Prospective associations of triglyceride-glucose related indices with cardiovascular disease and mortality in individuals with metabolic syndrome: evidence from the UK biobank

Triglyceride‒glucose (TyG) related indices have been implicated in metabolic syndrome (MetS), cardiovascular disease (CVD), and mortality. However, their prospective associations with CVD and mortality among individuals with MetS remain limited.

In this large-scale prospective study, we included 113,699 UK Biobank participants with MetS who were free of CVD at baseline. The TyG index, TyG-body mass index (TyG-BMI), TyG-waist circumference (TyG-WC), and TyG-waist-to-height ratio (TyG-WHtR) were calculated and categorized into quartiles. Cox proportional hazards models, restricted cubic splines, two-piecewise regression models, and K-means clustering were applied to evaluate the associations of TyG-related indices with CVD and mortality outcomes. Incremental predictive performance was further assessed using the net reclassification index (NRI) and integrated discrimination improvement (IDI).