Evidence mapPaperPMID 39574113Full record

ArticleLipids in health and disease2024

Correlation of the triglyceride-glucose index and heart rate with 28-day all-cause mortality in severely ill patients: analysis of the MIMIC-IV database.

Yuekai Shao, Zhikun Gan, Taishan Wang, Zhiqiang Shao, Hong Yu, Song Qin, Hong Mei, Tao Chen, Xiaoyun Fu, Guoyue Liu and 1 more

Abstract read
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Article in Lipids in health and disease, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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2 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

11 authors.

Yuekai ShaoDepartment of Critical Care Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, China.
Zhikun GanDepartment of Critical Care Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, China.
Taishan WangDepartment of Anesthesiology, Zhejiang Provincial People's Hospital Bijie Hospital, Bijie, 551700, China.
Zhiqiang ShaoDepartment of Critical Care Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, China.
Hong YuDepartment of Critical Care Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, China.
Song QinDepartment of Critical Care Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, China.
Hong MeiDepartment of Critical Care Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, China.
Tao ChenDepartment of Critical Care Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, China.
Xiaoyun FuDepartment of Critical Care Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, China.
Guoyue LiuIntensive Care Unit, The Second Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, China. drliuguoyue@outlook.com.
Miao ChenDepartment of Critical Care Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, China. chenmiao64@163.com.

Funding

Science and Technology Projects of Guizhou Province QKHZC [2020]4Y199
6 · The paper itself

Abstract

backgroundResearch has identified a link between the triglyceride-glucose index (TyG-i) and the risk of mortality in severely ill patients. However, it remains uncertain if the TyG-i affects mortality by influencing heart rate (HR).

methodsThis study enrolled 3,509 severely ill participants from the Medical Information Mart for Intensive Care (MIMIC-IV) database who had triglyceride, glucose, and HR data upon entering the ICU. Cox regression models were applied to estimate the effect of the TyG-i and HR on 28-day all-cause mortality (ACM) and 28-day in-hospital mortality (IHM). Additionally, Kaplan-Meier (K-M) survival analysis was employed to explore outcome variations among different patient groups. The association of the TyG-i with HR, Sequential Organ Failure Assessment (SOFA) score, and Simplified Acute Physiology Score (SAPS) II was explored through linear regression analysis. Subgroup analysis explored potential interactions among patient characteristics, while sensitivity analysis gauged the robustness of the findings. Additionally, mediation analysis was conducted to assess whether elevated HR acts as an intermediary factor linking the TyG-i to both 28-day ACM and 28-day IHM.

resultsDuring the 28-day follow-up, 586 cases (16.7%) died from all causes, and 439 cases (12.5%) died during hospitalisation. Cox results showed that individuals with a heightened TyG-i and elevated HR had the highest 28-day ACM (Hazard Ratio 1.70, P-value below 0.001) and 28-day IHM (Hazard Ratio 1.72, P-value below 0.001) compared to those with a reduced TyG-i and HR. The K-M curves showed that individuals with low TyG-i and low HR had the lowest incidence of 28-day ACM and 28-day IHM. The linear analysis results evidenced that the TyG-i was independently connected to HR (beta = 3.05, P-value below 0.001), and the TyG-i was also independently associated with SOFA score (beta = 0.39, P-value below 0.001) and SAPS II (beta = 1.79, P-value below 0.001). Subgroup analysis revealed a significant association in participants without hypertension, the interaction of an elevated TyG-i and HR strongly correlated with a higher 28-day death risk (interaction P-value below 0.05). Furthermore, HR mediated 29.5% of the connection between the TyG-i and 28-day ACM (P-value = 0.002), as well as 20.4% of the connection between the TyG-i and 28-day IHM (P-value = 0.002).

conclusionFor severely ill patients, the TyG-i is distinctly correlated with HR, and elevated levels of both are strongly connected to greater 28-day ACM and 28-day IHM risks, especially in patients without hypertension. Furthermore, elevated HR mediates the connection between the TyG-i and 28-day mortality.

Indexed as

Blood GlucoseCritical IllnessHeart RateHospital MortalityTriglyceridesAgedDatabases, FactualFemaleHumansIntensive Care UnitsKaplan-Meier EstimateMaleMiddle AgedOrgan Dysfunction ScoresProportional Hazards ModelsRisk FactorsBlood GlucoseTriglyceridesHeart rateMediation analysisMortalitySeverely ill patientsTriglyceride-glucose index

Identifiers

PMID39574113
PMCPMC11580213

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.