ArticleFrontiers in endocrinology2026
Prognostic value of the triglyceride-glucose index for ICU mortality in non-diabetic sepsis: a restricted cubic spline analysis.
Article in Frontiers in endocrinology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The triglyceride-glucose (TyG) index has been identified as a metabolic marker associated with adverse outcomes in sepsis, but its prognostic value in non-diabetic septic patients remains unclear. Objective: To assess the association between TyG levels and ICU mortality in non-diabetic sepsis and validate the findings in an external cohort. Methods: A retrospective analysis of 2,217 non-diabetic sepsis patients from the MIMIC-IV database was conducted using multivariate logistic regression, threshold effect analysis, restricted cubic spline (RCS) modeling, and subgroup analyses. External validation was performed in an independent ICU cohort of 185 non-diabetic sepsis patients from The Central Hospital of Enshi, stratified by the MIMIC-derived TyG cut-off of 9.163. Results: ICU mortality in the MIMIC cohort was 12.2%. Compared with Q2, Q4 showed a significantly increased mortality risk (OR = 1.49, 95% CI: 1.12-1.97, P = 0.006). RCS analysis demonstrated a significant U-shaped association with a threshold at TyG = 9.163. Subgroup analyses confirmed consistent trends. In the external validation cohort, mortality was higher in the high-TyG group than in the low-TyG group (29.0% vs. 21.7%), showing a directionally consistent, though non-significant, trend (P = 0.23). Conclusion: The TyG index is independently associated with ICU mortality in non-diabetic sepsis and exhibits a clear U-shaped pattern. The external validation cohort demonstrated a similar risk trend, supporting the broader applicability of TyG as a simple metabolic marker for risk stratification.
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