Association of the triglyceride-glucose index with all-cause and cause-specific mortality in patients with comorbid hypertension and diabetes: A population-based cohort study.

Study objective: Although the triglyceride-glucose (TyG) index has been shown to be an independent risk factor for either hypertension or diabetes, its association with the coexistence of both conditions remains unclear. This study aimed to evaluate the association between the TyG index and all-cause and cause-specific mortality among patients with comorbid hypertension and diabetes. Design: To elucidate the correlation between the TyG index and various modes of death, three multifactorial Cox proportional risk regression models were constructed. Restricted cubic spline curves are utilised to fit dose-response associations with the TyG index and various mortality rates. The effect of the TyG index threshold on different types of mortality was assessed via a two-stage Cox regression model. Participants: The current study included 3222 patients from the National Health and Nutrition Examination Survey with hypertension combined with diabetes mellitus. Main outcome measures: The endpoints of interest were all-cause death, cardiovascular death, and diabetes death. Results: During the median 13.7-year follow-up, 1029 (31.9 %) all-cause deaths were observed, including 308 (9.6 %) cardiovascular deaths and 99 (3.1 %) diabetes deaths. Multivariate Cox proportional risk regression models revealed a positive correlation with TyG for all three outcome deaths. A restricted cubic spline demonstrated that the TyG index was linearly and positively associated with diabetes mortality, with U-shaped associations between cardiovascular mortality and all-cause mortality, with thresholds set at 8.87 and 9.37, respectively. Conclusions: Monitoring and maintaining appropriate TyG levels may help reduce the risk of mortality in patients with diabetes and hypertension.