tertile of TyG index was negatively associated with high-frequency hearing thresholds shifts. Furthermore, the non-linear relationships between TyG index and speech-frequency and high-frequency hearing thresholds were identified by smooth curve fittings. After adjusting for potential confounders, the fitted smooth curves were approximately U-shaped, and the two-segment linear regression models were constructed to calculate their inflection points. Conclusion Our findings suggested that the TyG index was nearly U-shaped association with speech-frequency and high-frequency hearing thresholds. These results may imply the importance of maintaining a balanced TyG index in health management.
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Affiliation(s)
- Jia-Ying Pan
- Department of Otorhinolaryngology, Head and Neck Surgery, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, Guangdong, People’s Republic of China
| | - Yuan Chen
- Department of Otorhinolaryngology, Head and Neck Surgery, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, Guangdong, People’s Republic of China
| | - Zhi-He Lin
- Department of Otorhinolaryngology, Head and Neck Surgery, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, Guangdong, People’s Republic of China
| | - Bo Lv
- Department of Otorhinolaryngology, Head and Neck Surgery, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, Guangdong, People’s Republic of China
| | - Lei Chen
- Department of Neurosurgery, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, Guangdong, People’s Republic of China
| | - Shao-Yan Feng
- Department of Otorhinolaryngology, Head and Neck Surgery, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, Guangdong, People’s Republic of China
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Wu X, Qiu W, Yang H, Chen YJ, Liu J, Zhao G. Associations of the triglyceride-glucose index and atherogenic index of plasma with the severity of new-onset coronary artery disease in different glucose metabolic states. Cardiovasc Diabetol 2024; 23:76. [PMID: 38378553 PMCID: PMC10880297 DOI: 10.1186/s12933-024-02163-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 02/12/2024] [Indexed: 02/22/2024] Open
Abstract
BACKGROUND The triglyceride-glucose (TyG) index is considered a dependable biomarker for gauging insulin resistance. The atherogenic index of plasma (AIP) represents a marker reflecting atherosclerosis. However, there is currently no study specifically exploring the associations of these two biomarkers with the severity of new-onset coronary artery disease (CAD) under different glucose metabolic states. Therefore, this study aims to evaluate the correlations of these two biomarkers with CAD severity in patients newly diagnosed with CAD under various glucose metabolism conditions. METHOD Totally 570 subjects first administered coronary angiography were enrolled, including 431 first diagnosed CAD patients and 139 non-CAD patients. CAD severity was gauged by the quantity of narrowed arteries (single-vessel and multi-vessel CAD). According to WHO diabetes guidelines, glucose metabolic states were divided into normal glucose regulation (NGR), pre-diabetes mellitus (Pre-DM), and diabetes mellitus (DM). The relationships of the TyG index and AIP with CAD severity were validated by logistic regression analysis, including adjustment for traditional cardiovascular risk elements and medical treatments. Their predictive efficacy for CAD was evaluated by receiver operating characteristic (ROC) curves. RESULT The TyG index and AIP were independently correlated with CAD in accordance with logistic regression analysis (both P < 0.05). Regardless of the glucose metabolic states, there was no statistical correlation between the TyG index and CAD severity. However, AIP in NGR patients was significantly related to CAD severity (P < 0.05). The areas under the curve of the TyG index and AIP for predicting CAD were 0.682 and 0.642 (both P < 0.001), respectively, and their optimal cut-off values were 3.210 (Youden index: 0.305) and 0.095 (Youden index:0.246), respectively. CONCLUSION The TyG index and AIP have significant associations with CAD. The TyG index had no association with CAD severity, regardless of glucose metabolic states. AIP exhibited a discernible link with CAD severity in NGR patients, but not in the pre-DM or DM populations. The TyG index and AIP have similar predictive values for new-onset CAD.
