Influencing and predictive factors of the decrease in the triglyceride-glucose index following sleeve gastrectomy.

Abstract

Background: The triglyceride-glucose index (TyG) has shown comprehensive value in relation to numerous obesity-associated comorbidities, especially cardiovascular diseases. Although their incidence risk and severity are lowered following sleeve gastrectomy (SG), the extent of relief varies.

Objectives: To analyze potential influencing factors of decrease in the TyG index (△TyG) following SG, and establish a predictive model using preoperative data.

Setting: University hospital, China.

Methods: Preoperative and 1-year postoperative data of patients with obesity who underwent SG were collected. After being randomly divided at a proportion of 70%, the patients in the modeling group were further divided into group A (decreased poorly) and group B (decreased satisfactorily) based on the degree of △TyG. After screening the variables with significant differences between the groups, we conducted logistic regression analysis to identify the influencing factors related to △TyG and those with a predictive value. Subsequently, a nomogram was established. Internal, external validations and decision curve analysis (DCA) were performed. Clinical impact curve (CIC) was drawn.

Results: The study included 744 patients. Four independent predictors, namely waist-hip ratio (WHR), high-density lipoprotein cholesterol (HDL-c), uric acid (UA), and TyG index were identified. The joint predictor formed by combining these four factors had an area under the curve of .838 (.803-.868) and a significantly better predictive value. The predictive accuracy and clinical net benefit of the nomogram established utilizing the joint predictor were verified.

Conclusions: SG can lead to significant △TyG, with preoperative WHR, HDL-c, UA, and TyG index being independent predictors. The joint predictor can effectively predict the magnitude of the decrease.