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Adipokines, Inflammation, and Metabolic Diseases / Regulation of Appetite and Obesity · Journal article
BMC Cardiovascular Disorders · September 6, 2026
Encouraging direction, but not yet definitive.
This prospective cohort analysis of 11,560 adults with overweight or obesity demonstrates that the TyG-WC index (triglyceride–glucose–waist circumference), a composite marker integrating insulin resistance and central adiposity, is independently associated with increased all-cause and cardiovascular mortality risk in a dose-dependent manner. The findings are observational and cross-sectional in exposure measurement; the authors appropriately call for prospective validation before clinical adoption.
Prospective cohort study with multivariable Cox proportional hazards regression, restricted cubic spline analyses, subgroup analyses, propensity score matching, and competing risk models.. 11,560 adults with overweight or obesity enrolled from the National Health and Nutrition Examination Survey (1999–2018).. Intervention: TyG-WC index (composite of triglyceride, glucose, and waist circumference), measured at baseline.. Compared with: Lowest TyG-WC quartile (Q1) for quartile analysis; linear per-unit increase for continuous analysis.. n = 11,560. United States (National Health and Nutrition Examination Survey)..
Over median 7.6-year follow-up, 1,098 all-cause deaths and 294 cardiovascular deaths occurred in 11,560 participants. Highest vs. lowest TyG-WC quartile: all-cause mortality HR 1.589 (95% CI 1.308–1.929) and cardiovascular mortality HR 1.728 (95% CI 1.158–2.579). TyG-WC as continuous variable: all-cause mortality adjusted HR 1.135 (95% CI 1.063–1.211) and cardiovascular mortality adjusted HR 1.168 (95% CI 1.031–1.324) per unit increase.
Source does not report absolute risk differences, number needed to harm, or discrimination metrics (e.g., C-statistic) for clinical utility assessment. Highest vs. lowest TyG-WC quartile: all-cause mortality HR 1.589 (95% CI 1.308–1.929) and cardiovascular mortality HR 1.728 (95% CI 1.158–2.579).
TyG-WC offers a simple, scalable composite marker that may complement existing risk stratification in overweight and obese populations; however, because exposure was measured cross-sectionally and causation cannot be established from observational data, prospective validation is necessary before clinical implementation.
Observational cohort study with hard clinical outcomes (mortality) in a large, nationally representative US sample, but dependent on cross-sectional exposure measurement and unable to establish causation; requires prospective validation.
As stated by the source record.
Quoted from the source exactly as published.
TyG-WC offers a simple, scalable composite marker that may complement existing risk stratification in overweight and obese populations; however, because exposure was measured cross-sectionally and causation cannot be established from observational data, prospective validation is necessary before clinical implementation.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Simple and scalable tools for mortality risk stratification in individuals with overweight or obesity remain limited. The triglyceride–glucose–waist circumference (TyG-WC) index integrates insulin resistance and central adiposity, but its prognostic value for mortality in this high-risk population is not well established. We analyzed 11,560 adults with overweight or obesity from the National Health and Nutrition Examination Survey (1999–2018) with mortality follow-up through 2019. Associations between TyG-WC and all-cause and cardiovascular mortality were assessed using multivariable Cox proportional hazards models and restricted cubic spline analyses. Subgroup, exploratory mediation, and sensitivity analyses, including propensity score matching and competing risk models, were performed. Over a median follow-up of 7.6 years, 1,098 deaths occurred, including 294 from cardiovascular disease. Compared with participants in the lowest TyG-WC quartile (Q1), those in the highest quartile (Q4) had significantly higher risks of all-cause mortality (HR 1.589, 95% CI 1.308–1.929) and cardiovascular mortality (HR 1.728, 95% CI 1.158–2.579). When analyzed as a continuous variable, higher TyG-WC levels were also independently associated with increased risks of all-cause mortality (adjusted HR 1.135, 95% CI 1.063–1.211) and cardiovascular mortality (adjusted HR 1.168, 95% CI 1.031–1.324). The associations showed an overall positive dose–response pattern and remained generally consistent across multiple sensitivity analyses. Exploratory mediation analysis suggested that white blood cell count partially mediated the observed relationships. TyG-WC is associated with increased mortality risk among individuals with overweight or obesity and may represent a complementary marker for risk assessment, pending further prospective validation.
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