Triglyceride glucose-weight-adjusted waist index as a cardiovascular mortality predictor: incremental value beyond the establishment of TyG-related indices

作者：Jiajun Qiu, Jine Li, Shan Xu, Jingqi Yang, Haixia Zeng, Yuying Zhang, Shiqi Yang, Lixuan Fang, Jiadian Huang, Hongtao Zhou, Jiaying Feng, Yujie Zan, Jia Zhan, Jianping Liu · 发表于：Cardiovascular Diabetology · 年份：2025 · DOI：10.1186/s12933-025-02873-8 · 被引用次数：31 · 研究领域：Diabetes, Cardiovascular Risks, and Lipoproteins、Obesity, Physical Activity, Diet、Cardiovascular Function and Risk Factors

BACKGROUND: Cardiovascular disease (CVD) remains the leading cause of mortality worldwide, emphasizing the need for enhanced risk stratification tools. The triglyceride‒glucose-weight adjusted waist index (TyG-WWI), which integrates insulin resistance and central obesity, has emerged as a potential predictor, but its performance relative to traditional TyG-related indices (TyG, TyG-WC, TyG-WHtR) requires further validation. METHODS: We analyzed data from 24,255 participants in the National Health and Nutrition Examination Survey (NHANES, 1999-2018). Weighted Cox proportional hazards models were used to assess the associations between TyG-related indices and cardiovascular mortality. Restricted cubic splines (RCSs) with four knots were employed to explore dose‒response relationships. Traditional and time-dependent receiver operating characteristic (ROC) analyses, net reclassification improvement (NRI) analyses, and subgroup and sensitivity analyses were conducted to evaluate predictive performance and robustness. RESULTS: Over a median follow-up of 9.67 years, 854 cardiovascular deaths were recorded. According to the fully adjusted models, each increase in the standard deviation of the TyG-WWI was associated with a 45% greater risk of cardiovascular mortality (HR = 1.45, 95% CI 1.31-1.60), which was stronger than the associations observed for TyG (HR = 1.24, 95% CI 1.12-1.38), TyG-WC (HR = 1.39, 95% CI 1.27-1.53), and TyG-WHtR (HR = 1.43, 95% CI 1.30-1.58). When stratified by ...