Association between the insulin resistance and all-cause mortality in patients with moderate and severe aortic stenosis: a retrospective cohort study
Abstract Background The triglyceride-glucose (TyG) index is a reliable surrogate marker of insulin resistance (IR). However, whether the TyG index has prognostic value in patients with moderate to severe aortic stenosis (AS) remains unclear. Methods This study enrolled 317 patients with moderate to...
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| Format: | Article |
| Language: | English |
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BMC
2023-09-01
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| Series: | Cardiovascular Diabetology |
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| Online Access: | https://doi.org/10.1186/s12933-023-01975-5 |
| _version_ | 1797454004305788928 |
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| author | Rihua Huang Xinghao Xu Chaoguang Xu Shaozhao Zhang Zhenyu Xiong Menghui Liu Yiquan Huang Han Wen Yue Guo Xinxue Liao Xiaodong Zhuang |
| author_facet | Rihua Huang Xinghao Xu Chaoguang Xu Shaozhao Zhang Zhenyu Xiong Menghui Liu Yiquan Huang Han Wen Yue Guo Xinxue Liao Xiaodong Zhuang |
| author_sort | Rihua Huang |
| collection | DOAJ |
| description | Abstract Background The triglyceride-glucose (TyG) index is a reliable surrogate marker of insulin resistance (IR). However, whether the TyG index has prognostic value in patients with moderate to severe aortic stenosis (AS) remains unclear. Methods This study enrolled 317 patients with moderate to severe AS at the First Affiliated Hospital of Sun Yat-Sen University. The patients were grouped according to the cut-off value of the TyG index. Cox regression with Firth’s penalized maximum likelihood method and restricted cubic splines regression were conducted to assess the association between the TyG index and all-cause mortality. The added value of the TyG index included in the traditional risk factors model for outcome prediction was also analyzed. Results Among 317 patients (mean age 67.70 years, 62.8% male), there was 84 all-cause mortality during a median 38.07 months follow-up. After fully adjusting for confounders, a per-unit increase in the TyG index was associated with a 62% higher all-cause mortality risk (HR 1.622, 95% CI 1.086–2.416, p = 0.018). The restricted cubic splines regression model revealed a linear association between the TyG index and the risk of all-cause mortality (p for nonlinearity = 0.632). The addition of the TyG index in the basic risk model has an incremental effect on the prediction of mortality [C-statistic change from 0.755 to 0.768; continuous net reclassification improvement (95% CI): 0.299 (0.051–0.546), p = 0.017; integrated discrimination improvement: 0.017 (0.001–0.033), p = 0.044]. Conclusions Higher IR assessed by the TyG index was associated with a higher risk of all-cause mortality in patients with moderate and severe AS. |
| first_indexed | 2024-03-09T15:30:59Z |
| format | Article |
| id | doaj.art-32c5347c2c804584b047cb142bf85e19 |
| institution | Directory Open Access Journal |
| issn | 1475-2840 |
| language | English |
| last_indexed | 2024-03-09T15:30:59Z |
| publishDate | 2023-09-01 |
| publisher | BMC |
| record_format | Article |
| series | Cardiovascular Diabetology |
| spelling | doaj.art-32c5347c2c804584b047cb142bf85e192023-11-26T12:15:38ZengBMCCardiovascular Diabetology1475-28402023-09-0122111010.1186/s12933-023-01975-5Association between the insulin resistance and all-cause mortality in patients with moderate and severe aortic stenosis: a retrospective cohort studyRihua Huang0Xinghao Xu1Chaoguang Xu2Shaozhao Zhang3Zhenyu Xiong4Menghui Liu5Yiquan Huang6Han Wen7Yue Guo8Xinxue Liao9Xiaodong Zhuang10Department of Cardiology, the First Affiliated Hospital of Sun Yat-Sen UniversityDepartment of Cardiology, the First Affiliated Hospital of Sun Yat-Sen UniversityDepartment of Cardiology, the First Affiliated Hospital of Sun Yat-Sen