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. 2024 Oct 1:19:2217-2228.
doi: 10.2147/COPD.S477268. eCollection 2024.

Elevated Triglyceride-Glucose (TyG) Index Predicts Poor Clinical Outcomes in Critically Ill AECOPD Patients: A Retrospective Study

Xin Wang #  1 , Xuerong Cui #  2 , Huaping Fan  3 , Tianyang Hu  4
Affiliations

Elevated Triglyceride-Glucose (TyG) Index Predicts Poor Clinical Outcomes in Critically Ill AECOPD Patients: A Retrospective Study

Xin Wang et al. Int J Chron Obstruct Pulmon Dis. .

Abstract

Purpose: The triglyceride-glucose (TyG) index is a surrogate biomarker of insulin resistance which has been widely used in intensive care unit (ICU) to predict prognosis. However, its role in critically ill acute exacerbation of COPD (AECOPD) patients remains largely unknown.

Material and methods: A total of 645 AECOPD patients were induced in this retrospective cohort study, which extracted data from the eICU Collaborative Research Database (eICU-CRD). The TyG index was calculated as Ln (fasting triglycerides (mg/dL) × fasting plasma glucose (mg/dL)/2). The primary endpoint includes in-hospital mortality and ICU mortality. The secondary endpoint was sepsis, acute kidney injury (AKI), and acute respiratory failure (ARF).

Results: Multivariable Cox regression analysis revealed that the TyG index was independently associated with an increased risk of in-hospital mortality (hazard ratio, HR: 1.45, 95% CI: 1.04-2.01, P = 0.028) and ICU mortality (HR: 2.13, 95% CI: 1.28-3.54, P = 0.004). Moreover, the TyG index was independently associated with an increased risk of sepsis (odds ratio, OR: 1.54, 95% CI: 1.24-1.93, P < 0.001), AKI (OR: 1.57, 95% CI: 1.26-2.02, P < 0.001) and ARF (OR: 1.50, 95% CI: 1.20-1.87, P < 0.001). Kaplan-Meier survival analysis revealed that higher TyG indexes were also related to increased in-hospital mortality and ICU mortality. In addition, the restricted cubic splines regression model demonstrated that the in-hospital mortality and ICU mortality increased linearly with increasing TyG index (P for non-linearity = 0.897, P for non-linearity = 0.897, respectively).

Conclusion: Elevated TyG index was independently associated with an increased risk of poor clinical outcomes in critically ill AECOPD patients. A prospective study to define TyG as a biomarker for prognosis prediction in critically ill AECOPD patients is warranted.

Keywords: AECOPD; eICU-CRD database; mortality; triglyceride-glucose index.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Figure 1
Figure 1
The flow chart of this study.
Figure 2
Figure 2
Kaplan-Meier survival analysis curves of the quartile of TyG index for in-hospital mortality (A) and ICU mortality (B). TyG index, triglyceride-glucose index, ICU, intensive care unit.
Figure 3
Figure 3
Restricted cubic spline curve for (A) in-hospital mortality and (B) ICU mortality. CI, confidence interval; TyG index, triglyceride-glucose index, ICU, intensive care unit.
Figure 4
Figure 4
The forest plot revealed the results of subgroup analysis for in-hospital mortality and ICU mortality, respectively, based on the TyG index.
Figure 5
Figure 5
The forest plot revealed the results of subgroup analysis for sepsis, acute kidney injury, and acute respiratory failure, respectively, based on the TyG index.
See this image and copyright information in PMC

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