AbstractThe association between insulin resistance (IR) and the risk of all-cause mortality and cardiovascular mortality among osteoarthritis (OA) patients remains uncertain. This study aims to clarify the correlation between a novel marker of IR, the triglyceride glucose-body mass index (TyG-BMI), and the risk of all-cause mortality and cardiovascular mortality in OA patients.

摘要胰岛素抵抗（IR）与骨关节炎（OA）患者全因死亡和心血管死亡风险之间的关联仍不确定。本研究旨在阐明IR的新标志物甘油三酯-葡萄糖体重指数（TyG-BMI）与OA患者全因死亡率和心血管死亡率风险之间的相关性。

Data from the National Health and Nutrition Examination Survey (NHANES) spanning from 1999 to 2020 were analyzed. Multivariable Cox proportional hazards regression analysis and restricted cubic spline plots were employed to elucidate the association between the TyG-BMI index and the risk of all-cause mortality or cardiovascular mortality in OA patients.

分析了1999年至2020年全国健康与营养调查（NHANES）的数据。采用多变量Cox比例风险回归分析和限制性三次样条图来阐明TyG BMI指数与OA患者全因死亡或心血管死亡风险之间的关联。

Additionally, subgroup analysis was conducted to explore potential interactions and identify populations at elevated risk of mortality. The study cohort comprised 4097 OA patients who were followed up for a period of 20 years, during which 1197 cases of all-cause mortality and 329 cases of mortality attributed to cardiovascular disease were recorded.

此外，还进行了亚组分析，以探索潜在的相互作用，并确定死亡风险升高的人群。该研究队列包括4097名OA患者，随访20年，其中记录了1197例全因死亡率和329例心血管疾病死亡率。

Our findings revealed a U-shaped nonlinear relationship between the TyG-BMI index and the risk of all-cause mortality or cardiovascular mortality in OA patients, with the lowest mortality risk thresholds identified at 282 and 270, respectively. Moreover, surpassing these thresholds was associated with a 3% increase in the risk of all-cause mortality and a 5% increase in the risk of cardiovascular mortality for every 10-unit increment in TyG-BMI level.

我们的研究结果显示，TyG BMI指数与OA患者全因死亡或心血管死亡风险之间存在U型非线性关系，最低死亡率风险阈值分别为282和270。此外，超过这些阈值，TyG BMI水平每增加10个单位，全因死亡风险增加3%，心血管死亡风险增加5%。

Among American OA patients, a U-shaped nonlinear relationship exists between the TyG-BMI index and the risk of all-cause mortality or cardiovascular mortality. These findings underscore the significant role of IR in the progression of OA..

在美国OA患者中，TyG BMI指数与全因死亡或心血管死亡风险之间存在U型非线性关系。这些发现强调了IR在OA进展中的重要作用。。

IntroductionOsteoarthritis (OA) stands as the predominant form of chronic arthritis, inflicting pain, joint deformity, and escalating healthcare expenditures1, particularly among the elderly population, affecting an estimated 240 million individuals worldwide2,3. The etiology of OA is intricate, involving a nexus of genetic, biological, and biomechanical factors1.

引言骨关节炎（OA）是慢性关节炎的主要形式，造成疼痛，关节畸形和医疗保健支出不断增加1，特别是在老年人群中，影响全球约2.4亿人2,3。OA的病因错综复杂，涉及遗传，生物学和生物力学因素的联系1。

Recent decades have witnessed a surge in OA prevalence owing to demographic aging and mounting obesity rates4. Notably, mounting evidence underscores that OA patients face heightened susceptibility to cardiovascular fatalities and all-cause mortality relative to the general populace5,6,7. Consequently, the pursuit of prognostic biomarkers for OA to prognosticate and mitigate the long-term mortality risk represents a paramount endeavor, notably concerning cardiovascular-related mortality events.Obesity is widely acknowledged as a cardinal risk factor precipitating the onset and progression of OA8.

近几十年来，由于人口老龄化和肥胖率上升，OA患病率激增4。值得注意的是，越来越多的证据强调，相对于普通人群，OA患者对心血管死亡和全因死亡率的敏感性更高[5,6,7]。因此，追求OA的预后生物标志物来预测和减轻长期死亡风险是一项最重要的努力，特别是关于心血管相关死亡事件。肥胖被广泛认为是导致OA8发病和进展的主要危险因素。

Historically, mechanical attrition resultant from excess weight, joint overburden, or malformations has been the predominant explanatory paradigm1,8. However, contemporary research posits OA as a multifaceted malady, implicating diverse factors such as adipose deposition, inflammatory mediators, and insulin resistance (IR) in the genesis and progression of obesity-associated OA8,9.

从历史上看，超重，关节覆盖或畸形导致的机械磨损一直是主要的解释范例1,8。然而，当代研究认为OA是一种多方面的疾病，在肥胖相关OA8,9的发生和发展中涉及多种因素，如脂肪沉积，炎症介质和胰岛素抵抗（IR）。

Current scholarship delineates IR and type 2 diabetes mellitus (T2DM) as independent risk factors expediting OA progression10,11,12,13. IR denotes a state of diminished sensitivity and responsivity to insulin action14, intricately entwined with aberrations in glucose metabolism, lipid dysregulation, maladjusted inflammatory cascades, and oxidative stress13,15.

