ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Cardiovascular Endocrinology
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1551825
Association between the TyGBS index and all-cause and cardiovascular mortality in diabetic stroke patients
Provisionally accepted
- Shaanxi Provincial People's Hospital, Xi'an, China
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Abstract Background Stroke patients with diabetes face elevated mortality risks, posing a global public health challenge. The TyG (Triglyceride-Glucose) index and Oxidative Balance Score (OBS) are potential predictors of mortality, but their combined impact remains unclear. This study explores the association between Triglyceride-Glucose to Oxidative Balance Score Ratio (TyGBS) and all-cause and cardiovascular mortality in diabetic stroke patients. Methods Data from 556 diabetic stroke patients in the NHANES 1999–2018 cohort were analyzed. Mortality outcomes were determined using the National Death Index . TyGBS, calculated as the TyG index divided by OBS, was assessed for its association with mortality through Kaplan-Meier analysis, multivariable Cox regression, restricted cubic splines (RCS), and subgroup analyses. Results Over a mean follow-up of 73 months, 210 (49.4%) patients died, including 65 (15.3%) from cardiovascular causes. Higher TyGBS levels were significantly associated with increased mortality risks. Kaplan-Meier analysis showed the lowest mortality in the lowest TyGBS quartile (Q1) and the highest in Q4 (log-rank p<0.001). Cox regression revealed that each unit increase in TyGBS raised all-cause mortality risk by 360% (HR 4.60, 95% CI 3.21–6.59) and cardiovascular mortality risk by 357% (HR 4.57, 95% CI 2.43–8.60). The RCS analysis indicated a nonlinear association, showing a significant increase in mortality risk when TyGBS was less than 1.163 (p for nonlinearity = 0.002). Conclusion TyGBS, a novel ratio integrating metabolic and oxidative pathways, demonstrates a critical clinical threshold for prioritizing interventions in diabetic stroke.
Keywords: TyGBS, diabetes, Stroke, All-cause mortality, Cardiovascular mortality, Oxidative Stress, Insulin Resistance
Received: 06 Feb 2025; Accepted: 08 Sep 2025.
Copyright: © 2025 Lu, Miao, Meng, Liu and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Ganggui Lu, Shaanxi Provincial People's Hospital, Xi'an, China
Man Zhang, Shaanxi Provincial People's Hospital, Xi'an, China
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