JMIR Publications

ABSTRACT

Background:

Chronic obstructive pulmonary disease (COPD), emphysema, bronchiectasis, and cor pulmonale are chronic lung diseases (CLD) that pose a global public health challenge. However, there remains a lack of accurate assessment and predictive indicators. The triglyceride-glucose (TyG) index serves as a reliable indicator of insulin resistance (IR). IR is associated with an increased incidence, prevalence, or severity of CLD.

Objective:

This study aims to investigate the relationship between the TyG index and the risk of CLD, as well as to assess the predictive role of the TyG index in CLD.

Methods:

Based on data collected from the China Health and Aging Longitudinal Study (CHARLS) from 2011 to 2020, a total of 3,776 research subjects were included for data analysis. K-means clustering analysis was employed to categorize the subjects into three groups. The Kaplan-Meier curve was used to compare the survival rates of CLD events among the groups. Multivariate Cox proportional hazards regression analysis was conducted to examine the relationship between the TyG index and CLD events across the groups. A restricted cubic splines (RCS) regression model was utilized to explore potential linear associations between the TyG index and CLD events. The Receiver Operating Characteristic Curve (ROC) was used to evaluate the predictive value of the TyG index for CLD events.

Results:

During the follow-up period from 2013 to 2020, 940 subjects were diagnosed with CLD. Based on baseline characteristics, the K-means clustering analysis identified three groups of subjects. The Kaplan-Meier curve indicated statistically significant survival differences among the groups (p=0.0064). After a follow-up period exceeding 50 months, Group 1 exhibited the fastest decline and the lowest rate of disease-free survival. Multivariate Cox proportional hazards analysis revealed that in the unadjusted model, the TyG index of Group 1 was significantly associated with CLD events (HR, 1.58 [95% CI 1.18-2.13], p<0.05). This association remained significant in models adjusted for demographic factors (HR, 1.61 [95% CI 1.18-2.20], p<0.05) and in models adjusted for both demographic factors and disease status (HR, 1.64 [95% CI 1.19-2.26], p<0.05). Similarly, the TyG index in Group 3 showed a significant association with CLD events in both the unadjusted (HR, 1.62 [95% CI 1.12-2.32], p<0.05) and adjusted models (HR, 1.66 [95% CI 1.15-2.39], p<0.05; HR, 1.66 [95% CI 1.14-2.41], p<0.05). RCS curves demonstrated a positive association between the TyG index and CLD events in Groups 1 and 3. ROC curves indicated that the predictive value of the TyG index for CLD events was limited (AUC=0.511-0.548).

Conclusions:

Research indicates a positive association between the TyG index and CLD in specific populations, although it is not an independent predictor. The calculation and monitoring of the TyG index can aid in risk stratification and the development of intervention strategies for populations.