糖尿病前期个体中甘油三酯-葡萄糖相关指标与全因死亡率和特定病因死亡率的关联。（注：原文中“prediabetesss”拼写有误，正确应为“prediabetes”）

Association of triglyceride-glucose-related indices with all-cause and cause-specific mortality in individuals with prediabetesss.

作者信息

Zhang Liwen, Zhao Weili, Zheng Panpan, Huang Fang, Zhang Lili, Zhang Yuxin, Xiu Xian, Zhang Pei, Liu Zanchao, Liu Lipeng

机构信息

Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University, Hebei Key Laboratory of Environment and Human Health, 050017, Shijiazhuang, China.

Hebei Key Laboratory of Basic Medicine for Diabetes, The Second Hospital of Shijiazhuang, Shijiazhuang, 050000, Hebei, China.

出版信息

Cardiovasc Diabetol. 2025 Aug 12;24(1):330. doi: 10.1186/s12933-025-02883-6.

DOI:10.1186/s12933-025-02883-6

PMID:40797320

Abstract

BACKGROUND

The triglyceride-glucose (TyG) index has been linked to the occurrence of prediabetes, but there is limited evidence regarding its association with mortality in individuals with prediabetes. Thus, this study aimed to explore the association between TyG-related indices and all-cause and cause-specific mortality in individuals with prediabetes.

METHOD

Based on NHANES data from 1999 to 2018, the TyG index, TyG-waist circumference (TyG-WC), and TyG-waist-to-height ratio (TyG-WHtR) were calculated. Mortality data including all-cause mortality, cardiovascular disease (CVD) mortality, and cancer mortality were determined as of December 31, 2019. Kaplan-Meier curves, Cox regression analysis, and restricted cubic splines (RCS) were used to assess associations of TyG-related indices with all-cause and cause-specific mortality (CVD and cancer) in individuals with prediabetes. Subgroup and sensitivity analyses were used to confirm the robustness of the results.

RESULTS

In total, 9,574 participants with prediabetes were included. Kaplan-Meier curves indicated that overall survival and cancer-specific survival were associated with different quartiles of the TyG index, with quartile 1 having the lowest all-cause mortality (P = 0.042 and P = 0.008). TyG-WHtR was negatively correlated with overall survival and CVD-specific survival (P < 0.001 and P = 0.012). Multivariate Cox regression analysis showed a significant positive correlation between the TyG index and cancer mortality (Q4: HR = 1.957, 95% CI: 1.126-3.402, P = 0.017). High quartiles of TyG-WC were significantly associated with cancer mortality in participants with prediabetes (HR = 2.397, 95% CI, 1.062-5.409, P = 0.035). Similarly, higher quartiles of TyG-WHtR were positively associated with all-cause, CVD, and cancer mortality. RCS analysis showed that TyG-WC and TyG-WHtR were nonlinearly correlated with cancer mortality (P for nonlinear = 0.028 and 0.006).

CONCLUSION

Elevated TyG and TyG-WC levels were significantly associated with increased cancer mortality risk, while TyG-WHtR showed stronger associations with all-cause and cause-specific mortality in individuals with prediabetes. These indices could serve as surrogate biomarkers for follow-up and clinical management of individuals with prediabetes.

摘要

背景

甘油三酯-葡萄糖（TyG）指数与糖尿病前期的发生有关，但关于其与糖尿病前期个体死亡率的关联证据有限。因此，本研究旨在探讨TyG相关指数与糖尿病前期个体全因死亡率和特定病因死亡率之间的关联。

方法

基于1999年至2018年的美国国家健康与营养检查调查（NHANES）数据，计算TyG指数、TyG-腰围（TyG-WC）和TyG腰高比（TyG-WHtR）。截至2019年12月31日确定包括全因死亡率、心血管疾病（CVD）死亡率和癌症死亡率在内的死亡率数据。采用Kaplan-Meier曲线、Cox回归分析和限制立方样条（RCS）来评估TyG相关指数与糖尿病前期个体全因死亡率和特定病因死亡率（CVD和癌症）之间的关联。采用亚组分析和敏感性分析来确认结果的稳健性。

结果

总共纳入了9574名糖尿病前期参与者。Kaplan-Meier曲线表明，总体生存率和癌症特异性生存率与TyG指数的不同四分位数相关，第一四分位数的全因死亡率最低（P = 0.042和P = 0.008）。TyG-WHtR与总体生存率和CVD特异性生存率呈负相关（P < 0.001和P = 0.012）。多变量Cox回归分析显示，TyG指数与癌症死亡率之间存在显著正相关（第四四分位数：HR = 1.957，95%置信区间：1.126 - 3.402，P = 0.017）。TyG-WC的高四分位数与糖尿病前期参与者的癌症死亡率显著相关（HR = 2.397，95%置信区间，1.062 - 5.409，P = 0.035）。同样，TyG-WHtR的较高四分位数与全因、CVD和癌症死亡率呈正相关。RCS分析表明，TyG-WC和TyG-WHtR与癌症死亡率呈非线性相关（非线性P = 0.028和0.006）。