Triglyceride glucose-body mass index is associated with cardiovascular outcomes and overall mortality in type-2 diabetes mellitus patients.

Abstract

Background: Although recent studies have reported the reliability of triglyceride-glucose index (TyG) as a biomarker for evaluation of insulin resistance, the research exploring the association of TyG-body mass index (BMI) with major cardiovascular outcomes and all-cause mortality among the type 2 diabetes mellitus (T2DM) population remains scarce.

Aim: To ascertain whether TyG-BMI correlates with cardiovascular outcomes and mortality risk in individuals diagnosed with T2DM.

Methods: Data were drawn from the ACCORD trial and its subsequent follow-up (ACCORDION), which together included 10190 participants. To evaluate the associations of TyG-BMI with future cardiovascular outcomes and overall mortality risk among T2DM patients, Cox's proportional-hazards model was employed. Non-linear associations and thresholds were investigated by performing restricted cubic spline regression, fitting smooth curves, and conducting piecewise regression. Additionally, we examined whether the above findings were robust through interaction and subgroup analyses. The robustness of results was further verified by a series of sensitivity assessments. Through the area under the receiver operating characteristic curve estimation, the incremental predictive power of TyG-BMI beyond conventional risk factors was also evaluated.

Results: Applying multivariable Cox regression analysis, we identified a significant correlation of TyG-BMI with both cardiovascular outcomes and overall mortality. Specifically, after adjusting for multiple confounders, the cardiovascular mortality, congestive heart failure (CHF) and overall mortality risks in the highest TyG-BMI quartile were 1.74, 2.65 and 1.42 times greater, respectively, when compared to the lowest quartile. The analysis revealed that TyG-BMI was linked nonlinearly to both types of mortality, while a two-stage linear regression discerned inflection points at 252.77 for cardiovascular mortality and 245.90 for overall mortality. TyG-BMI was found to correlate positively with future CHF. Additionally, introducing TyG-BMI into conventional prediction models resulted in a substantial improvement of their predictability for cardiovascular outcomes and overall mortality when compared to incorporating TyG or BMI alone.

Conclusion: Among T2DM individuals, a higher TyG-BMI is linked strongly to elevated risks of cardiovascular outcomes and overall mortality, highlighting its utility as a predictive marker for these risks.