The triglyceride-glucose index and mortality in chronic kidney and cardiovascular disease patients: A cohort study.

BackgroundChronic kidney disease (CKD) comorbid with cardiovascular disease (CVD) results in substantial mortality. The predictive value of the triglyceride-glucose (TyG) index for mortality in this population remains unverified. We aimed to evaluate the association of the TyG index with mortality in individuals with CKD and CVD.MethodsUsing National Health and Nutrition Examination Survey (NHANES) data (1999-2018), we analyzed 1104 adults with CKD and CVD. Multivariable Cox proportional hazards models and restricted cubic splines assessed associations between the TyG index and mortality. Threshold effects were evaluated.ResultsOver a median 10.3-years follow-up, 623 all-cause and 311 cardiovascular deaths occurred. A significant U-shaped association existed between the TyG index and both all-cause (p-nonlinear = 0.002) and cardiovascular mortality (p-nonlinear = 0.014). Above a threshold of 8.91, higher TyG index predicted increased all-cause mortality risk (HR 1.34, 95% CI 1.07-1.67; p = 0.01). Below 8.91, the association was non-significant (HR 0.82, 95% CI 0.62-1.28; p = 0.537). This U-shaped relationship was significant in males (p-nonlinear < 0.05) but not females.ConclusionsThe TyG index demonstrates a U-shaped association with all-cause and cardiovascular mortality in patients with comorbid CKD and CVD. Maintaining TyG index within a specific range may reduce mortality risk, highlighting its potential role in risk stratification and targeted management.