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Background Triglyceride-glucose (TyG) index has been determined to play a role in the onset of metabolic syndrome (MetS). Whether the TyG index and TyG with the combination of obesity indicators are associated with the clinical outcomes of the MetS population remains unknown. Method Participants were extracted from multiple cycles of the National Health and Nutrition Examination Survey (NHANES) between 1999 and 2018 years. Three indicators were constructed including TyG index, TyG combining with waist circumference (TyG-WC), and TyG combining with waist-to-height ratio (TyG-WHtR). The MetS was defined according to the National Cholesterol Education Program (NCPE) Adult Treatment Panel III. Kaplan-Meier (KM) curves, restricted cubic splines (RCS), and the Cox proportional hazard model were used to evaluate the associations between TyG-related indices and mortality of the MetS population. The sensitive analyses were performed to check the robustness of the main findings. Results There were 10,734 participants with MetS included in this study, with 5,570 females and 5,164 males. The median age of the study population was 59 years old. The multivariate Cox regression analyses showed high levels of TyG-related indices were significantly associated with the all-cause mortality of MetS population [TyG index: adjusted hazard ratio (aHR): 1.36, 95%confidence interval (CI): 1.18–1.56, p  < 0.001; TyG-WHtR index: aHR = 1.29, 95%CI: 1.13–1.47, p  < 0.001]. Meanwhile, the TyG-WC and TyG-WHtR index were associated with cardiovascular mortality of the MetS population (TyG-WC: aHR = 1.45, 95%CI: 1.13–1.85, p  = 0.004; TyG-WHtR: aHR = 1.50 95%CI: 1.17–1.92, p  = 0.002). Three TyG-related indices showed consistent significant correlations with diabetes mortality (TyG: aHR = 4.06, 95%CI: 2.81–5.87, p  < 0.001; TyG-WC: aHR = 2.55, 95%CI: 1.82–3.58, p  < 0.001; TyG-WHtR: aHR = 2.53 95%CI: 1.81–3.54, p  < 0.001). The RCS curves showed a non-linear trend between TyG and TyG-WC indices with all-cause mortality (p for nonlinearity = 0.004 and 0.001, respectively). The sensitive analyses supported the positive correlations between TyG-related indices with mortality of the MetS population. Conclusion Our study highlights the clinical value of TyG-related indices in predicting the survival of the MetS population. TyG-related indices would be the surrogate biomarkers for the follow-up of the MetS population.

Background The predictive value of the triglyceride-glucose (TyG)-related indices for colorectal cancer (CRC) occurrence remains unclear. This study aims to establish the association between the TyG-related index and the risk of CRC among the US population. Methods The TyG index, along with the Triglyceride glucose-body mass index (TyG-BMI), Triglyceride glucose-waist circumference (TyG-WC), and Triglyceride glucose-waist-to-height ratio (TyG-WHtR), were calculated using data from CRC patients in the National Health and Nutrition Examination Surveys (NHANES) spanning 1999 to 2020. Weighted multivariate logistic regression and generalized additive models assessed the independent associations between these indices and CRC risk. Subgroup analyses and sensitivity tests evaluated the robustness and reliability of the findings. Receiver operating characteristic curve (ROC) was performed for predicting CRC risk using different TyG-related indices. Results Among 18,418 participants with an average age of 47.7 years, 126 were diagnosed with CRC. After adjusting for key confounding covariates, the TyG index was not significantly associated with CRC risk (OR = 1.32, 95% CI: 0.90–1.95, P  = 0.1553), whereas significant positive associations remained for TyG-BMI, TyG-WC, and TyG-WtHR when analyzed as continuous variables. When categorized into quartiles, individuals in the highest quartile exhibited elevated CRC prevalence compared to the reference group (TyG: OR = 1.88, 95% CI: 0.86–4.12, P  = 0.1632; TyG-BMI: OR = 2.80, 95% CI: 1.29–6.05, P  = 0.0155; TyG-WC: OR = 2.71, 95% CI: 1.06–6.92, P  = 0.0154; TyG-WtHR: OR = 3.62, 95% CI: 1.22–10.75, P  = 0.0046), with statistically significant associations persisting for TyG-BMI, TyG-WC, and TyG-WtHR (all P  < 0.05). Subgroup and interaction tests indicated that sex, age, hypertension, and diabetes did not significantly influence the association between TyG related indices and CRC risk (all P  > 0.05). ROC analysis demonstrated that TyG-WtHR (AUC: 0.644, 95% CI: 0.6014–0.6917) outperformed other indices in CRC risk prediction ( P  < 0.001). Conclusions In the U.S. adult population, elevated TyG-WHtR index levels are significantly associated with a higher risk of developing CRC.

