The association between triglyceride glucose-body mass index and mortality in critically ill patients with respiratory failure: insights from ICU data
Abstract Respiratory failure (RF) lead to high mortality rates and extended hospital stays in intensive care unit (ICU). The Triglyceride-Glucose (TyG) index, a reliable surrogate marker for insulin resistance (IR), predicted adverse outcomes in various diseases. Combining weight-related indices lik...
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Nature Portfolio
2025-05-01
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| author | Ce Sun Xiao-Li Niu Li-Xiong Zeng |
| author_facet | Ce Sun Xiao-Li Niu Li-Xiong Zeng |
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| description | Abstract Respiratory failure (RF) lead to high mortality rates and extended hospital stays in intensive care unit (ICU). The Triglyceride-Glucose (TyG) index, a reliable surrogate marker for insulin resistance (IR), predicted adverse outcomes in various diseases. Combining weight-related indices like body mass index (BMI) with TyG to form the TyG-BMI enhanced the assessment of IR and its impact on patient outcomes. However, the association between TyG-BMI and outcomes in patients with RF remained underexplored. This study retrospectively analyzed data from the MIMIC-IV database, focusing on critically ill patients with RF. From an initial cohort of 19,429 patients, 2177 met the inclusion criteria and were divided into quartiles based on TyG-BMI values. Key clinical information was collected within the first 24 h of ICU admission, including demographics, lab results, vital signs, and scoring systems such as SAPS II and SOFA. Primary outcome was 28-day, secondary outcomes were 180-day and 1-year mortality. Data were analyzed using multivariable Cox regression models, Kaplan–Meier survival curves, and restricted cubic splines to assess the nonlinear relationship between TyG-BMI and mortality. The study found significant differences in baseline characteristics across TyG-BMI quartiles. Kaplan–Meier survival curves indicated a higher survival probability for patients in the lowest TyG-BMI quartile (Q1) compared to higher quartiles (Q2–Q4). Adjusted hazard ratios demonstrated a nonlinear association between higher TyG-BMI values and increased mortality risk at all three time points. The RCS-derived cut-off value of 269 for TyG-BMI was identified as a significant threshold, with higher TyG-BMI values correlating with lower mortality risks. Subgroup analyses reinforced these findings across different patient demographics and clinical profiles. Higher TyG-BMI was associated to lower short-term and long-term mortality, suggesting a potential protective effect. These findings highlighted the importance of the TyG-BMI as a robust prognostic marker, providing valuable insights for improving treatment strategies for patients with RF. |
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| spelling | doaj-art-94e4141e9bcf4e4ca2c3a19cedbbd1602025-08-20T02:15:11ZengNature PortfolioScientific Reports2045-23222025-05-0115111310.1038/s41598-025-00254-5The association between triglyceride glucose-body mass index and mortality in critically ill patients with respiratory failure: insights from ICU dataCe Sun0Xiao-Li Niu1Li-Xiong Zeng2The First Clinical Medical College, Guangzhou University of Chinese MedicineShenzhen Bao’an Chinese Medicine Hospital, Guangzhou University of Chinese MedicineDepartment of Cardiology, The Third Xiangya Hospital of Central South UniversityAbstract Respiratory failure (RF) lead to high mortality rates and extended hospital stays in intensive care unit (ICU). The Triglyceride-Glucose (TyG) index, a reliable surrogate marker for insulin resistance (IR), predicted adverse outcomes in various diseases. Combining weight-related indices like body mass index (BMI) with TyG to form the TyG-BMI enhanced the assessment of IR and its impact on patient outcomes. However, the association between TyG-BMI and outcomes in patients with RF remained underexplored. This study retrospectively analyzed data from the MIMIC-IV database, focusing on critically ill patients with RF. From an initial cohort of 19,429 patients, 2177 met the inclusion criteria and were divided into quartiles based on TyG-BMI values. Key clinical information was collected within the first 24 h of ICU admission, including demographics, lab results, vital signs, and scoring systems such as SAPS II and SOFA. Primary outcome was 28-day, secondary outcomes were 180-day and 1-year mortality. Data were analyzed using multivariable Cox regression models, Kaplan–Meier survival curves, and restricted cubic splines to assess the nonlinear relationship between TyG-BMI and mortality. The study found significant differences in baseline characteristics across TyG-BMI quartiles. Kaplan–Meier survival curves indicated a higher survival probability for patients in the lowest TyG-BMI quartile (Q1) compared to higher quartiles (Q2–Q4). Adjusted hazard ratios demonstrated a nonlinear association between higher TyG-BMI values and increased mortality risk at all three time points. The RCS-derived cut-off value of 269 for TyG-BMI was identified as a significant threshold, with higher TyG-BMI values correlating with lower mortality risks. Subgroup analyses reinforced these findings across different patient demographics and clinical profiles. Higher TyG-BMI was associated to lower short-term and long-term mortality, suggesting a potential protective effect. These findings highlighted the importance of the TyG-BMI as a robust prognostic marker, providing valuable insights for improving treatment strategies for patients with RF.https://doi.org/10.1038/s41598-025-00254-5Triglyceride glucose-body mass index (TyG-BMI)Respiratory failureInsulin resistanceMortality |
| spellingShingle | Ce Sun Xiao-Li Niu Li-Xiong Zeng The association between triglyceride glucose-body mass index and mortality in critically ill patients with respiratory failure: insights from ICU data Scientific Reports Triglyceride glucose-body mass index (TyG-BMI) Respiratory failure Insulin resistance Mortality |
| title | The association between triglyceride glucose-body mass index and mortality in critically ill patients with respiratory failure: insights from ICU data |
| title_full | The association between triglyceride glucose-body mass index and mortality in critically ill patients with respiratory failure: insights from ICU data |
| title_fullStr | The association between triglyceride glucose-body mass index and mortality in critically ill patients with respiratory failure: insights from ICU data |
| title_full_unstemmed | The association between triglyceride glucose-body mass index and mortality in critically ill patients with respiratory failure: insights from ICU data |
| title_short | The association between triglyceride glucose-body mass index and mortality in critically ill patients with respiratory failure: insights from ICU data |
| title_sort | association between triglyceride glucose body mass index and mortality in critically ill patients with respiratory failure insights from icu data |
| topic | Triglyceride glucose-body mass index (TyG-BMI) Respiratory failure Insulin resistance Mortality |
| url | https://doi.org/10.1038/s41598-025-00254-5 |
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