ArticleAmerican journal of preventive cardiology2025
Relationships among fibrosis-4, triglyceride-glucose index, and cardiovascular disease: Evidence from the NHANES 2003-2018.
Article in American journal of preventive cardiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Comprehensive evaluation of triglyceride glucose index-a body shape index (TyG-ABSI) for incident peripheral artery disease: data-driven phenotyping and machine learning-based risk prediction in the UK Biobank.Cardiovascular diabetology · 2026Article
- Association between the triglyceride-glucose-frailty index and all-cause and cardiovascular mortality in individuals with cardiovascular-kidney-metabolic syndrome: the mediating role of the poverty-income ratio.Cardiovascular diabetology · 2026Article
- Association of the fibrosis-4 index with prevalent diabetes among adults: a cross-sectional analysis of NHANES 2003-2018 and a Chinese hospital-based health examination population.Frontiers in endocrinology · 2026Article
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Abstract
Objective: The Fibrosis-4 (FIB-4) index is linked to cardiovascular diseases (CVD), but the role of the triglyceride-glucose (TyG) index in this relationship remains unclear. This study evaluates the associations among FIB-4, TyG, and CVD-related outcomes, and explores whether TyG mediates these effects. Methods: This cross-sectional and cohort study analyzed data from NHANES (2003-2018). Logistic regression and Cox proportional hazards models assessed the associations between FIB-4, TyG, CVD, and all-cause mortality (ACM). Restricted cubic spline (RCS) curves examined potential non-linear relationships, and mediation analysis tested TyG's role in mediating the effect of FIB-4 on CVD and ACM. Results: Among 19,119 participants, 2229 (9.28 %) were diagnosed with CVD. Individuals with FIB-4 levels above the median and elevated TyG levels (above the median) exhibited the highest risk of CVD (odds ratio = 6.02; 95 % CI: 3.60-10.06). Among CVD patients, those with elevated FIB-4 and TyG levels faced a substantially higher risk of ACM (HR = 2.98; 95 % CI: 1.75-5.09). RCS curves revealed a strong positive correlation between FIB-4, TyG, and both CVD and the risk of ACM. Mediation analysis revealed that TyG partially mediated the effect of FIB-4 on CVD incidence (mediation proportion: 31.82 %, P Conclusion: Elevated FIB-4 levels indirectly increase CVD risk via TyG, and combining both indices improve CVD and mortality prediction. These findings suggest that managing both liver fibrosis and insulin resistance could reduce CVD and mortality risk.
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