Background The prognostic value of triglyceride-glucose (TyG) related indices in non-alcoholic fatty liver disease (NAFLD) or metabolic dysfunction-associated steatotic liver disease (MASLD) is still unclear. This study aimed to determine the associations between TyG-related indices and long-term mortality in this population. Methods The data came from the National Health and Nutrition Examination Survey (NHANES III) and National Death Index (NDI). Baseline TyG, TyG combining with body mass index (TyG-BMI), and TyG combining with waist circumference (TyG-WC) indices were calculated, and mortality status was determined through 31 December 2019. Multivariate Cox and restricted cubic spline (RCS) regression models were performed to evaluate the relationship between TyG-related indices and long-term mortality among participants with NAFLD/MASLD. In addition, we examined the association between TyG-related indices and all-cause mortality within subgroups defined by age, sex, race/ethnicity, and fibrosis-4 index (FIB-4). Results There were 10,390 participants with completed ultrasonography and laboratory data included in this study. NAFLD was diagnosed in 3672/10,390 (35.3%) participants, while MASLD in 3556/10,390 (34.2%) amongst the overall population. The multivariate Cox regression analyses showed high levels of TyG-related indices, particularly in TyG-BMI and TyG-WC indices were significantly associated with the all-cause mortality, cardiovascular mortality, and diabetes mortality in either NAFLD or MASLD. The RCS curves showed a nonlinear trend between three TyG-related indices with all-cause mortality in either NAFLD or MASLD. Subgroup analyses showed that TyG-BMI and TyG-WC indices were more suitable for predicting all-cause mortality in patients without advanced fibrosis. Conclusion Our study highlights the clinical value of TyG-related indices in predicting the survival of the NAFLD/MASLD population. TyG-BMI and TyG-WC indices would be the surrogate biomarkers for the follow-up of the population without advanced fibrosis.

Backgrounds Insulin resistance (IR) plays a vital role in the pathogenesis of the metabolic dysfunction-associated steatotic liver disease (MASLD). However, it remains unclear whether triglyceride–glucose (TyG) related parameters, which serve as useful biomarkers to assess IR, have prognostic effects on mortality outcomes of MASLD. Methods Participants in the National Health and Nutrition Examination Survey (NHANES) database from 1999 to 2018 years were included. TyG and its related parameters [TyG-waist circumference (TyG-WC) and TyG-waist to height ratio (TyG-WHtR)] were calculated. Kaplan–Meier curves, Cox regression analysis, and restricted cubic splines (RCS) were conducted to evaluate the association between TyG-related indices with the all-cause and cardiovascular mortality of adults with MASLD. The concordance index (C-index) was used to evaluate the prediction accuracy of TyG-related indices. Results A total of 8208 adults (4209 men and 3999 women, median age 49.00 years) with MASLD were included in this study. Multivariate-adjusted Cox regression analysis revealed that high quartile levels of TyG-related indices were significantly associated with the all-cause mortality of participants with MASLD [ TyG adjusted hazard ratio (aHR) = 1.25, 95% confidence interval (CI) 1.05–1.50, P  = 0.014; TyG-WC aHR for all-cause mortality = 1.28, 95% CI 1.07–1.52, P  = 0.006; TyG-WHtR aHR for all-cause mortality = 1.50, 95% CI 1.25–1.80, P  < 0.001; TyG-WC aHR for cardiovascular mortality = 1.81, 95% CI 1.28–2.55, P  = 0.001; TyG-WHtR aHR for cardiovascular mortality = 2.22, 95% CI 1.55–3.17, P  < 0.001]. The C-index of TyG-related indices for predicting all-cause mortality was 0.563 for the TyG index, 0.579 for the TyG-WC index, and 0.585 for the TyG-WHtR index, respectively. Regarding cardiovascular mortality, the C-index was 0.561 for the TyG index, 0.607 for the TyG-WC index, and 0.615 for the TyG-WHtR index, respectively. Nonlinear trends were observed between TyG and TyG-WC indices with all-cause mortality of MASLD ( P  < 0.001 and = 0.012, respectively). A non-linear relationship was observed between the TyG index and cardiovascular mortality of MASLD ( P  = 0.025). Subgroup analysis suggested that adults aged < 65 years old and those without comorbidities were more sensitive to the mortality prediction of TyG-related indices. Conclusion Findings of this study highlight the predictive value of TyG-related indices, especially the TyG-WHtR index, in the mortality outcomes of adults with MASLD. TyG-related indices would be surrogate biomarkers for the clinical management of MASLD.

