Association between triglyceride high-density cholesterol-glucose body index and 28-day mortality in critically ill patients: a multicenter observational study in China.
- 1Department of Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No.197 Ruijin 2nd Road, Shanghai 200025, China.
Abstract
Background
The triglyceride high-density lipoprotein cholesterol-glucose body mass index (TyHGB) is a novel composite indicator integrating triglyceride, high-density lipoprotein cholesterol, fasting glucose and body mass index and may provide a more comprehensive assessment of systemic metabolic status than current indices. This multicenter landmark cohort study aimed to determine the association between TyHGB measured at the landmark time and 28-day mortality in patients present in the intensive care units (ICUs) at that time and to evaluate its potential utility as a prognostic marker.Methods
This multicenter observational cohort study included 1649 patients from 113 ICUs in China. The association between TyHGB and 28-day mortality was evaluated using three sequentially adjusted logistic regression models with restricted cubic splines: Model 1 adjusted for demographics; Model 2 further adjusted for disease severity and organ dysfunction; Model 3 additionally adjusted for therapeutic interventions. Subgroup analyses with interaction tests were conducted. Model performance was assessed by discrimination (AUC), calibration (Brier score and calibration slope) and internal validation via bootstrap resamples.Results
Restricted cubic spline analysis demonstrated a positive association between TyHGB and 28-day mortality across fully adjusted models (P < 0.05). Subgroup analyses identified a statistically significant interaction with diabetes (P for interaction = 0.011). In the overall cohort, adding TyHGB to the base model improved AUC from 0.731 to 0.745 (ΔAUC = +0.014, P = 0.043), with significant improvements in reclassification (NRI = 0.328, P < 0.001; IDI = 0.012, P = 0.009) and model fit (LRT P < 0.001). Among diabetic patients (N = 401), TyHGB significantly improved AUC from 0.673 to 0.723 (ΔAUC = +0.050, P = 0.049; NRI = 0.515, P < 0.001; IDI = 0.041, P = 0.022). In contrast, no significant improvement was observed in non-diabetic patients (ΔAUC = +0.009, P = 0.152).Conclusion
Among patients present in participating ICUs at the landmark time, higher TyHGB was associated with subsequent 28-day mortality. However, adding TyHGB to the baseline risk prediction model led to only small improvements in overall predictive performance. Findings in diabetic patients are exploratory and require further validation.
Related
- Triglyceride–high-density lipoprotein cholesterol–glucose–body mass index predicts 28-day all-cause mortality in critically ill patients with heart failure
- Association of the triglyceride-to-high-density lipoprotein cholesterol ratio with kidney stone status: cross-sectional and machine-learning analyses
- Association of triglyceride-glucose index and triglyceride-glucose-body mass index with all-cause mortality in critically ill patients with aortic disease: A retrospective cohort study.
- Association between neutrophil percentage-to-albumin ratio and all-cause mortality in stroke survivors stratified by triglyceride-glucose index : A prospective observational study based on the NHANES database from 1999 to 2018
- Association Between Triglyceride-glucose Index, Neutrophil to High-density Lipoprotein Cholesterol Ratio and Atrial Fibrillation: A Retrospective Study in China.
BibTeX
@article{pan2026association,
title = {{Association between triglyceride high-density cholesterol-glucose body index and 28-day mortality in critically ill patients: a multicenter observational study in China.}},
author = {Xiaojun Pan and Yueming Xiao and Hangxiang Du and Zhenliang Wen and Hui Li and Chengchen Yang and Wenzhe Li and Sisi Huang and Yizhu Chen and Lidi Zhang and Tao Wang and Yongan Liu and Sheng Zhang and Dechang Chen and Jiao Liu},
journal = {Annals of intensive care},
year = {2026},
month = sep,
doi = {10.1016/j.aicoj.2026.100173},
url = {https://europepmc.org/article/MED/42959645},
note = {CC BY},
}
RIS
TY - JOUR
TI - Association between triglyceride high-density cholesterol-glucose body index and 28-day mortality in critically ill patients: a multicenter observational study in China.
AU - Xiaojun Pan
AU - Yueming Xiao
AU - Hangxiang Du
AU - Zhenliang Wen
AU - Hui Li
AU - Chengchen Yang
AU - Wenzhe Li
AU - Sisi Huang
AU - Yizhu Chen
AU - Lidi Zhang
AU - Tao Wang
AU - Yongan Liu
AU - Sheng Zhang
AU - Dechang Chen
AU - Jiao Liu
PY - 2026
DA - 2026/09/30
JO - Annals of intensive care
DO - 10.1016/j.aicoj.2026.100173
UR - https://europepmc.org/article/MED/42959645
AB - Background The triglyceride high-density lipoprotein cholesterol-glucose body mass index (TyHGB) is a novel composite indicator integrating triglyceride, high-density lipoprotein cholesterol, fasting glucose and body mass index and may provide a more comprehensive assessment of systemic metabolic status than current indices. This multicenter landmark cohort study aimed to determine the association between TyHGB measured at the landmark time and 28-day mortality in patients present in the intensive care units (ICUs) at that time and to evaluate its potential utility as a prognostic marker.Methods This multicenter observational cohort study included 1649 patients from 113 ICUs in China. The association between TyHGB and 28-day mortality was evaluated using three sequentially adjusted logistic regression models with restricted cubic splines: Model 1 adjusted for demographics; Model 2 further adjusted for disease severity and organ dysfunction; Model 3 additionally adjusted for therapeutic interventions. Subgroup analyses with interaction tests were conducted. Model performance was assessed by discrimination (AUC), calibration (Brier score and calibration slope) and internal validation via bootstrap resamples.Results Restricted cubic spline analysis demonstrated a positive association between TyHGB and 28-day mortality across fully adjusted models (P < 0.05). Subgroup analyses identified a statistically significant interaction with diabetes (P for interaction = 0.011). In the overall cohort, adding TyHGB to the base model improved AUC from 0.731 to 0.745 (ΔAUC = +0.014, P = 0.043), with significant improvements in reclassification (NRI = 0.328, P < 0.001; IDI = 0.012, P = 0.009) and model fit (LRT P < 0.001). Among diabetic patients (N = 401), TyHGB significantly improved AUC from 0.673 to 0.723 (ΔAUC = +0.050, P = 0.049; NRI = 0.515, P < 0.001; IDI = 0.041, P = 0.022). In contrast, no significant improvement was observed in non-diabetic patients (ΔAUC = +0.009, P = 0.152).Conclusion Among patients present in participating ICUs at the landmark time, higher TyHGB was associated with subsequent 28-day mortality. However, adding TyHGB to the baseline risk prediction model led to only small improvements in overall predictive performance. Findings in diabetic patients are exploratory and require further validation.
SN - 2110-5820
ER -