ORIGINAL RESEARCH article
Front. Nutr.
Sec. Nutrition and Metabolism
Volume 12 - 2025 | doi: 10.3389/fnut.2025.1612402
Correlation of the Triglyceride-Glucose-Body Mass Index with All-cause and Cardiovascular Mortality in Patients Undergoing Peritoneal Dialysis: A Retrospective Cohort Study
Provisionally accepted
- Department of Nephrology, Tianjin First Central Hospital, Tianjin, China
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Background: Triglyceride-glucose-body mass index (TyG-BMI) is a simple indicator of insulin resistance and is linked to an elevated risk of mortality. Nevertheless, limited research has explored the associations between the TyG-BMI and all-cause and cardiovascular mortality in patients undergoing peritoneal dialysis (PD). Methods: Patients initiating PD treatment at Tianjin First Central Hospital’s nephrology department from July 2013 to February 2024 had triglycerides, fasting blood glucose, height, and weight measured at baseline and monthly during follow-up. TyG-BMI was calculated, dividing PD patients into high, middle, or low TyG-BMI groups using tri-quantile method. Cox regression analysis assessed hazard ratios (HRs) for all-cause and cardiovascular mortality among these groups. A restricted cubic spline regression was used to explore the relationship between TyG-BMI and the primary and secondary outcomes. Results: A total of 865 patients were included. The mean TyG-BMI value for the entire study population was 212.27±46.64. Patients in the high group had a higher proportion of patients whose primary kidney disease was diabetic nephropathy and the greatest proportion of patients with comorbid diabetes mellitus. During the follow-up, 266 (30.75%) deaths occurred, with CVD being the dominant cause in 110 (41.35%) patients. Univariate and multivariate Cox regression analyses showed that middle group patients had a significantly lower risk of all-cause mortality compared to other groups. For CVD mortality, high group patients had a significantly greater hazard ratio than middle group, while there was no significant difference between low and middle groups. Restricted cubic spline regression revealed U-shaped association between TyG-BMI and all-cause mortality risk, as well as J-shaped association with CVD mortality, inflection points were identified at 209.73 and 206.64 respectively. In the subgroup analysis, we found that higher TyG-BMI values were associated with increased all-cause and cardiovascular mortality in men, lower TyG-BMI values were linked to elevated all-cause mortality in women. Conclusion: The TyG-BMI shows U-shaped and J-shaped relationships with all-cause and CVD mortality risk, respectively, in PD patients. Additionally, significant sex differences were observed in these associations. Keywords: Triglyceride glucose-body mass index; Peritoneal dialysis; All-cause mortality; Cardiovascular mortality; Insulin resistance
Keywords: Triglyceride glucose-body mass index, Peritoneal Dialysis, All-cause mortality, Cardiovascular mortality, Insulin Resistance
Received: 15 Apr 2025; Accepted: 30 Jul 2025.
Copyright: © 2025 Li, Wang, Zhang, Sun, Han and Chang. 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: Wenxiu Chang, Department of Nephrology, Tianjin First Central Hospital, Tianjin, China
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