Association of triglyceride-glucose index and its combination with obesity indicators in predicting the risk of aortic aneurysm and dissection

Background The association between the triglyceride-glucose (TyG) index and its combination with obesity indictors in aortic aneurysm and dissection (AAD) remains unclear. We aimed to investigate the association between TyG and TyG-body mass index (TyG-BMI), TyG-waist circumference (TyG-WC), TyG-waist height ratio (TyG-WHtR) and AAD risk.Methods This study included 387,483 baseline participants from the UK Biobank with complete data on TyG, TyG-BMI, TyG-WC and TyG-WHtR. Cox proportional hazard models evaluated the relationship between these four indicators and the risk of AAD occurrence. Restricted cubic spline (RCS) examined the non-linear relationship between these indicators and AAD risk, while receiver operating characteristic (ROC) curves assessed the predictive value of these four indicators for AAD risk.Results Over a median follow-up of 13.7 years, 3,041 AAD events were recorded. Multivariate Cox regression analysis indicated that for each standard deviation increase, the risk of AAD occurrence increased by 33% (HR: 1.33, 95%CI: 1.29-1.38), 25% (HR: 1.25, 95%CI: 1.21-1.29), 61% (HR: 1.61, 95%CI: 1.56-1.66) and 44% (HR: 1.44, 95%CI: 1.39-1.49) for TyG, TyG-BMI, TyG-WC and TyG-WHtR, respectively. RCS demonstrated a linear relationship between these indicators and AAD risk, with TyG-WC demonstrating the best performance in predicting AAD occurrence based on ROC curves.Conclusion The present study, based on a large prospective cohort design, showed that higher TyG index and its combination with obesity indices were significantly associated with the risk of AAD. Moreover, AFT models further showed that elevation of these indicators significantly advanced the onset of AAD. In addition, RCS analyses demonstrated a linear association between these indicators and the risk of AAD, and the TyG-WC showed higher predictive ability for AAD. These findings emphasize the potential application of the TyG index and its combination with obesity indicators in the early identification of AAD.