Dataset Information

Fasting status modifies the association between triglyceride and all-cause mortality: A cohort study.

ABSTRACT:

Background and aims

Both fasting and non-fasting levels of triglyceride have been shown positively associated with all-cause mortality. It is unknown whether fasting status modifies this association. This study aimed to address this question.

Methods

This study included 34,512 US adults (27,036 fasting and 7476 nonfasting participants). All-cause mortality was ascertained by linkage to the National Death Index records. Cox proportional hazards models were used to estimate hazard ratios of triglyceride for mortality.

Results

This cohort was followed up for a mean of 13.0 years. During the follow-up, 8491 all-cause deaths were recorded. A 1-natural-log-unit increase in triglyceride was associated with an 8% higher multivariate-adjusted risk of all-cause mortality. Interaction analyses showed that fasting status interacted with triglyceride in predicting all-cause mortality. Sub-analyses showed that a 1-natural-log-unit increase in triglyceride was associated with a 17% higher multivariate-adjusted risk of all-cause mortality in the nonfasting subcohort; however, there lacked such an association in the fasting sub-cohort. Similarly, high (200-499 mg/dL) and very high levels of triglyceride (≥500 mg/dL) were associated with higher all-cause mortality risks compared with low normal triglyceride (<100 mg/dL) only in the nonfasting subcohort.

Conclusion

This study found that, compared to fasting triglyceride, nonfasting triglyceride was more sensitive in predicting all-cause mortality. This study supports the initiatives by some guidelines to recommend the use of nonfasting triglycerides for risk assessment.

SUBMITTER: Fang Y

PROVIDER: S-EPMC9110781 | biostudies-literature | 2022 May

REPOSITORIES: biostudies-literature

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Publications

Fasting status modifies the association between triglyceride and all-cause mortality: A cohort study.

Fang Yan Y Wang Yutang Y

Health science reports 20220516 3

<h4>Background and aims</h4>Both fasting and non-fasting levels of triglyceride have been shown positively associated with all-cause mortality. It is unknown whether fasting status modifies this association. This study aimed to address this question.<h4>Methods</h4>This study included 34,512 US adults (27,036 fasting and 7476 nonfasting participants). All-cause mortality was ascertained by linkage to the National Death Index records. Cox proportional hazards models were used to estimate hazard r ...[more]

PMID: 35601035

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Project description:BackgroundAlthough triglyceride-glucose (TyG) index is a reliable indicator of insulin resistance and cardiometabolic disease, its effectiveness in predicting mortality risk has not been adequately validated. We aimed to investigate the association between the TyG-related indices and all-cause and cause-specific mortality in the general population.MethodsA total of 27,642 individuals were included from the National Health and Nutrition Examination Survey (NHANES) between 1999 and 2018. Three indicators were constructed, including the TyG index, TyG combined with waist-to-height ratio (TyG-WHtR), and TyG combined with waist circumference (TyG-WC). Mortality data was acquired through the linkage of NHANES data with National Death Index records. Weighted Cox proportional hazards models were used to estimate the independent association between the TyG-related indices and mortality. Nonlinear associations were explored using restricted cubic splines.ResultsMultivariable adjusted models showed a progressive increase in all-cause and cause-specific mortality across quartiles of the TyG-related indices. Compared with the lowest quartile of the TyG index, the highest quartile had adjusted hazard ratios of 1.26 (95% CI 1.04-1.52) for all-cause mortality, 1.38 (1.04-1.74) for cardiovascular mortality, and 1.23 (1.01-1.50) for non-cardiovascular mortality, respectively. For the TyG-WHtR index, the corresponding hazard ratios were 1.60 (1.25-2.05), 1.86 (1.26-2.50), and 1.48 (1.10-1.99), respectively. For the TyG-WC index, the corresponding hazard ratios were 1.42 (1.11-1.75), 1.48 (1.04-1.96), and 1.38 (1.05-1.72), respectively. The associations between the three TyG-related indices and all-cause, cardiovascular and non-cardiovascular mortality were J-shaped. Interaction tests revealed significant effect modification by age, low-density lipoprotein cholesterol (LDL-C) level, and statin use (all P values < 0.05).ConclusionsThe TyG-related indices were independent predictors of all-cause and cause-specific mortality in the general population. Young individuals should be particularly vigilant, whereas low LDL-C levels and statin use are potentially protective.

Project description:BackgroundPrevious studies have shown that an elevated triglyceride-glucose (TyG) index was associated with all-cause mortality in both general adult individuals and critically ill adult patients. However, the relationship between the TyG index and clinical prognosis in pediatric patients admitted to the intensive care unit (ICU) remains unknown. We aimed to investigate the association of the TyG index with in-hospital all-cause mortality in critically ill pediatric patients.MethodsA total of 5706 patients in the Pediatric Intensive Care database were enrolled in this study. The primary outcome was 30-day in-hospital all-cause mortality, and secondary outcome was 30-day in-ICU all-cause mortality. The restricted cubic spline (RCS) curves and two-piecewise multivariate Cox hazard regression models were performed to explore the relationship between the TyG index and outcomes.ResultsThe median age of the study population was 20.5 [interquartile range (IQR): 4.8, 63.0] months, and 3269 (57.3%) of the patients were male. The mean TyG index level was 8.6 ± 0.7. A total of 244 (4.3%) patients died within 30 days of hospitalization during a median follow-up of 11 [7, 18] days, and 236 (4.1%) patients died in ICU within 30 days of hospitalization during a median follow-up of 6 [3, 11] days. The RCS curves indicated a U-shape association between the TyG index and 30-day in-hospital and in-ICU all-cause mortality (both P values for non-linear < 0.001). The risk of 30-day in-hospital all-cause mortality was negatively correlated with the TyG index until it bottoms out at 8.6 (adjusted hazard ratio [HR], 0.72, 95% confidence interval [CI] 0.55-0.93). However, when the TyG index was higher than 8.6, the risk of primary outcome increased significantly (adjusted HR, 1.51, 95% CI 1.16-1.96]). For 30-day in-ICU all-cause mortality, we also found a similar relationship (TyG < 8.6: adjusted HR, 0.75, 95% CI 0.57-0.98; TyG ≥ 8.6: adjusted HR, 1.42, 95% CI 1.08-1.85). Those results were consistent in subgroups and various sensitivity analysis.ConclusionsOur study showed that the association between the TyG index and 30-day in-hospital and in-ICU all-cause mortality was nonlinear U-shaped, with a cutoff point at the TyG index of 8.6 in critically ill pediatric patients. Our findings suggest that the TyG index may be a novel and important factor for the short-term clinical prognosis in pediatric patients.

