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ORIGINAL RESEARCH article
Front. Cardiovasc. Med.
Sec. Lipids in Cardiovascular Disease
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1570239
This article is part of the Research TopicHDL and Cardiovascular Disease: Mechanisms, Clinical Relevance, and Therapeutic ImpactsView all articles
Association of triglyceride-glucose-related indices with adverse clinical outcomes in individuals with normal body mass index
Provisionally accepted- 1Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
- 2Center of Infectious Diseases, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
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AbstractBackground and Aims: The triglyceride-glucose (TyG) index serves as a reliable indicator of insulin resistance and metabolic risk factors. Most research has focused on obese individuals, with limited exploration in those with a normal body mass index (BMI).Method: This study analyzed 4,440 adults with normal BMI from NHANES 2003–2018. Logistic regression, linear regression, subgroup analysis, and survival analysis examined the relationship between TyG-related indices (TyG, TyG-BMI, TyG-WC, TyG-WHtR) and outcomes like liver fibrosis, stroke, cardiovascular disease (CVD), and mortality.Results: In 4440 individuals, 279 developed CVD, 134 had stroke, 1382 developed liver fibrosis, and 548 died, with a median observation period of 100 months (IQR, 59-145 months). The TyG index was divided into four quartiles (Q1, Q2, Q3, Q4) and significant trends in various clinical indicators across the quartiles were observed (demographic characteristics, metabolic and biochemical indicators). Further analysis revealed linear correlations between TyG, TyG-WC, TyG-BMI, TyG-WHtR and liver function metrics (ALT, AST, GGT, FIB-4, APRI), kidney function metrics (creatinine, eGFR, uric acid), and blood lipids (triglycerides, cholesterol) (P < 0.01). Univariate logistic regression showed that compared to Q1, Q4 showed a significantly higher risk of liver fibrosis, CVD, stroke, and death for all TyG-related parameters (P < 0.001). After adjusting for cofounders, TyG Q4 still had a significantly higher risk of liver fibrosis (P < 0.05) and mortality (P < 0.001); TyG-BMI Q4 showed a higher risk of mortality (P < 0.001); TyG-WC Q4 showed a significantly higher risk of liver fibrosis (P < 0.001), stroke (P < 0.01), CVD (P < 0.001), and mortality (P < 0.001); TyG-WHtR Q4 showed a significantly higher risk of liver fibrosis (P < 0.001), stroke (P < 0.01), CVD (P < 0.001), and mortality (P < 0.001). Subgroup analysis yielded similar conclusions. Additionally. Survival analysis revealed significant differences in survival across the different quartiles of TyG, TyG-WC, TyG-BMI, and TyG-WHtR (P < 0.001).Conclusion: The study identified a link between TyG-related markers and negative outcomes in individuals with a normal BMI, indicating that insulin resistance exists even in non-obese populations.
Keywords: TyG index, liver fibrosis, Stroke, cardiovascular disease, Mortality
Received: 03 Feb 2025; Accepted: 09 Apr 2025.
Copyright: © 2025 Xie, Pei, Zhu, Jiang, Tang, Wu and Xie. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Hong Tang, Center of Infectious Diseases, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
Dongbo Wu, Center of Infectious Diseases, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
Yan Xie, Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
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