ArticleCardiovascular diabetology2025
The synergistic effect of the triglyceride-glucose index and a body shape index on cardiovascular mortality: the construction of a novel cardiovascular risk marker.
Article in Cardiovascular diabetology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 73 papers, 1 of them a synthesis that pooled it.
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Who cites it
73 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Associations of triglyceride-glucose-related composite obesity indices with cardiovascular diseases and mortality: a systematic review and meta-analysis.Cardiovascular diabetology · 2026Pooled it
- Association and predictive value of the triglyceride glucose-weight adjusted waist index for cardiovascular outcomes in patients with type 2 diabetes.Scientific reports · 2025Trial
- Assessing the Diagnostic Performance of Triglyceride-Glucose-Based Indices for Early Detection of Metabolic Syndrome in Paediatric Down Syndrome.Journal of intellectual disability research : JIDR · 2026Article
- Nine anthropometric insulin resistance indices predict mortality and life expectancy across glucose states.iScience · 2026Article
- Metabolic and Atherogenic Thresholds in the Severity of Erectile Dysfunction: The Dominant Role of the Triglyceride-Glucose Index.Journal of clinical medicine · 2026Article
- Associations of Physical Activity, Sedentary Behaviour, and Sleep with Somatotype Components and a Body Shape Index in Young Adults.Journal of functional morphology and kinesiology · 2026Article
- Long-Term Air Pollution Exposure, Cardiovascular Disease, and Cardiometabolic Risk Factors in Middle-Aged and Older Chinese Adults: A Prospective Cohort Study.Bioengineering (Basel, Switzerland) · 2026Article
- Association Between the Preoperative Triglyceride-Glucose Index and Intraoperative Blood Pressure Variability in Major Abdominal Surgery: A Retrospective Cohort Study.Journal of clinical medicine · 2026Article
- Association Between TyG-WC and Gout in American Adults: A Cross-Sectional Study of NHANES 2003-2018.Health science reports · 2026Article
- Risk Factors for Cardiovascular Disease: Epidemiology, Screening, Prevention, and Therapeutic Interventions.MedComm · 2026Review
- Longitudinal inflammatory-metabolic-adiposity burden and incident heart failure across cardiovascular-kidney-metabolic stages: a prospective cohort study.Cardiovascular diabetology · 2026Article
- Association of C-reactive protein-triglyceride glucose index and its modified indices with stroke risk in individuals at cardiovascular-kidney-metabolic syndrome stages 0-3: a population-based cohort study.Cardiovascular diabetology · 2026Article
- Insulin resistance surrogate indices and incident cardiovascular disease across cardiovascular-kidney-metabolic stages 0-3: a prospective cohort study.Cardiovascular diabetology · 2026Article
- Association of the atherogenic index of plasma and its integrative novel adiposity-based composites with all-cause and cardiovascular mortality in individuals with cardiovascular-kidney-metabolic syndrome: novel adiposity-derived AIP indices provide modest incremental prognostic information.Cardiovascular diabetology · 2026Article
- Correlation between surrogate indicators of insulin resistance and all-cause mortality in patients with severe hemorrhagic stroke: a multicenter retrospective cohort study in the United States.Cardiovascular diabetology · 2026Article
- Combined effect of the triglyceride-glucose index and frailty index on advanced stages among cardiovascular-kidney-metabolic syndrome patients.Journal of cardiothoracic surgery · 2026Article
- Cardiovascular-liver-metabolic multimorbidity: preliminary insights into the associations with the triglyceride glucose index (TyG), its obesity-derived indices and their effects on long-term survival.Cardiovascular diabetology · 2026Article
- Association between insulin resistance surrogate markers and cardiovascular disease risk in individuals with subclinical metabolic disorders: a prospective cohort study based on baseline levels, cumulative exposure, and longitudinal trajectories.Cardiovascular diabetology · 2026Article
- Joint association of TyG-ABSI composite index and inflammatory score with diabetes in middle-aged and older Chinese adults: a prospective cohort study from CHARLS (2011-2020).BMC endocrine disorders · 2026Article
- Integration of triglyceride-glucose index and biological aging to predict cardiovascular disease risk in cardiovascular-kidney-metabolic syndrome stages 0-3: a multiple prospective cohort study.Cardiovascular diabetology · 2026Article
13 more citing papers are in PubMed but not listed here.
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Authors and funding
10 authors.
Funding
Abstract
backgroundInsulin resistance, represented by increased triglyceride-glucose (TyG) index levels, shows interplay with visceral obesity and together promotes cardiovascular diseases and mortality. However, significant controversies exist regarding whether modified TyG indices, such as TyG-BMI, TyG-WC, and TyG-WHtR, outperform the TyG index in predicting cardiovascular outcomes. We aimed to explore whether there was a synergistic effect of a body shape index (ABSI), a better parameter reflecting visceral obesity, and the TyG index on cardiovascular mortality.
methodsWe analyzed data from the National Health and Nutrition Examination Survey (NHANES) 2001-2018 of 17,329 individuals. The associations of the TyG index and ABSI with cardiovascular mortality were investigated via Cox regression analysis and restricted cubic splines. Receiver operating characteristic (ROC) curve analysis was performed to compare the predictive value. Mediation analysis was used to explore the potential mediator.
resultsA total of 673 (3.9%) cardiovascular deaths occurred during a median follow-up of 8.92 years. Individuals with high TyG and high ABSI (TyG > 9.04 and ABSI > 0.085) were at the highest cardiovascular mortality risk both in individuals with (HR = 1.714, 95% CI 1.123-2.616) and without diabetes (HR = 1.402, 95% CI 1.003-1.960), suggesting a synergistic effect. Next, we multiplied these two indicators and established TyG-ABSI. It showed a J-shaped relationship and a positive linear relationship with cardiovascular mortality in individuals with and without diabetes, respectively. Arterial stiffness, represented by estimated pulse wave velocity, partially mediated the effect of TyG-ABSI on cardiovascular mortality, with a mediation proportion of 42.7%. The predictive value of TyG-ABSI was greater than that of the TyG index, TyG-BMI, TyG-WC, and TyG-WHtR (Harrell's C-index: 0.710 vs 0.623 vs 0.539 vs 0.612 vs 0.622, all p < 0.001).
conclusionsThe simultaneous assessment of the TyG index and ABSI revealed a synergistic effect on cardiovascular mortality. We recommended the use of TyG-ABSI instead of the TyG index and other modified TyG indices in cardiovascular risk assessment.
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