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

Area of Science:

• Metabolic Surgery
• Obesity Management
• Cardiovascular Disease Prevention

Background:

• The triglyceride-glucose (TyG) index is linked to obesity-related comorbidities, particularly cardiovascular diseases.
• Sleeve gastrectomy (SG) can improve these conditions, but the extent of improvement varies among patients.

Purpose of the Study:

• To identify factors influencing the decrease in the TyG index (△TyG) after SG.
• To develop a predictive model for △TyG using preoperative patient data.

Main Methods:

• Collected preoperative and 1-year postoperative data from 744 obese patients undergoing SG.
• Utilized logistic regression to identify predictors of △TyG and developed a nomogram for prediction.
• Validated the nomogram using internal and external datasets and decision curve analysis.

Main Results:

• Identified four independent predictors of △TyG: waist-hip ratio (WHR), high-density lipoprotein cholesterol (HDL-c), uric acid (UA), and the preoperative TyG index.
• The combined predictor achieved an AUC of 0.838, demonstrating significant predictive value.
• The established nomogram showed verified predictive accuracy and clinical utility.

Conclusions:

• SG effectively reduces the TyG index in obese patients.
• Preoperative WHR, HDL-c, UA, and TyG index are key independent predictors of the magnitude of TyG reduction post-SG.
• A predictive model incorporating these factors can accurately forecast the extent of TyG index decrease.