Degang Mo, Peng Zhang, Mengmeng Wang, Jun Guan, Hongyan Dai
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Kaplan-Meier survival curve models and Cox proportional hazards regression models were used to evaluate the prognostic significance of the TyG index. Receiver Operating Characteristic (ROC) curve analysis was used to determine the predictive efficacy of the TyG index for mortality. Subgroup analyses were conducted to determine the association between the TyG index and mortality across different groups.</p><p><strong>Results: </strong>Non-survivors had a significantly higher TyG index (ICU: 9.30 vs. 9.13, p = 0.008; in-hospital: 9.29 vs. 9.13, p = 0.004). Adjusted Cox models showed that each 1-unit increase in the TyG index increased ICU mortality risk by 24% (hazard ratio [HR] = 1.24, 95% confidence interval [CI]:1.04-1.48; p = 0.015) and in-hospital mortality by 44% (HR = 1.44, 95% CI:1.11-1.88; p = 0.007). The Quartile 4 TyG index ICU mortality was increased by 77% (HR = 1.77, 95% CI:1.09-2.89) compared to that for Quartile 1 and in-hospital mortality was increased by 61% (HR = 1.61, 95% CI:1.08-2.38). The area under the ROC curve (AUROC) showed a modest standalone predictive ability of 0.56, but when combined with clinical variables, the AUROC improved to 0.80 (ICU) and 0.78 (in-hospital). Subgroup analyses identified stronger associations in patients ≥ 60 years, females, non-septic, and those with acute myocardial infarction or heart failure.</p><p><strong>Conclusions: </strong>The TyG index is significantly associated with short-term mortality in patients with CS and may serve as a useful biomarker for risk stratification.</p><p><strong>Trial registration: </strong>Not applicable.</p>","PeriodicalId":18073,"journal":{"name":"Lipids in Health and Disease","volume":"24 1","pages":"130"},"PeriodicalIF":3.9000,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969958/pdf/","citationCount":"0","resultStr":"{\"title\":\"Associations of the triglyceride-glucose index with short-term mortality in patients with cardiogenic shock: a cohort study.\",\"authors\":\"Degang Mo, Peng Zhang, Mengmeng Wang, Jun Guan, Hongyan Dai\",\"doi\":\"10.1186/s12944-025-02548-z\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Cardiogenic shock (CS) is a severe cardiac disorder with a high mortality rate. The triglyceride-glucose (TyG) index, a biomarker of insulin resistance, is associated with cardiovascular disease-related mortality. This study aimed to investigate the association between the TyG index and mortality in patients with CS.</p><p><strong>Methods: </strong>This retrospective cohort study analyzed 727 patients with CS from the Medical Information Mart for Intensive Care IV database. The TyG index was calculated as follows: ln[triglycerides (mg/dL) × fasting blood glucose (mg/dL)/2]. Outcomes included 28-day intensive care unit (ICU) mortality and 28-day in-hospital mortality. Kaplan-Meier survival curve models and Cox proportional hazards regression models were used to evaluate the prognostic significance of the TyG index. Receiver Operating Characteristic (ROC) curve analysis was used to determine the predictive efficacy of the TyG index for mortality. Subgroup analyses were conducted to determine the association between the TyG index and mortality across different groups.</p><p><strong>Results: </strong>Non-survivors had a significantly higher TyG index (ICU: 9.30 vs. 9.13, p = 0.008; in-hospital: 9.29 vs. 9.13, p = 0.004). Adjusted Cox models showed that each 1-unit increase in the TyG index increased ICU mortality risk by 24% (hazard ratio [HR] = 1.24, 95% confidence interval [CI]:1.04-1.48; p = 0.015) and in-hospital mortality by 44% (HR = 1.44, 95% CI:1.11-1.88; p = 0.007). The Quartile 4 TyG index ICU mortality was increased by 77% (HR = 1.77, 95% CI:1.09-2.89) compared to that for Quartile 1 and in-hospital mortality was increased by 61% (HR = 1.61, 95% CI:1.08-2.38). The area under the ROC curve (AUROC) showed a modest standalone predictive ability of 0.56, but when combined with clinical variables, the AUROC improved to 0.80 (ICU) and 0.78 (in-hospital). 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引用次数: 0
摘要
