Triglyceride-glucose Index and Mortality in a Large Regional-based Italian Database (URRAH Project).

Area of Science:

• Cardiovascular Disease Epidemiology
• Metabolic Syndrome Research
• Biomarker Discovery

Background:

• Insulin resistance (IR) is a key factor in metabolic and cardiovascular diseases.
• The triglyceride-glucose (TyG) index is a novel, simple, and cost-effective surrogate marker for IR.
• Limited data exist on the TyG index's association with mortality in non-Asian general populations.

Purpose of the Study:

• To evaluate the predictive role of baseline TyG index for all-cause and cardiovascular (CV) mortality in a large general population.
• To investigate the combined effect of the TyG index and serum uric acid (SUA) on mortality risk, given their known associations with IR and CV risk.

Main Methods:

• Analysis of 16,649 participants from the URRAH cohort.
• Kaplan-Meier estimator and Cox multivariate analysis were used to assess all-cause and CV mortality risk.
• Optimal cut-off points for TyG index were determined for all-cause (4.62) and CV mortality (4.53).

Main Results:

• A median follow-up of 144 months revealed 2569 deaths.
• Participants with a TyG index above the established cut-offs demonstrated a significantly higher risk of all-cause and CV mortality.
• Concurrently elevated TyG index and SUA levels were associated with a greater mortality risk compared to having none or only one elevated factor.

Conclusions:

• Specific thresholds of the TyG index serve as reliable, noninvasive predictors of increased mortality risk in a large, homogeneous general population.
• A synergistic effect exists between the TyG index and SUA in predicting overall mortality risk.