Background: Insulin resistance (IR) may play a crucial role in irritable bowel syndrome (IBS) pathogenesis. However, it remains unclear whether triglyceride-glucose (TyG)-related indices, useful biomarkers for assessing IR, are associated with IBS development. Objectives: To investigated the link between baseline TyG-related indices and incident IBS. Design: A prospective, population-based cohort study. Methods: Participants free of IBS with available TyG-related indices (TyG-waist circumference (TyG-WC), TyG-waist-to-height ratio (TyG-WHtR), and TyG-body mass index (TyG-BMI)) at enrollment were included (N = 356,904). Primary endpoint was incident IBS. Cox regression was used to evaluate the association between TyG-related indices and IBS. Results: During a median 14.6 years of follow-up (5,023,899 person-years), 7381 (2.1%) participants developed IBS. The mean (standard deviation) level of baseline TyG index was 8.7(0.6), with 8.0 (0.2), 8.5 (0.1), 8.9 (0.1), and 9.5 (0.3) in quartile 1–4. Compared with the lowest quartile, the highest quartile of all TyG-related indices was significantly associated with greater risk of incident IBS (TyG hazard ratio (HR) = 1.24, 95% confidence interval (CI): 1.16–1.33, <0.001; TyG-WC HR = 1.25, 95% CI: 1.16–1.34, <0.001; TyG-WHtR HR = 1.24, 95% CI: 1.16–1.33, <0.001; TyG-BMI HR = 1.15, 95% CI: 1.07–1.23, <0.001). Meanwhile, per standardized deviation increment of TyG-related indices were also associated with 6%–9% greater risk of IBS (TyG HR = 1.09, 95% CI: 1.07–1.12; TyG-WC HR = 1.09, 95% CI: 1.07–1.12; TyG-WHtR HR = 1.09, 95% CI: 1.06–1.11; TyG-BMI HR = 1.06, 95% CI: 1.03–1.08). Similar results were observed in various sensitivity analyses and subgroup analysis. Conclusion: Higher TyG-related indices are linked to higher risk of incident IBS, highlighting the importance of IR in IBS pathogenesis.

Background This study investigated and compared the abilities of the triglyceride glucose index (TyG) and its correlated factors involving TyG-body mass index (TyG-BMI), TyG-waist-to-height ratio (TyG-WHtR), and TyG-waist circumference (TyG-WC) to predict cardiovascular disease (CVD) among Chinese postmenopausal women. This topic has not been adequately explored in the existing literature. Methods This prospective study included 1110 Chinese postmenopausal women, stratified into the CVD group and the non-CVD group. The TyG index and its correlated components (TyG, TyG-BMI, TyG-WHtR, and TyG-WC) were calculated. The primary endpoint was CVD. Results Across a 12-year follow-up period, 76 (6.84%) CVDs were documented. The TyG index, in collaboration with various indicators of obesity, demonstrated a robust positive correlation with the risk of CVD. In comparison to other TyG indices, TyG-WC was the strongest predictor for CVD (HR: 2.61, 95%CI:1.64–4.14; P  < 0.001), and the TyG-WHtR index exhibited the strongest diagnostic value in identifying CVD (AUC: 0.632, 95%CI: 0.603–0.660; P  < 0.001). Incorporating TyG-WHtR into the base model significantly enhanced incremental risk stratification for CVD (NRI: 0.115, 95%CI: 0.040–0.190, P  < 0.05; AIC: 996; BIC: 1041; Harrell’s C-index: 0.73). Decision curve analysis (DCA) suggested that TyG, TyG-WHtR, and TyG-WC can provide significant clinical benefits for Chinese postmenopausal women. The sensitivity analyses have demonstrated the robustness of these results. Conclusions The TyG index and its correlated factors can effectively predict CVD in Chinese postmenopausal women. TyG-WHtR has the most potent ability to predict CVD among postmenopausal women.

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. 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. 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). 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.

