ORIGINAL RESEARCH article
Front. Med.
Sec. Precision Medicine
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1549578
Association of triglyceride-glucose index with all-cause and non-cardiovascular mortality in patients with obstructive sleep apnea: an age-stratified analysis
Provisionally accepted
- 1Department of Cardiology, The Affiliated Huaian No.1 People’s Hospital of Nanjing Medical University, Huaian, China
- 2Department of Respiratory and Critical Care Medicine, the Affiliated Huaian No.1 People’s Hospital of Nanjing Medical University, Huaian, China
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Background: The predictive value of the triglyceride-glucose (TyG) index in patients with obstructive sleep apnea (OSA) remains unclear. Therefore, we aimed to investigate the associations between the TyG index and all-cause and non-cardiovascular (non-CV) mortality in an OSA cohort, focusing on age differences.Methods: This study enrolled 10,274 patients with OSA from the National Health and Nutrition Examination Survey (2005–2008 and 2015–2018). Mortality outcomes were ascertained by linking to National Death Index records through December 31, 2019. Multivariable Cox proportional hazards regression models with restricted cubic splines (RCS) and interaction tests with age were employed to evaluate the association between the TyG index and all-cause and non-CV mortality. Kaplan-Meier analysis was used to evaluate mortality differences.Results: During a mean follow-up of 88 months, 1027 all-cause deaths occurred, of which non-CV deaths accounted for 77.8% of the total mortality burden. The RCS curves revealed a U-shaped association between the TyG index and all-cause/non-CV mortality, with inflection points at 9.27 and 9.29. A statistically significant age interaction was observed between the TyG index and mortality. The TyG index was linearly associated with higher risks of all-cause [Hazard Ratio (HR) 1.30, 95% Confidence Interval (CI): 1.09–1.55, p = 0.004] and non-CV mortality (HR 1.33, 95% CI: 1.08–1.62, p = 0.006) in participants aged < 65, but not in participants aged ≥ 65. Kaplan–Meier curves indicated that patients with higher TyG index had a significantly lower survival probability (All-cause mortality: p for log-rank test < 0.001; non-CV mortality: p for log-rank test = 0.001).Conclusions: This study identified a U-shaped association between the TyG index and all-cause and non-CV mortality in an OSA population, with a statistically significant interaction with age. A linear relationship was detected between the TyG index and mortality in those aged < 65, while a non-linear association was established in those aged ≥ 65.
Keywords: Triglyceride-glucose index, Mortality, Age interaction, obstructive sleep apnea, NHANES
Received: 14 Feb 2025; Accepted: 03 Jun 2025.
Copyright: © 2025 Hu, Xu and Gu. 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: Yang Gu, Department of Cardiology, The Affiliated Huaian No.1 People’s Hospital of Nanjing Medical University, Huaian, China
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