The association between TyG index and cardiovascular mortality is modified by antidiabetic or lipid-lowering agent: a prospective cohort study
Abstract Background The triglyceride-glucose (TyG) index is recognized as an alternative measure of insulin resistance (IR) and has been linked to the risks of cardiovascular disease (CVD) and mortality. This study aimed to evaluate whether the association between the TyG index and CVD mortality is...
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BMC
2025-02-01
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| Series: | Cardiovascular Diabetology |
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| Online Access: | https://doi.org/10.1186/s12933-025-02620-z |
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| author | Changchang Fang Nanqin Peng Jiang Cheng Xiyu Zhang Wenli Gu Zicheng Zhu Xiaoping Yin Zhiwei Yan Jing Zhang Peng Yu Xiao Liu |
| author_facet | Changchang Fang Nanqin Peng Jiang Cheng Xiyu Zhang Wenli Gu Zicheng Zhu Xiaoping Yin Zhiwei Yan Jing Zhang Peng Yu Xiao Liu |
| author_sort | Changchang Fang |
| collection | DOAJ |
| description | Abstract Background The triglyceride-glucose (TyG) index is recognized as an alternative measure of insulin resistance (IR) and has been linked to the risks of cardiovascular disease (CVD) and mortality. This study aimed to evaluate whether the association between the TyG index and CVD mortality is influenced by the use of antidiabetic and hypolipidemic agents, given their potential modifying effects on the TyG index. Methods Participants from the National Health and Nutrition Examination Survey (1999–2018) were included in the study. Mortality outcomes were tracked through linkage with National Death Index records until December 31, 2019. Data on the use of antidiabetic and hypolipidemic medications (including prescribed insulin, diabetic pills, and cholesterol-lowering agents) were self-reported by participants. Results A total of 5,046 adults (representing 42,753,806 individuals, weighted mean age 61.08 years [SE: 0.24]; 49.35% female) were analyzed. The TyG index was significantly associated with all-cause and CVD mortality, and these associations were modified by the use of antidiabetic and hypolipidemic agents (p < 0.01). Significant interactions were observed between the TyG index and the use of these agents for mortality outcomes after full adjustments (p-value for interaction < 0.05). Exposure-effect analysis revealed a U-shaped relationship between TyG index levels and the risks of all-cause and CVD mortality in participants using these agents, while a linear positive relationship was observed in participants not using these agents. Conclusions The use of antidiabetic and hypolipidemic agents modify the association between the TyG index and all-cause and CVD mortality. These findings suggest that future studies on the TyG index and its relationship with CVD and mortality should account for the modifying effects of these agents. Graphical abstract |
| format | Article |
| id | doaj-art-96a132549dd84f1592b9fa0dd30855be |
| institution | Kabale University |
| issn | 1475-2840 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMC |
| record_format | Article |
| series | Cardiovascular Diabetology |
| spelling | doaj-art-96a132549dd84f1592b9fa0dd30855be2025-02-09T12:10:47ZengBMCCardiovascular Diabetology1475-28402025-02-0124111510.1186/s12933-025-02620-zThe association between TyG index and cardiovascular mortality is modified by antidiabetic or lipid-lowering agent: a prospective cohort studyChangchang Fang0Nanqin Peng1Jiang Cheng2Xiyu Zhang3Wenli Gu4Zicheng Zhu5Xiaoping Yin6Zhiwei Yan7Jing Zhang8Peng Yu9Xiao Liu10Department of Endocrinology and Metabolism, the Second Affiliated Hospital, Jiangxi Medical College, Nanchang UniversityDepartment of Endocrinology and Metabolism, the Second Affiliated Hospital, Jiangxi Medical College, Nanchang UniversityDepartment of Anesthesiology, the Second Affiliated Hospital, Jiangxi Medical College, Nanchang UniversityDepartment of Endocrinology and Metabolism, the Second Affiliated Hospital, Jiangxi Medical College, Nanchang UniversityCardiology Division, Department of Medicine, Queen Mary Hospital, The