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Affiliation(s)
- Xiaosheng Wu
- Affiliated Qingyuan Hospital, Guangzhou Medical University (Qingyuan People's Hospital), Qingyuan, Guangdong, China
- Guangzhou Medical University, Guangzhou, China
| | - Weiping Qiu
- Affiliated Qingyuan Hospital, Guangzhou Medical University (Qingyuan People's Hospital), Qingyuan, Guangdong, China
| | - Huancheng Yang
- Department of Radiology, The Third Affiliated Hospital of Shenzhen University (Luohu Hospital Group), Shenzhen, 518000, China
- Shantou University Medical College, Shantou University, Shantou, 515000, China
| | - Yan-Jun Chen
- Department of Pathology, Southwest Hospital, Third Military Medical University, Chongqing, 400038, People's Republic of China
| | - Jianling Liu
- Affiliated Qingyuan Hospital, Guangzhou Medical University (Qingyuan People's Hospital), Qingyuan, Guangdong, China.
| | - Guojun Zhao
- Affiliated Qingyuan Hospital, Guangzhou Medical University (Qingyuan People's Hospital), Qingyuan, Guangdong, China.
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Yao Y, Wang B, Geng T, Chen J, Chen W, Li L. The association between TyG and all-cause/non-cardiovascular mortality in general patients with type 2 diabetes mellitus is modified by age: results from the cohort study of NHANES 1999-2018. Cardiovasc Diabetol 2024; 23:43. [PMID: 38281973 PMCID: PMC10823741 DOI: 10.1186/s12933-024-02120-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 01/02/2024] [Indexed: 01/30/2024] Open
Abstract
BACKGROUND The prognostic value of triglyceride-glucose (TyG) index in general type 2 diabetes mellitus (T2DM) patients is still unclear. Therefore, we aimed to determine the associations between TyG and all-cause/cause-specific death in a T2DM cohort and explore whether such associations would be modified by age. METHODS A total of 3,376 patients with T2DM from the National Health and Nutrition Examination Survey (NHANES) 1999-2018 were selected and divided into the younger group (< 65 yrs) and the older group (≥ 65 yrs). Baseline TyG was calculated and cause-specific mortality status [cardiovascular (CV), cancer, and non-CV] was determined by the NHANES Public-Use Linked Mortality Files through 31 December 2019. Multivariate Cox and restricted cubic spline (RCS) regression models were used to evaluate the association between TyG and all-cause/cause-specific mortality. Interaction between TyG and age to mortality was also evaluated. Sensitivity analyses were performed in patients without cardiovascular disease, chronic kidney disease, or insulin treatment. RESULTS During a median follow-up of 107 months, 805 all-cause deaths occurred, of which 250 and 144 were attributed to CV and cancer deaths. There was a significant age interaction to the association between TyG and all-cause/non-CV mortality. After fully adjusting for potential confounding factors, higher TyG was associated with an increased risk of all-cause [TyG per unit increase Hazard Ratio (HR) 1.33, 95% Confidence Interval (CI) 1.06-1.66, p = 0.014] and non-CV mortality (TyG per unit increase HR 1.54, 95% CI 1.18-2.01, p = 0.002) only in the younger group, but not in the older group. There was no significant association between TyG and CV/cancer death in the total cohort and two age subgroups. Similar results were found in RCS and sensitivity analyses. CONCLUSION In a national sample of patients with T2DM in the United States, we found that the association between TyG and all-cause/non-CV death was modified by age. Higher TyG was only associated with an increased risk of all-cause/non-CV only in T2DM patients younger than 65 years old, but not in older patients.
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Affiliation(s)
- Younan Yao
- Department of Cardiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, China
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China
| | - Bo Wang
- Department of Emergency Medicine, Research Center of Cardiovascular Disease, the People's Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical Sciences, Nanning, 530021, China
| | - Tian Geng
- Department of Emergency Medicine, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, China
| | - Jiyan Chen
- Department of Cardiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, China.
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China.
| | - Wan Chen
- Department of Emergency Medicine, Research Center of Cardiovascular Disease, the People's Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical Sciences, Nanning, 530021, China.
| | - Liwen Li
- Department of Cardiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, China.
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China.
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