Purpose: The triglyceride glucose (TyG) index and TyG-related indicators have been proposed as a marker of insulin resistance. It is unclear which is the best indicator to predict diabetes mellitus (DM) in Chinese. This study aimed to investigate the predictive value of different biomarkers for the incidence of DM. Patients and methods: Between January 2017 and December 2020, 5575 subjects who underwent health examinations in Hebei General Hospital were retrospectively included. The primary endpoint was new onset DM. Results: During a median follow-up of 3.03 years, 133(2.39%) individuals developed DM. Multivariable cox proportional hazards models revealed that TyG index and TyG-related parameters were positively associated with DM risk. As the interaction analyses showed, there were significant interactions with sex and age levels in relation to DM risk (both P for interaction <0.05). Risk prediction for DM was significantly improved by adding TyG index to the baseline model using conventional diabetic risk factors in predicting DM at follow-up. Conclusion: This population-based cohort study suggested a causal relationship between TyG index and DM after adjusting for other confounding factors. This independent and significant association was more apparent in females and subjects younger than 65 years. Compared with the TyG-BMI, TyG-WC, TyG-WHtR, the TyG index was a more effective predictor of DM. Keywords: diabetes mellitus, TyG index, cohort study

Relationships of triglyceride-glucose (TyG) index and TyG combined with obesity indicators [TyG-waist circumference (TyG-WC), TyG-waist height ratio (TyG-WHtR), TyG-body mass index (TyG-BMI)] with kidney stone (KS) have been infrequently investigated among the American. This study aimed to examine these relationships within a substantial, nationwide population. The current cross-sectional study recruited totally 9,808 adult participants in National Health and Nutrition Examination Survey (NHANES) 2007-2018. For investigating relations of the TyG index, TyG-WC, TyG-WHtR, and TyG-BMI with KS, multivariate logistic regression, restricted cubic spline (RCS), mediation, sensitivity, subgroup and interaction analyses were used. This analysis indicated that TyG combined with obesity indicators [TyG-WC, (odds ratio (OR) = 2.19, 95% CI: 1.69-2.84, < 0.001); TyG-WHtR, (OR = 2.26, 95% CI: 1.73-2.95, < 0.001); TyG-BMI, (OR = 1.88, 95% CI: 1.48-2.39, < 0.001)] exhibited a stronger correlation with KS compared to the TyG index alone (OR = 1.40, 95% CI: 1.10-1.78, = 0.006). Based on RCS analysis, TyG index and TyG combined with obesity indicators were linearly related to KS ( -overall < 0.0001, -nonlinear > 0.05). Mediation analysis indicated that high-density lipoprotein cholesterol (HDL-C) had a significant mediating effect. In this study, TyG index and TyG combined with obesity indicators (TyG-WC, TyG-WHtR and TyG-BMI) show a significantly positive relationship to KS. Furthermore, in comparison to the TyG index alone, TyG combined with obesity indicators exhibited enhanced diagnostic relevance.

The triglyceride-glucose (TyG) index, a marker of insulin resistance, is linked to mortality in coronary artery disease, ischemic stroke, and heart failure. However, its association with functional disability remains unclear. This study explored the relationship between the TyG index, its related parameters, and functional disability. Data were obtained from the China Health and Retirement Longitudinal Study (CHARLS). Functional disability was evaluated using the Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) scales. Multivariate logistic regression and restricted cubic spline (RCS) models were used to assess the associations between TyG-related indices and the risk of functional disability. Subgroup analyses stratified by age, sex, smoking, drinking, and diabetes were performed. Additionally, propensity score matching (PSM) was applied to ensure the robustness of the findings. The diagnosis rates were 1,510(16.32%) for ADL limited and 2,620(28.32%) for ADL-IADL limited. The TyG-related indices were significantly associated with ADL limited. [TyG index: Full adjusted OR = 1.23, 95%CI: 1.16-1.30,  < 0.001; TyG-BMI index: Full adjusted OR = 1.11, 95%CI: 1.05-1.18,  < 0.001; TyG-WC index: Full adjusted OR = 1.20, 95%CI: 1.13-1.27,  < 0.001; TyG-WHtR index: Full adjusted OR = 1.07, 95%CI: 1.01-1.14,  = 0.025]. The TyG-related indices were significantly associated with ADL-IADL limited. [TyG index: Full adjusted OR = 1.20, 95%CI: 1.14-1.26,  < 0.001; TyG-BMI index: Full adjusted OR = 1.13, 95%CI: 1.08-1.19,  < 0.001; TyG-WC index: Full adjusted OR = 1.14, 95%CI: 1.09-1.20,  < 0.001; TyG-WHtR index: Full adjusted OR = 1.13, 95%CI: 1.07-1.18,  < 0.001]. Our findings indicated a trend that, TyG-related indices significantly associated with increased risks of ADL limited and ADL-IADL limited populations.