Project description:BackgroundWe determined utilizing a sepsis participant cohort whether there is a significant association between TyG-BMI (triglyceride glucose body mass index) and mortality rates at any stage.MethodsHerein, a historical cohort investigation approach was adopted, using information provided by the Medical Information Mart for Intensive Care-IV (MIMIC-IV). We categorized the included individuals in accordance with their TyG-BMI data quartiles, and the primary outcomes were mortality during the hospital stay and death rate due to any reason at postadmission day 28, 90, and 365. To evaluate TyG-BMI mortality's relationship with sepsis-induced mortality risk, we employed restricted cubic spline regression (RCS) and Cox regression models. Additionally, we confirmed TyG-BMI's significant predictive value for mortality via machine learning methods. Furthermore, we performed subgroup analyses to investigate possible differences among various patient groups.ResultsThe cohort included 4759 individuals, aged 63.9 ± 15.0 years, involving 2885 males (60.6%). The rates of death that took place during hospital stay and at 28, 90 and 365 days postadmission were respectively 19.60%, 24.70%, 28.80%, and 35.20%. As reflected by Cox models, TyG-BMI was negatively associated with mortality risk at various intervals: in-hospital [hazard ratio (HR) 0.47 (0.39-0.56), P = 0.003], 28 days postadmission [HR 0.42 (0.35-0.49), P < 0.001], 90 days postadmission [HR 0.41 (0.35-0.48), P < 0.001], and 365 days postadmission [HR 0.41 (0.35-0.47), P < 0.001]. Additionally, the relationship between TyG-BMI and death rates was L-shaped, as reflected by the RCS, with a TyG-BMI of 249 being the turning point.ConclusionsAmong sepsis patients in critical care, TyG-BMI is negatively correlated with mortality possibility at various intervals: during hospital stay and 28 days, 90 days, and one year postadmission. TyG-BMI is a beneficial parameter for categorizing risk levels among sepsis patients and for predicting their mortality risk within one year.

Project description:ObjectiveTo determine the association between levels of low density lipoprotein cholesterol (LDL-C) and all cause mortality, and the concentration of LDL-C associated with the lowest risk of all cause mortality in the general population.DesignProspective cohort study.SettingDenmark; the Copenhagen General Population Study recruited in 2003-15 with a median follow-up of 9.4 years.ParticipantsIndividuals randomly selected from the national Danish Civil Registration System.Main outcome measuresBaseline levels of LDL-C associated with risk of mortality were evaluated on a continuous scale (restricted cubic splines) and by a priori defined centile categories with Cox proportional hazards regression models. Main outcome was all cause mortality. Secondary outcomes were cause specific mortality (cardiovascular, cancer, and other mortality).ResultsAmong 108 243 individuals aged 20-100, 11 376 (10.5%) died during the study, at a median age of 81. The association between levels of LDL-C and the risk of all cause mortality was U shaped, with low and high levels associated with an increased risk of all cause mortality. Compared with individuals with concentrations of LDL-C of 3.4-3.9 mmol/L (132-154 mg/dL; 61st-80th centiles), the multivariable adjusted hazard ratio for all cause mortality was 1.25 (95% confidence interval 1.15 to 1.36) for individuals with LDL-C concentrations of less than 1.8 mmol/L (<70 mg/dL; 1st-5th centiles) and 1.15 (1.05 to 1.27) for LDL-C concentrations of more than 4.8 mmol/L (>189 mg/dL; 96th-100th centiles). The concentration of LDL-C associated with the lowest risk of all cause mortality was 3.6 mmol/L (140 mg/dL) in the overall population and in individuals not receiving lipid lowering treatment, compared with 2.3 mmol/L (89 mg/dL) in individuals receiving lipid lowering treatment. Similar results were seen in men and women, across age groups, and for cancer and other mortality, but not for cardiovascular mortality. Any increase in LDL-C levels was associated with an increased risk of myocardial infarction.ConclusionsIn the general population, low and high levels of LDL-C were associated with an increased risk of all cause mortality, and the lowest risk of all cause mortality was found at an LDL-C concentration of 3.6 mmol/L (140 mg/dL).

Dataset Information

Fasting status modifies the association between triglyceride and all-cause mortality: A cohort study.

Background and aims

Methods

Results

Conclusion

Publications

Fasting status modifies the association between triglyceride and all-cause mortality: A cohort study.

Similar Datasets

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