Triglyceride-glucose related indices as predictors for major adverse cardiovascular events and overall mortality in type-2 diabetes mellitus patients.

IF 4.6 3区医学 Q1 ENDOCRINOLOGY & METABOLISM World Journal of Diabetes Pub Date : 2025-03-15 DOI:10.4239/wjd.v16.i3.101488

Mao-Jun Liu, Jun-Yu Pei, Cheng Zeng, Ying Xing, Yi-Feng Zhang, Pei-Qi Tang, Si-Min Deng, Xin-Qun Hu

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Abstract

Background: Recent studies have indicated that triglyceride glucose (TyG)-waist height ratio (WHtR) and TyG-waist circumference (TyG-WC) are effective indicators for evaluating insulin resistance. However, research on the association in TyG-WHtR, TyG-WC, and the risk and prognosis of major adverse cardiovascular events (MACEs) in type 2 diabetes mellitus (T2DM) cases are limited.

Aim: To clarify the relation in TyG-WHtR, TyG-WC, and the risk of MACEs and overall mortality in T2DM patients.

Methods: Information for this investigation was obtained from Action to Control Cardiovascular Risk in Diabetes (ACCORD)/ACCORD Follow-On (ACCORDION) study database. The Cox regression model was applied to assess the relation among TyG-WHtR, TyG-WC and future MACEs risk and overall mortality in T2DM cases. The RCS analysis was utilized to explore the nonlinear correlation. Subgroup and interaction analyses were conducted to prove the robustness. The receiver operating characteristic curves were applied to analysis the additional predicting value of TyG-WHtR and TyG-WC.

Results: After full adjustment for confounding variables, the highest baseline TyG-WHtR cohort respectively exhibited a 1.353-fold and 1.420-fold higher risk for MACEs and overall mortality, than the lowest quartile group. Similarly, the highest baseline TyG-WC cohort showed a 1.314-fold and 1.480-fold higher risk for MACEs and overall mortality, respectively. Each 1 SD increase in TyG-WHtR was significantly related to an 11.7% increase in MACEs and a 14.9% enhance in overall mortality. Each 1 SD increase in TyG-WC corresponded to an 11.5% in MACEs and a 16.6% increase in overall mortality. Including these two indexes in conventional models significantly improved the predictive power for MACEs and overall mortality.

Conclusion: TyG-WHtR and TyG-WC were promising predictors of MACEs and overall mortality risk in T2DM cases.

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甘油三酯-葡萄糖相关指标作为2型糖尿病患者主要不良心血管事件和总死亡率的预测指标

背景：近年来研究表明，甘油三酯葡萄糖(TyG)-腰高比（WHtR）和TyG-腰围（TyG- wc）是评价胰岛素抵抗的有效指标。然而，关于TyG-WHtR、TyG-WC与2型糖尿病（T2DM）患者主要不良心血管事件（mace）的风险和预后之间关系的研究有限。目的：阐明T2DM患者TyG-WHtR、TyG-WC与mace风险及总死亡率的关系。方法：本研究的信息来自控制糖尿病心血管风险行动(ACCORD)/ACCORD随访（ACCORDION）研究数据库。采用Cox回归模型评估T2DM患者TyG-WHtR、TyG-WC与未来mace风险及总死亡率的关系。采用RCS分析探讨非线性相关性。进行亚组分析和相互作用分析以证明稳健性。应用受试者工作特征曲线分析TyG-WHtR和TyG-WC的附加预测值。结果：在完全调整混杂变量后，与最低四分位数组相比，最高基线TyG-WHtR组mace和总死亡率的风险分别高出1.353倍和1.420倍。同样，最高基线TyG-WC队列显示mace和总死亡率分别高出1.314倍和1.480倍。TyG-WHtR每增加1 SD， mace增加11.7%，总死亡率增加14.9%。TyG-WC每增加1 SD， mace增加11.5%，总死亡率增加16.6%。将这两项指标纳入常规模型，可显著提高mace和总死亡率的预测能力。结论：TyG-WHtR和TyG-WC是T2DM患者mace和总死亡风险的预测指标。

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来源期刊

World Journal of Diabetes ENDOCRINOLOGY & METABOLISM-

自引率

2.40%

发文量

909

期刊介绍： The WJD is a high-quality, peer reviewed, open-access journal. The primary task of WJD is to rapidly publish high-quality original articles, reviews, editorials, and case reports in the field of diabetes. In order to promote productive academic communication, the peer review process for the WJD is transparent; to this end, all published manuscripts are accompanied by the anonymized reviewers’ comments as well as the authors’ responses. The primary aims of the WJD are to improve diagnostic, therapeutic and preventive modalities and the skills of clinicians and to guide clinical practice in diabetes. Scope: Diabetes Complications, Experimental Diabetes Mellitus, Type 1 Diabetes Mellitus, Type 2 Diabetes Mellitus, Diabetes, Gestational, Diabetic Angiopathies, Diabetic Cardiomyopathies, Diabetic Coma, Diabetic Ketoacidosis, Diabetic Nephropathies, Diabetic Neuropathies, Donohue Syndrome, Fetal Macrosomia, and Prediabetic State.