Objective: Cardiovascular diseases remain the leading cause of mortality worldwide, highlighting the need for reliable and easily applicable markers for long-term risk stratification. The TyG index and TyG-BMI have emerged as practical surrogate markers for insulin resistance and metabolic dysfunction. TyG index calculates risk using fasting triglycerides and glucose, while TyG-BMI incorporates body mass index to reflect adiposity related insulin resistance. Therefore, this study aimed to evaluate the associations of TyG and TyG-BMI with all-cause and cardiovascular mortality in a rural adult population from the EHUH1 cohort. Design and method: This prospective cohort study included adult participants from the nationwide EHUH1 study (random sample) with available baseline data on metabolic and kidney biomarkers (N=451, 42.4% men; median age 58 years IQR 47–69). Baseline TyG and TyG-BMI indices were calculated and analyzed as standardized continuous variables (per 1–SD increase) and by tertiles. All-cause and cardiovascular (CV) mortality data were recorded during long-term follow-up (median 17.0 years IQR 16.0-17.00). Mortality data were obtained from the records of the Croatian Institute of Public Health. Associations were assessed using Cox proportional hazards regression with adjustment for age and gender, and further for hypertension, diabetes mellitus, prior myocardial infarction, and prior stroke. Kaplan–Meier analyses were performed across tertiles with log-rank testing. Results: Among participants, 118 died from any cause (26%), and 57 from cardiovascular causes (13%) during follow-up. TyG was associated with all-cause mortality in unadjusted analysis (HR 1.20, 95%CI 1.02–1.43; p=0.033), but this association was attenuated after multivariable adjustment. TyG was not independently associated with CV mortality in adjusted models (HR 0.98, 95% CI 0.73–1.31; p=0.890). TyG-BMI was not significantly associated with all-cause or CV mortality in unadjusted or fully adjusted Cox models (all p>0.05). Kaplan–Meier analyses showed no significant differences in all-cause or CV mortality across tertiles of TyG or TyG-BMI (log-rank p>0.25 for both). Conclusions: TyG and TyG-BMI were not independently linked to all-cause and CV mortality. Our findings indicate these biomarkers do not enhance long-term risk assessment beyond traditional factors in general adult populations.
Kokic et al. (Fri,) studied this question.
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