Association of the TyG index and its body fat distribution composites with CHD and MACE risk in adults with OSAHS: incremental discrimination and exploratory mediation analysis.
Obstructive sleep apnea-hypopnea syndrome (OSAHS) is closely associated with coronary heart disease (CHD) and adverse cardiovascular outcomes, but the comparative value of the triglyceride-glucose (TyG) index and its body fat distribution composites for cardiovascular risk stratification in OSAHS remains unclear.
We assessed the associations of TyG, TyG-weight-adjusted waist index (TyG-WWI), TyG-Chinese visceral adiposity index (TyG-CVAI), and TyG-body roundness index (TyG-BRI) with prevalent CHD and incident major adverse cardiovascular events (MACE) in adults with OSAHS. This single-center retrospective observational study included 1,122 adults with OSAHS who underwent both polysomnography and coronary angiography, including 533 patients with CHD and 589 without CHD. TyG-related indices were standardized and analyzed per 1-standard deviation increase. Multivariable logistic regression, restricted cubic spline analysis, Cox proportional hazards models, time-dependent receiver operating characteristic analysis, and exploratory statistical decomposition were performed.
All TyG-related indices were independently associated with prevalent CHD after full adjustment. TyG-WWI showed the strongest association (odds ratio 3.21, 95% confidence interval 2.68-3.89 per 1-standard deviation increase). Adding TyG-WWI to conventional risk factors plus apnea-hypopnea index provided the greatest improvement in CHD discrimination (area under the curve 0.802; integrated discrimination improvement 0.150; continuous net reclassification improvement 0.706; all P<0.001). During a median follow-up of 17 months, 80 MACE occurred, and TyG-WWI showed the strongest association with incident MACE among the evaluated indices(hazard ratio 1.545, 95% confidence interval 1.217-1.961). Exploratory statistical decomposition suggested potential indirect pathway signals involving TyG-WWI and TyG-CVAI.
In this selected high-risk cohort of adults with OSAHS undergoing coronary evaluation, TyG and its adiposity-based composites were associated with prevalent CHD and showed supportive associations with follow-up MACE. TyG-WWI showed the most consistent cross-sectional, supportive longitudinal, and incremental discriminative value, suggesting its potential as a candidate marker for cardiovascular risk stratification. Given the limited MACE events and the exploratory nature of the statistical decomposition, these findings should be interpreted cautiously and validated prospectively.
We assessed the associations of TyG, TyG-weight-adjusted waist index (TyG-WWI), TyG-Chinese visceral adiposity index (TyG-CVAI), and TyG-body roundness index (TyG-BRI) with prevalent CHD and incident major adverse cardiovascular events (MACE) in adults with OSAHS. This single-center retrospective observational study included 1,122 adults with OSAHS who underwent both polysomnography and coronary angiography, including 533 patients with CHD and 589 without CHD. TyG-related indices were standardized and analyzed per 1-standard deviation increase. Multivariable logistic regression, restricted cubic spline analysis, Cox proportional hazards models, time-dependent receiver operating characteristic analysis, and exploratory statistical decomposition were performed.
All TyG-related indices were independently associated with prevalent CHD after full adjustment. TyG-WWI showed the strongest association (odds ratio 3.21, 95% confidence interval 2.68-3.89 per 1-standard deviation increase). Adding TyG-WWI to conventional risk factors plus apnea-hypopnea index provided the greatest improvement in CHD discrimination (area under the curve 0.802; integrated discrimination improvement 0.150; continuous net reclassification improvement 0.706; all P<0.001). During a median follow-up of 17 months, 80 MACE occurred, and TyG-WWI showed the strongest association with incident MACE among the evaluated indices(hazard ratio 1.545, 95% confidence interval 1.217-1.961). Exploratory statistical decomposition suggested potential indirect pathway signals involving TyG-WWI and TyG-CVAI.
In this selected high-risk cohort of adults with OSAHS undergoing coronary evaluation, TyG and its adiposity-based composites were associated with prevalent CHD and showed supportive associations with follow-up MACE. TyG-WWI showed the most consistent cross-sectional, supportive longitudinal, and incremental discriminative value, suggesting its potential as a candidate marker for cardiovascular risk stratification. Given the limited MACE events and the exploratory nature of the statistical decomposition, these findings should be interpreted cautiously and validated prospectively.
Authors
Liang Liang, Zhu Zhu, Chen Chen, Maimaitimin Maimaitimin, Nihemaiti Nihemaiti, Shata Shata, Maihemutijiang Maihemutijiang
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