J Diabetes Investig. 2026 May 15. doi: 10.1111/jdi.70333. Online ahead of print.
ABSTRACT
BACKGROUND: Patients with diabetes are at an increased risk of heart failure. The triglyceride-glucose index increases the risk of diabetes-related heart failure (dHF). We aimed to validate a practical clinical risk score for dHF in a large diabetic cohort and assess whether this score can identify dHF patients with an elevated triglyceride-glucose (TyG) index who have poor outcomes.
METHODS: Participants were drawn from multiple NHANES cycles (1999-2018). A simplified TRS-HF score (0-6 points) and TyG-related parameters were calculated in 3,455 participants with dHF. Candidate variables were evaluated using multivariable Cox proportional hazards models, Kaplan-Meier curves, and restricted cubic splines (RCS); independent predictors with statistical significance were included. Sensitivity analyses tested robustness.
RESULTS: Kaplan-Meier analysis revealed that higher levels of TRS-HF were significantly associated with poor dHF participants survival. Multivariate-adjusted Cox regression analysis revealed that high quartile levels of TyG-related indices were significantly associated with mortality in participants with dHF [TyG-Age: HR = 6.94, 95% CI: 4.34-11.08, P < 0.001; TyG-eGFR: HR = 3.78, 95% CI: 2.66-5.37, P < 0.001]. The participants in the highest quartile of TyG-Age had a six-fold increased risk of mortality compared to those in the lowest quartile (95% CI: 3.93-10.24). Nonlinear trends were observed between TyG-Age indices and mortality of dHF participants (P for overall < 0.0001; P for nonlinear < 0.0001). The sensitivity analyses supported the positive correlations between TyG-related indices and mortality of the TRS-HF-determined dHF population.
CONCLUSION: TyG-related indices, especially TyG-Age, have strong prognostic value for mortality in adults with dHF. TyG-Age and TRS-HF may serve as surrogate biomarkers for clinical management of dHF.
PMID:42141525 | DOI:10.1111/jdi.70333