The cumulative exposure to triglyceride-glucose index and the risk of onset fragility fractures.

Abstract

Objective: To investigate the association between the cumulative exposure to triglyceride-glucose index (cumTyG index) and fragility fractures in the general population.

Methods: This prospective cohort study analyzed active and retired employees of Kailuan Group who participated in three consecutive health examinations in 2006, 2008 and 2010, and were followed up until 31st December 2022. The cohort comprised 55,824 participants who met the inclusion and exclusion criteria and were grouped using the cumTyG index quartiles. The outcome event was onset fragility fracture. The cumulative incidence of fragility fracture in each group was calculated by the Kaplan-Meier method, and the incidence curve was plotted. Between-group comparisons were performed using the log-rank test. A Cox regression model was used to analyze the hazard ratio (HR) and 95 % confidence interval (CI) of fragility fractures.

Results: Nine-hundred fragility fractures occurred during a mean follow-up of 11.35 years. After multivariate Cox regression analysis and adjustment for confounders (full model), the HR (95 % CI) of the group with the highest cumTyG index compared with the group with the lowest cumTyG index was 1.30 (1.04-1.61). The risk of fragility fracture was higher in men (HR 1.37, 95 % CI 1.06-1.77) and those taking antihypertensive drugs (HR 2.47, 95 % CI 1.25-4.86). There was a linear association between the cumTyG index and the risk of fragility fracture.

Conclusion: A high cumTyG index is a risk factor for fragility fracture and should be considered in the management of patients with high blood sugar and high cholesterol concentrations.