ArticleCardiovascular diabetology2026
Evaluative performance of triglyceride-glucose-frailty index versus surrogate insulin resistance indices for advanced cardiovascular-kidney-metabolic syndrome, cardiometabolic multimorbidity, and mortality: the role of estimated glomerular filtration rate.
Article in Cardiovascular diabetology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
Abstract
backgroundCardiovascular-kidney-metabolic (CKM) syndrome and cardiometabolic multimorbidity (CMM) carry substantial mortality, yet whether a composite index integrating insulin resistance and frailty shows stronger associations with advanced CKM syndrome, CMM, and mortality than conventional metabolic markers remains unclear. This study evaluated the associations of the triglyceride-glucose-frailty index (TyG-FI) with CKM, CMM, and all-cause and cardiovascular mortality, and explored the role of baseline estimated glomerular filtration rate (eGFR).
methodsThe analysis included 11,228 adults aged 20-79 years from the National Health and Nutrition Examination Survey 2001-2018. TyG-FI was calculated as the TyG index multiplied by the frailty index. Survey-weighted logistic and Cox proportional-hazards models were used to estimate odds and hazard ratios, with sequential adjustment for demographic, socioeconomic, and behavioral confounders. Restricted cubic splines examined non-linear relationships. Overall model performance was assessed using receiver operating characteristic curves with DeLong's test, time-dependent AUC, Harrell's C-index, calibration, and decision curve analysis. Exploratory mediation analyses quantified the proportion of mortality associations accounted for by baseline eGFR. Robustness was verified through multiple sensitivity and subgroup analyses.
resultsOver a median follow-up of 90 months (1,220 all-cause and 379 cardiovascular deaths), higher TyG-FI quartiles were associated with graded decreases in survival. Compared with the lowest TyG-FI quartile, the highest quartile yielded markedly elevated odds for advanced CKM syndrome (OR = 4.57, 95% CI: 3.50-5.99) and CMM (OR = 5.09, 95% CI: 2.83-9.16), and higher hazard for all-cause (HR = 3.90, 95% CI: 2.96-5.13) and cardiovascular death (HR = 5.82, 95% CI: 3.38-10.03). Among participants with CMM, the relationship remained for all-cause death (HR = 2.69, 95% CI: 1.69-4.28). The dose-response patterns were non-linear for outcomes (P for non-linearity < 0.001). TyG-FI demonstrated higher discrimination than most surrogate insulin resistance indices, and lower baseline eGFR partly accounted for 16.45% to 26.74% of the associations with mortality. Sensitivity analyses corroborated the consistency of all findings.
conclusionsTyG-FI, which captures both metabolic dysfunction and physiological frailty, showed stronger associations with advanced CKM syndrome, prevalent CMM, and mortality than most surrogate insulin resistance indices. In exploratory analyses, lower baseline eGFR partly accounted for a proportion of the association with mortality. TyG-FI may offer a pragmatic tool for early mortality risk stratification in individuals with high cardiometabolic risk.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.