Cardiovascular
Do TyG and TyG-WHtR predict death and CVD in NAFLD?
Open access · cc by · source: Europe PMC
In 6,627 NHANES adults with NAFLD, TyG-WHtR better predicted all-cause death, CVD death, and heart failure, while the TyG index tracked total CVD, CHD, and angina.
How this study connects
Role on claims
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No single index dominated; the better predictor changed with the endpoint.
Composite indices can outperform their components, and which one wins depends on the outcome. TyG-WHtR predicted all-cause mortality (HR 1.31), cardiovascular mortality (HR 2.22) and heart failure (OR 3.99) more strongly than TyG alone, while TyG was stronger for total cardiovascular disease (OR 2.00), coronary heart disease (1.85) and angina (2.93).
Evidence for the claim as stated.
Study at a glance
- Design
- Cohort — NHANES 1999–2018 NAFLD adults; Cox models for mortality via NDI and logistic models for prevalent CVD; TyG vs TyG-WHtR quartiles
- N
- N=6627 · 6,627 adults ≥18 years with NAFLD (USFLI ≥30) from NHANES 1999–2018
- Population
- US adults with NAFLD in NHANES 1999–2018
- Outcome
- All-cause mortality, CVD mortality, and prevalent total-CVD, CHF, CHD, and angina
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Inspect source passages
Do TyG and TyG-WHtR predict death and CVD in NAFLD?
These passages occur verbatim in the stored paper text. They support the points listed below; they do not verify every statement in the explanation.
Analytic sample was 6,627 NHANES adults with NAFLD.
This study enrolled 6627 adults aged 18 and above diagnosed NAFLD from the National Health and Nutrition Examination Survey (NHANES, 1999–2018).
TyG-WHtR HRs/OR: 1.31 all-cause death, 2.22 CVD death, 3.99 CHF.
For all-cause mortality, CVD mortality and CHF, TyG-WHtR was a better predictor than TyG (TyG-WHtR: HR 1.31, 95%CI 1.03–1.66; HR 2.22, 95%CI 1.42–3.47; OR 3.99, 95%CI 1.79–8.93).
Key findings
TyG-WHtR predicted all-cause mortality (HR 1.31), CVD mortality (HR 2.22), and CHF (OR 3.99) more strongly than TyG; TyG was stronger for total-CVD (OR 2.00), CHD (OR 1.85), and angina (OR 2.93). Mean TyG was 9.05 and TyG-WHtR 6.03. Adding either index improved C-statistics.
Methodology
Identified NAFLD by USFLI ≥30 in NHANES 1999–2018, computed TyG and TyG-WHtR quartiles, and modeled mortality (Cox/NDI) and self-reported CVD (logistic regression), with RCS curves and mediation by HbA1c, insulin, and hypertension.
Limitations
Observational NHANES data cannot prove TyG causes CVD; NAFLD was index-defined not biopsy-proven, CVD was often self-reported, and findings may not generalize beyond US survey participants.
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