UniversityDepartment of Cardiology, the First Affiliated Hospital of Sun Yat-Sen UniversityDepartment of Cardiology, the First Affiliated Hospital of Sun Yat-Sen UniversityDepartment of Cardiology, the First Affiliated Hospital of Sun Yat-Sen UniversityDepartment of Cardiology, the First Affiliated Hospital of Sun Yat-Sen UniversityDepartment of Cardiology, the First Affiliated Hospital of Sun Yat-Sen UniversityDepartment of Cardiology, the First Affiliated Hospital of Sun Yat-Sen UniversityDepartment of Cardiology, the First Affiliated Hospital of Sun Yat-Sen UniversityDepartment of Cardiology, the First Affiliated Hospital of Sun Yat-Sen UniversityAbstract Background The triglyceride-glucose (TyG) index is a reliable surrogate marker of insulin resistance (IR). However, whether the TyG index has prognostic value in patients with moderate to severe aortic stenosis (AS) remains unclear. Methods This study enrolled 317 patients with moderate to severe AS at the First Affiliated Hospital of Sun Yat-Sen University. The patients were grouped according to the cut-off value of the TyG index. Cox regression with Firth’s penalized maximum likelihood method and restricted cubic splines regression were conducted to assess the association between the TyG index and all-cause mortality. The added value of the TyG index included in the traditional risk factors model for outcome prediction was also analyzed. Results Among 317 patients (mean age 67.70 years, 62.8% male), there was 84 all-cause mortality during a median 38.07 months follow-up. After fully adjusting for confounders, a per-unit increase in the TyG index was associated with a 62% higher all-cause mortality risk (HR 1.622, 95% CI 1.086–2.416, p = 0.018). The restricted cubic splines regression model revealed a linear association between the TyG index and the risk of all-cause mortality (p for nonlinearity = 0.632). The addition of the TyG index in the basic risk model has an incremental effect on the prediction of mortality [C-statistic change from 0.755 to 0.768; continuous net reclassification improvement (95% CI): 0.299 (0.051–0.546), p = 0.017; integrated discrimination improvement: 0.017 (0.001–0.033), p = 0.044]. Conclusions Higher IR assessed by the TyG index was associated with a higher risk of all-cause mortality in patients with moderate and severe AS.https://doi.org/10.1186/s12933-023-01975-5Triglyceride-glucose indexMortalityAortic stenosis |
| spellingShingle | Rihua Huang Xinghao Xu Chaoguang Xu Shaozhao Zhang Zhenyu Xiong Menghui Liu Yiquan Huang Han Wen Yue Guo Xinxue Liao Xiaodong Zhuang Association between the insulin resistance and all-cause mortality in patients with moderate and severe aortic stenosis: a retrospective cohort study Cardiovascular Diabetology Triglyceride-glucose index Mortality Aortic stenosis |
| title | Association between the insulin resistance and all-cause mortality in patients with moderate and severe aortic stenosis: a retrospective cohort study |
| title_full | Association between the insulin resistance and all-cause mortality in patients with moderate and severe aortic stenosis: a retrospective cohort study |
| title_fullStr | Association between the insulin resistance and all-cause mortality in patients with moderate and severe aortic stenosis: a retrospective cohort study |
| title_full_unstemmed | Association between the insulin resistance and all-cause mortality in patients with moderate and severe aortic stenosis: a retrospective cohort study |
| title_short | Association between the insulin resistance and all-cause mortality in patients with moderate and severe aortic stenosis: a retrospective cohort study |
| title_sort | association between the insulin resistance and all cause mortality in patients with moderate and severe aortic stenosis a retrospective cohort study |
| topic | Triglyceride-glucose index Mortality Aortic stenosis |
| url | https://doi.org/10.1186/s12933-023-01975-5 |
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