Triglyceride-Glucose Body Mass Index Predicts Asthma Exacerbations: A Prospective Study

Insulin resistance, a central feature of metabolic syndrome, has been associated with asthma exacerbations. However, the role of metabolic markers, specifically the triglyceride-glucose body mass index (TyG-BMI), in predicting asthma exacerbations is not fully explored. This study explored the predictive value of the TyG-BMI, a biomarker of metabolic syndrome and insulin resistance, in the risk of asthma exacerbations.

This single-center prospective cohort study enrolled 484 patients with stable asthma between March and October of 2023. The study employed K-means clustering analysis to categorize patients according to TyG-BMI. The primary endpoint was the first occurrence of asthma exacerbation during one year of follow-up. Additionally, weighted quantile sum regression was performed to quantify the contribution of fasting triglycerides (TGs), fasting blood glucose, and BMI to the TyG-BMI, aiming to provide a more comprehensive explanation.

Of the 484 patients who met the study criteria, 359 experienced exacerbations during the study period. The fully adjusted model showed an odds ratio of 10.65 (95% confidence interval, 2.51-45.25) for patients with higher TyG-BMI levels. Restricted cubic spline analysis revealed a threshold effect at the TyG-BMI of 215, beyond which the asthma exacerbation rate increased significantly. Weight assignment analysis indicated that TG was the primary contributor to the TyG-BMI.

The TyG-BMI is an independent risk factor for asthma exacerbation, highlighting its potential utility in identifying high-risk patients and guiding personalized interventions.