Evidence mapPaperPMID 41904528Full record

ArticleCardiovascular diabetology2026

Association between triglyceride-glucose index and related indicators with heart failure-related mortality in individuals with early-stage cardiovascular-kidney-metabolic syndrome.

Xiandu Jin, Yurong Feng, Chang Liu, Tianwei Cheng, Yanye Jin, Zibin Shao, Yongyu Bian, Hao Wu, Jiao Li, Yue Liu and 3 more

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Article in Cardiovascular diabetology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

13 authors.

Xiandu JinSchool of Medicine, Nankai University, Tianjin, People's Republic of China.
Yurong FengSchool of Medicine, Nankai University, Tianjin, People's Republic of China.
Chang LiuSchool of Medicine, Nankai University, Tianjin, People's Republic of China.
Tianwei ChengSchool of Medicine, Nankai University, Tianjin, People's Republic of China.
Yanye JinSchool of Medicine, Nankai University, Tianjin, People's Republic of China.
Zibin ShaoSchool of Medicine, Nankai University, Tianjin, People's Republic of China.
Yongyu BianSchool of Medicine, Nankai University, Tianjin, People's Republic of China.
Hao WuSchool of Medicine, Nankai University, Tianjin, People's Republic of China.
Jiao LiDepartment of Cardiology, Tianjin Union Medical Center, The First Affiliated Hospital of Nankai University, Nankai University, Tianjin, People's Republic of China.
Yue LiuSchool of Medicine, Nankai University, Tianjin, People's Republic of China. liuyue0422@163.com.
Liping WeiSchool of Medicine, Nankai University, Tianjin, People's Republic of China. weilipingme@163.com.
Zhi QiSchool of Medicine, Nankai University, Tianjin, People's Republic of China. qizhi@nankai.edu.cn.
Xin QiSchool of Medicine, Nankai University, Tianjin, People's Republic of China. qixinx2011@126.com.

Funding

National International Science and Technology Cooperation Project of China No. S2011ZR02601Tianjin Science and Technology Planning Project No.16ZXMJSY00060Tianjin Science and Technology Project No.23JCYBJC01470
6 · The paper itself

Abstract

backgroundInsulin resistance is a central pathophysiological feature of cardiovascular-kidney-metabolic (CKM) syndrome and has been implicated in adverse cardiovascular outcomes. However, the association between triglyceride-glucose (TyG) index-related indicators and heart failure (HF)-related mortality in individuals with early-stage CKM syndrome remains unclear.

methodsThis research conducted a prospective analysis using data from the National Health and Nutrition Examination Survey (NHANES) 2005-2018. Participants with CKM stages 0-2 and without clinical cardiovascular disease at baseline were included. TyG and related indices (TyG-BMI, TyG-WC, and TyG-WHtR) were analyzed as continuous and quartile-based variables. The primary outcome was HF-related mortality, ascertained via linkage to the National Death Index. Associations were assessed using Cox proportional hazards and Fine-Gray competing risk models with hierarchical adjustment, including additional adjustment for CKM stage in extended models. Machine learning approaches (Boruta and SHAP) were applied for covariate selection. Nonlinear associations, predictive performance, mediation by HbA1c, and subgroup effects were further evaluated.

resultsAmong 14,830 participants, higher TyG-related indices were associated with increased HF-related mortality during follow-up. After full adjustment, each 1-SD increase in TyG-WC and TyG-WHtR was associated with a 2.27-fold and 2.94-fold higher risk of HF-related mortality, respectively (all P < 0.05). The associations remained consistent after additional adjustment for CKM stage. Restricted cubic spline analyses demonstrated predominantly linear dose-response relationships. TyG-WHtR exhibited the strongest discriminatory ability (AUC = 0.641, 95% CI 0.601-0.680). Mediation analyses indicated that HbA1c accounted for approximately 15%-30% of the observed associations. Associations were generally consistent across clinically relevant subgroups and remained robust in competing risk analyses and sensitivity analyses.

conclusionsIn individuals with early-stage CKM syndrome, TyG-related indices-particularly those incorporating central adiposity-are independently associated with HF-related mortality. These findings highlight the prognostic relevance of insulin resistance-related metabolic burden in the early stages of CKM syndrome.

Indexed as

Blood GlucoseCardio-Renal SyndromeHeart FailureMetabolic SyndromeTriglyceridesAgedBiomarkersFemaleHumansInsulin ResistanceMaleMiddle AgedNutrition SurveysPredictive Value of TestsPrognosisProspective StudiesBiomarkersBlood GlucoseTriglyceridesCKM syndromeHbA1cHeart failure-related mortalityTyGTyG-related indicators

Identifiers

PMID41904528
PMCPMC13151195

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LicenceCC BY-NC-ND
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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.