University of Hong KongDepartment of Anesthesiology, the Second Affiliated Hospital, Jiangxi Medical College, Nanchang UniversityDepartment of Neurology, Affiliated Hospital of Jiujiang UniversityProvincial University Key Laboratory of Sport and Health Science, School of Physical Education and Sport Sciences, Fujian Normal UniversityDepartment of Anesthesiology, the Second Affiliated Hospital, Jiangxi Medical College, Nanchang UniversityDepartment of Endocrinology and Metabolism, the Second Affiliated Hospital, Jiangxi Medical College, Nanchang UniversityDepartment of Cardiology, Sun Yat-sen Memorial Hospital of Sun Yat-sen UniversityAbstract Background The triglyceride-glucose (TyG) index is recognized as an alternative measure of insulin resistance (IR) and has been linked to the risks of cardiovascular disease (CVD) and mortality. This study aimed to evaluate whether the association between the TyG index and CVD mortality is influenced by the use of antidiabetic and hypolipidemic agents, given their potential modifying effects on the TyG index. Methods Participants from the National Health and Nutrition Examination Survey (1999–2018) were included in the study. Mortality outcomes were tracked through linkage with National Death Index records until December 31, 2019. Data on the use of antidiabetic and hypolipidemic medications (including prescribed insulin, diabetic pills, and cholesterol-lowering agents) were self-reported by participants. Results A total of 5,046 adults (representing 42,753,806 individuals, weighted mean age 61.08 years [SE: 0.24]; 49.35% female) were analyzed. The TyG index was significantly associated with all-cause and CVD mortality, and these associations were modified by the use of antidiabetic and hypolipidemic agents (p < 0.01). Significant interactions were observed between the TyG index and the use of these agents for mortality outcomes after full adjustments (p-value for interaction < 0.05). Exposure-effect analysis revealed a U-shaped relationship between TyG index levels and the risks of all-cause and CVD mortality in participants using these agents, while a linear positive relationship was observed in participants not using these agents. Conclusions The use of antidiabetic and hypolipidemic agents modify the association between the TyG index and all-cause and CVD mortality. These findings suggest that future studies on the TyG index and its relationship with CVD and mortality should account for the modifying effects of these agents. Graphical abstracthttps://doi.org/10.1186/s12933-025-02620-zTriglyceride-glucose indexCardiovascular DiseaseAll-cause mortalityHypolipidemic agents |
| spellingShingle | Changchang Fang Nanqin Peng Jiang Cheng Xiyu Zhang Wenli Gu Zicheng Zhu Xiaoping Yin Zhiwei Yan Jing Zhang Peng Yu Xiao Liu The association between TyG index and cardiovascular mortality is modified by antidiabetic or lipid-lowering agent: a prospective cohort study Cardiovascular Diabetology Triglyceride-glucose index Cardiovascular Disease All-cause mortality Hypolipidemic agents |
| title | The association between TyG index and cardiovascular mortality is modified by antidiabetic or lipid-lowering agent: a prospective cohort study |
| title_full | The association between TyG index and cardiovascular mortality is modified by antidiabetic or lipid-lowering agent: a prospective cohort study |
| title_fullStr | The association between TyG index and cardiovascular mortality is modified by antidiabetic or lipid-lowering agent: a prospective cohort study |
| title_full_unstemmed | The association between TyG index and cardiovascular mortality is modified by antidiabetic or lipid-lowering agent: a prospective cohort study |
| title_short | The association between TyG index and cardiovascular mortality is modified by antidiabetic or lipid-lowering agent: a prospective cohort study |
| title_sort | association between tyg index and cardiovascular mortality is modified by antidiabetic or lipid lowering agent a prospective cohort study |
| topic | Triglyceride-glucose index Cardiovascular Disease All-cause mortality Hypolipidemic agents |
| url | https://doi.org/10.1186/s12933-025-02620-z |
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