ArticleBMC infectious diseases2024
The triglyceride-glucose index dynamic trajectory reveals the association between the clinical subphenotype of insulin resistance and mortality in patients with sepsis.
Article in BMC infectious diseases, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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9 citing papers in PubMed.
- Blood Glucose Trajectories and Mortality in Sepsis-Induced Coagulopathy: A Latent Growth Mixture Modeling Analysis.Shock (Augusta, Ga.) · 2026Article
- The U-shaped relationship between triglyceride glucose-body mass index and prognosis of sepsis patients: a retrospective study.BMC infectious diseases · 2026Article
- Association of Triglyceride-to-HDL-C Ratio, Triglyceride-Glucose Index, and Inflammatory Biomarkers with Mortality in Intensive Care Unit Patients with Sepsis.Diagnostics (Basel, Switzerland) · 2026Article
- Triglyceride-glucose index at ICU admission predicts hospital mortality in patients with acute coronary syndrome concomitant sepsis: a Bayesian network analysis of retrospective multicenter cohort study.Frontiers in nutrition · 2026Article
- Association between triglyceride-glucose index trajectories and in-hospital mortality in sepsis: a cohort study based on the MIMIC-IV database.Lipids in health and disease · 2025Article
- Association between trajectory of triglyceride-glucose index and all-cause mortality in critically ill patients with atrial fibrillation: a retrospective cohort study.Cardiovascular diabetology · 2025Observational
- Dynamic trajectories of the triglyceride-glucose index link to all-cause hospital mortality in patients with hypertension and kidney failure: a multicenter study.Frontiers in endocrinology · 2025Article
- Identifying early blood glucose trajectories in sepsis linked to distinct long-term outcomes: a K-means clustering study with external validation.Frontiers in immunology · 2025Article
- Indicators of insulin resistance as predictors of 28-day mortality in patients with VA-ECMO: a retrospective study.Frontiers in medicine · 2025Article
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6 authors.
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Abstract
backgroundThe relationship between the dynamic changes in insulin resistance (IR) and the prognosis of septic patients remains unclear. This study aims to investigate the correlation between the clinical subphenotype of IR represented by the triglyceride-glucose (TyG) index trajectory and the mortality rate among patients with sepsis.
methodsIn this retrospective cohort study, we utilized data from septic patients within the Medical Information Mart for Intensive Care (MIMIC)-IV database version 2.0 to construct trajectories of the TyG index over 72 h. Subsequently, we computed the similarity among various TyG index trajectories with the dynamic time warping (DTW) algorithm and utilized the hierarchical clustering (HC) algorithm to demarcate distinct cluster and identified subphenotypes according to the trajectory trend. Subsequently, we assessed the mortality risk between different subphenotypes using analyses such as survival analysis and validated the robustness of the results through propensity score matching (PSM) and various models.
resultsA total of 2350 patients were included in the study. Two trajectory trends: TyG index decreasing (n = 926) and TyG index increasing (n = 1424) were identified, which indicated corresponding to the clinical subphenotype of increased and alleviative IR respectively. The 28-day and in-hospital mortality for the increased IR group was 28.51% and 25.49% respectively. In comparison, patients in the alleviative IR group with a 28-day mortality of 23.54% and an in-hospital mortality of 21.60%. These subphenotypes exhibited distinct prognosis, time dependent Cox model showed the increased IR group with a higher 28-day mortality [hazard ratio (HR): 1.07, 95% confidence interval (CI): 1.02-1.12, P = 0.01] and in-hospital mortality [HR: 1.05, 95% CI: 1.00-1.11, P = 0.045] compared to the alleviative IR group. Sensitivity analyses with various models further validated the robustness of our findings.
conclusionDynamic increase in the TyG index trajectory is associated with elevated mortality risk among patients with sepsis, which suggests that dynamic increased IR exacerbates the risk of poor outcomes in patients.
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