Influencing and predictive factors of the decrease in the triglyceride-glucose index following sleeve gastrectomy

The triglyceride-glucose index (TyG) has shown comprehensive value in relation to numerous obesity-associated comorbidities, especially cardiovascular diseases. Although their incidence risk and severity are lowered following sleeve gastrectomy (SG), the extent of relief varies.

To analyze potential influencing factors of decrease in the TyG index (△TyG) following SG, and establish a predictive model using preoperative data.

University hospital, China.

Preoperative and 1-year postoperative data of patients with obesity who underwent SG were collected. After being randomly divided at a proportion of 70%, the patients in the modeling group were further divided into group A (decreased poorly) and group B (decreased satisfactorily) based on the degree of △TyG. After screening the variables with significant differences between the groups, we conducted logistic regression analysis to identify the influencing factors related to △TyG and those with a predictive value. Subsequently, a nomogram was established. Internal, external validations and decision curve analysis (DCA) were performed. Clinical impact curve (CIC) was drawn.

The study included 744 patients. Four independent predictors, namely waist-hip ratio (WHR), high-density lipoprotein cholesterol (HDL-c), uric acid (UA), and TyG index were identified. The joint predictor formed by combining these four factors had an area under the curve of .838 (.803-.868) and a significantly better predictive value. The predictive accuracy and clinical net benefit of the nomogram established utilizing the joint predictor were verified.

SG can lead to significant △TyG, with preoperative WHR, HDL-c, UA, and TyG index being independent predictors. The joint predictor can effectively predict the magnitude of the decrease.