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. 2022 Jan 4:8:768101.
doi: 10.3389/fmed.2021.768101. eCollection 2021.

Predictive Value of Triglyceride-Glucose Index for In-hospital Mortality in Patients With Severe Fever With Thrombocytopenia Syndrome: A Multi-Center Observational Study

Tingyu Zhang  1 , Yuanni Liu  2 , Ziruo Ge  1 , Di Tian  1 , Ling Lin  2 , Zhenghua Zhao  3 , Yi Shen  4 , Xiaoli Yu  4 , Yang Feng  3 , Chunqian Qiang  2 , Jianping Duan  5 , Yanli Ma  5 , Tianli Fan  5 , Yongxiang Zhao  4 , Zhihai Chen  1
Affiliations

Predictive Value of Triglyceride-Glucose Index for In-hospital Mortality in Patients With Severe Fever With Thrombocytopenia Syndrome: A Multi-Center Observational Study

Tingyu Zhang et al. Front Med (Lausanne). .

Abstract

Background: Triglyceride-glucose (TyG) index has been proposed as a reliable indicator for insulin resistance and proved to be closely associated with the severity and mortality risk of infectious diseases. It remains indistinct whether TyG index performs an important role in predicting in-hospital mortality in patients with severe fever with thrombocytopenia syndrome (SFTS). Methods: The current study retrospectively recruited patients who were admitted for SFTS from January to December 2019 at five medical centers. TyG index was calculated in accordance with the description of previous study: Ln [fasting triglyceride (TG) (mg/dl) × fasting blood glucose (FBG) (mg/dl)/2]. The observational endpoint of the present study was defined as the in-hospital death. Results: In total, 79 patients (64.9 ± 10.5 years, 39.2% female) who met the enrollment criteria were enrolled in the current study. During the hospitalization period, 17 (21.5%) patients died in the hospital. TyG index remained a significant and independent predictor for in-hospital death despite being fully adjusted for confounders, either being taken as a nominal [hazard ratio (HR) 5.923, 95% CI 1.208-29.036, P = 0.028] or continuous (HR 7.309, 95% CI 1.854-28.818, P = 0.004) variate. TyG index exhibited a moderate-to-high strength in predicting in-hospital death, with an area under the receiver operating characteristic curve (AUC) of 0.821 (95% CI 0.712-0.929, P < 0.001). The addition of TyG index displayed significant enhancement on the predictive value for in-hospital death beyond a baseline model, manifested as increased AUC (baseline model: 0.788, 95% CI 0.676-0.901 vs. + TyG index 0.866, 95% CI 0.783-0.950, P for comparison = 0.041), increased Harrell's C-index (baseline model: 0.762, 95% CI 0.645-0.880 vs. + TyG index 0.813, 95% CI 0.724-0.903, P for comparison = 0.035), significant continuous net reclassification improvement (NRI) (0.310, 95% CI 0.092-0.714, P = 0.013), and significant integrated discrimination improvement (0.111, 95% CI 0.008-0.254, P = 0.040). Conclusion: Triglyceride-glucose index, a novel indicator simply calculated from fasting TG and FBG, is strongly and independently associated with the risk of in-hospital death in patients with SFTS.

Keywords: fasting blood glucose; in-hospital mortality; severe fever with thrombocytopenia syndrome; triglyceride; triglyceride-glucose index.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow diagram for the enrollment of study population. SFTS, severe fever with thrombocytopenia syndrome; SFTSV, SFTS virus.
Figure 2
Figure 2
Association between TyG index and in-hospital death. (A) Comparison of in-hospital mortality at different TyG index levels; (B) Comparison of TyG index between non-in-hospital death and in-hospital death cases. TyG, triglyceride-glucose.
Figure 3
Figure 3
Kaplan–Meier survival curves according to the median of TyG index. TyG, triglyceride-glucose.
Figure 4
Figure 4
The receiver operating characteristics (ROC) curve analysis. (A) The predictive value of TyG index for in-hospital death; (B) the incremental effect of TyG index on the prediction of in-hospital death. AUC, area under the ROC curve; CI, confidence interval; and TyG, triglyceride-glucose.
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