背景：心源性休克（CS）是一种死亡率很高的严重心脏疾病。甘油三酯-葡萄糖（TyG）指数是胰岛素抵抗的生物标志物，与心血管疾病相关的死亡率相关。本研究旨在探讨TyG指数与CS患者死亡率之间的关系。方法：本回顾性队列研究分析了重症监护医学信息市场IV数据库中的727例CS患者。TyG指数计算公式为ln[甘油三酯（mg/dL） ×空腹血糖(mg/dL)/2]。结果包括28天重症监护病房（ICU）死亡率和28天住院死亡率。采用Kaplan-Meier生存曲线模型和Cox比例风险回归模型评价TyG指数的预后意义。采用受试者工作特征（ROC）曲线分析确定TyG指数对死亡率的预测效果。进行亚组分析以确定不同组间TyG指数与死亡率之间的关系。结果：非幸存者的TyG指数显著高于对照组(ICU: 9.30 vs. 9.13, p = 0.008；住院：9.29 vs. 9.13, p = 0.004)。调整后的Cox模型显示，TyG指数每增加1个单位，ICU死亡风险增加24%(风险比[HR] = 1.24, 95%可信区间[CI]:1.04-1.48；p = 0.015)，住院死亡率降低44% (HR = 1.44, 95% CI:1.11-1.88；p = 0.007)。与四分位数1相比，四分位数4的TyG指数ICU死亡率增加了77% (HR = 1.77, 95% CI:1.09-2.89)，住院死亡率增加了61% （HR = 1.61, 95% CI:1.08-2.38）。ROC曲线下面积（AUROC）显示出适度的独立预测能力，为0.56，但当结合临床变量时，AUROC提高到0.80 （ICU）和0.78（院内）。亚组分析发现，≥60岁、女性、非脓毒症患者和急性心肌梗死或心力衰竭患者的相关性更强。结论：TyG指数与CS患者的短期死亡率显著相关，可作为危险分层的有用生物标志物。试验注册：不适用。
Associations of the triglyceride-glucose index with short-term mortality in patients with cardiogenic shock: a cohort study.
Background: Cardiogenic shock (CS) is a severe cardiac disorder with a high mortality rate. The triglyceride-glucose (TyG) index, a biomarker of insulin resistance, is associated with cardiovascular disease-related mortality. This study aimed to investigate the association between the TyG index and mortality in patients with CS.
Methods: This retrospective cohort study analyzed 727 patients with CS from the Medical Information Mart for Intensive Care IV database. The TyG index was calculated as follows: ln[triglycerides (mg/dL) × fasting blood glucose (mg/dL)/2]. Outcomes included 28-day intensive care unit (ICU) mortality and 28-day in-hospital mortality. Kaplan-Meier survival curve models and Cox proportional hazards regression models were used to evaluate the prognostic significance of the TyG index. Receiver Operating Characteristic (ROC) curve analysis was used to determine the predictive efficacy of the TyG index for mortality. Subgroup analyses were conducted to determine the association between the TyG index and mortality across different groups.
Results: Non-survivors had a significantly higher TyG index (ICU: 9.30 vs. 9.13, p = 0.008; in-hospital: 9.29 vs. 9.13, p = 0.004). Adjusted Cox models showed that each 1-unit increase in the TyG index increased ICU mortality risk by 24% (hazard ratio [HR] = 1.24, 95% confidence interval [CI]:1.04-1.48; p = 0.015) and in-hospital mortality by 44% (HR = 1.44, 95% CI:1.11-1.88; p = 0.007). The Quartile 4 TyG index ICU mortality was increased by 77% (HR = 1.77, 95% CI:1.09-2.89) compared to that for Quartile 1 and in-hospital mortality was increased by 61% (HR = 1.61, 95% CI:1.08-2.38). The area under the ROC curve (AUROC) showed a modest standalone predictive ability of 0.56, but when combined with clinical variables, the AUROC improved to 0.80 (ICU) and 0.78 (in-hospital). Subgroup analyses identified stronger associations in patients ≥ 60 years, females, non-septic, and those with acute myocardial infarction or heart failure.
Conclusions: The TyG index is significantly associated with short-term mortality in patients with CS and may serve as a useful biomarker for risk stratification.
期刊介绍：
Lipids in Health and Disease is an open access, peer-reviewed, journal that publishes articles on all aspects of lipids: their biochemistry, pharmacology, toxicology, role in health and disease, and the synthesis of new lipid compounds.
Lipids in Health and Disease is aimed at all scientists, health professionals and physicians interested in the area of lipids. Lipids are defined here in their broadest sense, to include: cholesterol, essential fatty acids, saturated fatty acids, phospholipids, inositol lipids, second messenger lipids, enzymes and synthetic machinery that is involved in the metabolism of various lipids in the cells and tissues, and also various aspects of lipid transport, etc. In addition, the journal also publishes research that investigates and defines the role of lipids in various physiological processes, pathology and disease. In particular, the journal aims to bridge the gap between the bench and the clinic by publishing articles that are particularly relevant to human diseases and the role of lipids in the management of various diseases.
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