目前的奖学金将IR和2型糖尿病（T2DM）描述为加速OA进展的独立危险因素10,11,12,13。IR表示对胰岛素作用的敏感性和反应性降低14，与葡萄糖代谢异常，脂质失调，炎症级联失调和氧化应激13,15错综复杂地交织在一起。

Prolonged IR precipitates pathological alterations including the accumulation of .

延长的IR会导致病理改变，包括积累。

Data availability

数据可用性

The data supporting the conclusions of this article can be accessed at National Health and Nutrition Examination Survey (NHANES). (https://wwwn.cdc.gov/nchs/nhanes/search/datapage.aspx?Component=Demographics) (https://wwwn.cdc.gov/nchs/nhanes/search/datapage.aspx?Component=Laboratory).

。（笑声）(https://wwwn.cdc.gov/nchs/nhanes/search/datapage.aspx?Component=Demographics)（笑声）(https://wwwn.cdc.gov/nchs/nhanes/search/datapage.aspx?Component=Laboratory)。

AbbreviationsOA:

缩写OA：

Osteoarthritis

骨关节炎

NHANES:

是啊。

National Health and Nutrition Examination Survey

全国健康与营养检查调查

TyG-BMI:

TyG BMI：

Triglyceride glucose-body mass index

甘油三酯葡萄糖体重指数

NCHS:

NCHS：

National Center for Health Statistics

国家卫生统计中心

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Download referencesAuthor informationAuthor notesThese authors contributed equally: Wei Wang and Fan Zhou.Authors and AffiliationsDepartment of Orthopedics, Dandong Central Hospital, China Medical University, No. 338 Jinshan Street, Zhenxing District, Dandong, 118002, Liaoning, People’s Republic of ChinaWei Wang, Yuhao Li, Haoran Sun & Wenbo DingWest China School of Nursing, Sichuan University, Chengdu, ChinaFan ZhouSchool of Clinical Medicine, Dalian Medical University, Dalian, ChinaYazhou LiuDepartment of Rheumatology, Dandong Central Hospital, China Medical University, Dandong, ChinaQiaomei LvAuthorsWei WangView author publicationsYou can also search for this author in.

下载参考文献作者信息作者注意到这些作者做出了同样的贡献：王伟和周凡。作者和所属单位中国医科大学丹东市中心医院骨科，丹东振兴区金山街338号，辽宁118002，中华人民共和国王伟，李玉浩，孙浩然，丁文波四川大学华西护理学院，成都，中国大连医科大学范洲临床医学院，大连，刘亚洲中国医科大学丹东市中心医院风湿病科，丹东，中国乔美LvAuthorsWei WangView作者出版物您也可以在中搜索这位作者。

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PubMed Google ScholarContributionsStudy concept: DWB and QML. Study design: All authors. Acquisition, analysis, or interpretation of data: WW, FZ, YHL. Statistical analysis: WW, FA, YZL, and HRS. Drafting of the manuscript: WW and YHL. Critical revision of the manuscript for important intellectual content: All authors.Corresponding authorCorrespondence to.

PubMed谷歌学术贡献研究概念：DWB和QML。研究设计：所有作者。数据的获取，分析或解释：WW，FZ，YHL。统计分析：WW，FA，YZL和HRS。手稿起草：WW和YHL。重要知识内容手稿的批判性修订：所有作者。对应作者对应。

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Reprints and permissionsAbout this articleCite this articleWang, W., Zhou, F., Li, Y. et al. U-shaped association between triglyceride glucose-body mass index with all-cause and cardiovascular mortality in US adults with osteoarthritis: evidence from NHANES 1999–2020.

转载和许可本文引用本文Wang，W.，Zhou，F.，Li，Y。等人。甘油三酯-葡萄糖体重指数与美国成人骨关节炎全因死亡率和心血管死亡率之间的U型关联：NHANES 1999-2020的证据。

Sci Rep 14, 19959 (2024). https://doi.org/10.1038/s41598-024-70443-1Download citationReceived: 10 July 2024Accepted: 16 August 2024Published: 28 August 2024DOI: https://doi.org/10.1038/s41598-024-70443-1Share this articleAnyone you share the following link with will be able to read this content:Get shareable linkSorry, a shareable link is not currently available for this article.Copy to clipboard.

Sci Rep 1419959（2024）。https://doi.org/10.1038/s41598-024-70443-1Download引文收到日期：2024年7月10日接受日期：2024年8月16日发布日期：2024年8月28日OI：https://doi.org/10.1038/s41598-024-70443-1Share本文与您共享以下链接的任何人都可以阅读此内容：获取可共享链接对不起，本文目前没有可共享的链接。复制到剪贴板。

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KeywordsOsteoarthritisTriglyceride glucose-body mass indexTyG-BMIMortalityNHANES

关键词骨质疏松症甘油三酯葡萄糖体重指数/BMI死亡率

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