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TyG Index and Frailty as Composite Biomarkers of Cardiometabolic Risk and Mortality Across CKM Stages 0-3
Yaocheng Luo1,2,3,4, Peng Zeng1,2,3,4, Shuoya Huang1,2,3,4
1School of Public Health, Chongqing Medical University, Chongqing 400016, China.
Insights
The triglyceride-glucose-frailty index (TyG-FI) is linked to higher risks of cardiovascular-kidney-metabolic (CKM) syndrome outcomes. This index may help stratify risk in early to mid-stages of CKM syndrome.
Area of Science:
- Cardiology
- Metabolic Syndrome Research
- Gerontology
Background:
- Cardiovascular-kidney-metabolic (CKM) syndrome is a significant health concern linked to cardiovascular disease and mortality.
- The combined impact of metabolic dysfunction and frailty, measured by the triglyceride-glucose-frailty index (TyG-FI), is not well understood in CKM syndrome.
- Investigating TyG-FI's role in early CKM stages (0-3) is crucial for risk assessment.
Purpose of the Study:
- To examine the association between the triglyceride-glucose-frailty index (TyG-FI) and incident composite outcomes in individuals with cardiovascular-kidney-metabolic (CKM) syndrome stages 0-3.
- To explore potential nonlinear relationships and dose-response patterns between TyG-FI and adverse outcomes.
- To assess the discriminatory power of TyG-FI for risk stratification in early to mid-stages of CKM syndrome.
Main Methods:
- Utilized data from two large cohort studies in China and the United States, focusing on participants in CKM stages 0-3.
- Employed Cox proportional hazards models to analyze the relationship between TyG-FI and incident composite outcomes.
- Investigated nonlinear associations using spline functions and assessed model performance across subgroups and assumptions.
Main Results:
- Higher quartiles of TyG-FI were significantly associated with increased incidence of composite outcomes, demonstrating a dose-response pattern.
- Nonlinear relationships were identified with inflection points at TyG-FI values of 1.01 and 2.29.
- TyG-FI showed moderate discriminatory power (AUCs 0.714 and 0.744) and consistent associations across subgroups.
Conclusions:
- Higher TyG-FI scores are independently linked to increased incident composite outcomes in CKM stages 0-3, with a nonlinear association.
- TyG-FI exhibits moderate predictive ability, suggesting its utility as a supplementary tool for risk stratification in early to mid-CKM syndrome.
- Further validation is needed to establish the full clinical predictive value of TyG-FI in CKM syndrome management.
Abstract:
Background: Cardiovascular disease and mortality are common outcomes of cardiovascular-kidney-metabolic (CKM) syndrome. The integrated role of metabolic dysfunction and frailty, quantified by the triglyceride-glucose-frailty index (TyG-FI), remains insufficiently explored. This study examined the association between TyG-FI and incident composite outcomes among participants with CKM stages 0-3. Methods: Data were obtained from two large cohort studies conducted in China and the United States. The analysis focused on participants classified as CKM stages 0-3. Cox proportional hazards models were used to estimate the relationship between TyG-FI and incident composite outcomes. Nonlinear associations were explored using spline functions. Additional analyses were performed across different subgroups and under varied assumptions. Model performance over time was also assessed. Results: Significant differences in outcome incidence were observed across TyG-FI levels. Higher quartiles showed a gradual increase in risk and displayed a dose-response pattern, with inflection points at 1.01 and 2.29. Associations were consistent across subgroups, and TyG-FI demonstrated moderate discrimination (AUCs 0.714 and 0.744). Conclusions: In the CHARLS and HRS cohorts, higher TyG-FI scores were independently associated with an increased risk of incident composite outcomes among participants with CKM stages 0-3, with a nonlinear relationship observed. Its discriminatory power was moderate, suggesting that TyG-FI may serve as a supplementary indicator for risk stratification in the early to mid-stages, although its clinical predictive value requires further validation.
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