The additive effect of the triglyceride-glucose index and estimated glucose disposal rate on long-term mortality among individuals with and without diabetes: a population-based study.

Publisher: BioMed Central Country of Publication: England NLM ID: 101147637 Publication Model: Electronic Cited Medium: Internet ISSN: 1475-2840 (Electronic) Linking ISSN: 14752840 NLM ISO Abbreviation: Cardiovasc Diabetol Subsets: MEDLINE

Original Publication: London : BioMed Central, [2002-

Blood Glucose*/metabolism ; Triglycerides*/blood ; Biomarkers*/blood ; Cardiovascular Diseases*/mortality ; Cardiovascular Diseases*/blood ; Cardiovascular Diseases*/diagnosis ; Diabetes Mellitus*/mortality ; Diabetes Mellitus*/blood ; Diabetes Mellitus*/diagnosis ; Cause of Death* ; Nutrition Surveys* ; Insulin Resistance*; Humans ; Male ; Female ; Middle Aged ; Risk Assessment ; Cross-Sectional Studies ; Time Factors ; Prognosis ; Aged ; Adult ; United States/epidemiology ; Predictive Value of Tests ; Risk Factors

Background: The triglyceride-glucose (TyG) index and estimated glucose disposal rate (eGDR), which are calculated using different parameters, are widely used as markers of insulin resistance and are associated with cardiovascular diseases and prognosis. However, whether they have an additive effect on the risk of mortality remains unclear. This study aimed to explore whether the combined assessment of the TyG index and eGDR improved the prediction of long-term mortality in individuals with and without diabetes.
Methods: In this cross-sectional and cohort study, data were derived from the National Health and Nutrition Examination Survey (NHANES) 2001-2018, and death record information was obtained from the National Death Index. The associations of the TyG index and eGDR with all-cause and cardiovascular mortality were determined by multivariate Cox regression analysis and restricted cubic splines.
Results: Among the 17,787 individuals included in the analysis, there were 1946 (10.9%) all-cause deaths and 649 (3.6%) cardiovascular deaths during a median follow-up of 8.92 years. In individuals with diabetes, the restricted cubic spline curves for the associations of the TyG index and eGDR with mortality followed a J-shape and an L-shape, respectively. The risk of mortality significantly increased after the TyG index was > 9.04 (all-cause mortality) or > 9.30 (cardiovascular mortality), and after eGDR was < 4 mg/kg/min (both all-cause and cardiovascular mortality). In individuals without diabetes, the association between eGDR and mortality followed a negative linear relationship. However, there was no association between the TyG index and mortality. Compared with individuals in the low TyG and high eGDR group, those in the high TyG and low eGDR group (TyG > 9.04 and eGDR < 4) showed the highest risk for all-cause mortality (hazard ratio [HR] = 1.592, 95% confidence interval [CI] 1.284-1.975) and cardiovascular mortality (HR = 1.683, 95% CI 1.179-2.400) in the overall population. Similar results were observed in individuals with and without diabetes.
Conclusions: There was a potential additive effect of the TyG index and eGDR on the risk of long-term mortality in individuals with and without diabetes, which provided additional information for prognostic prediction and contributed to improving risk stratification.
(© 2024. The Author(s).)

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2022-NHLHCRF-YSPY-01 National High Level Hospital Clinical Research Funding; 2022-YJXBF-04-03 Beijing Research Ward Construction Clinical Research Project; 82270352 National Natural Science Foundation of China; 2022-1-4062 Capital's Founds for Health Improvement and Research; CSCF2021B02 Chinese Society of Cardiology's Foundation

Keywords: Estimated glucose disposal rate; Insulin resistance; Mortality; NHANES; Triglyceride-glucose index

0 (Blood Glucose)
0 (Triglycerides)
0 (Biomarkers)

Date Created: 20240822 Date Completed: 20240823 Latest Revision: 20240825

20240826

PMC11342524

10.1186/s12933-024-02396-8

39175051