Higher TyG-FI was associated with prevalent CVD and cardiovascular mortality among US adults with self-reported RA, with TyG-FI demonstrating better discrimination than TyG alone for prevalent CVD.
Each 1-unit higher TyG-FI was associated with significantly higher odds of prevalent CVD in fully adjusted models.
Each 1-unit higher TyG-FI was associated with a significantly higher hazard of cardiovascular mortality in fully adjusted models.
Models incorporating TyG-FI demonstrated better discrimination for prevalent CVD compared to models incorporating TyG alone.
An exploratory subgroup analysis suggested that the association between TyG-FI and prevalent CVD was stronger among participants aged 65 years or younger.
The study population consisted of 1090 adults with self-reported rheumatoid arthritis drawn from 10 cycles of NHANES conducted between 1999 and 2018.
The authors concluded that TyG-FI may capture complementary metabolic and frailty-related information but noted that its incremental predictive value, calibration, clinical utility, and external validity require further evaluation before clinical implementation.
This research suggests that a combined measure called the TyG-FI — which multiplies a blood test marker of insulin resistance (the triglyceride-glucose index) by a score reflecting accumulated health deficits (a frailty index) — may be useful for identifying rheumatoid arthritis (RA) patients who are at higher risk for heart disease and cardiovascular death. Using data from over 1,000 American adults with self-reported RA collected between 1999 and 2018, the researchers found that people with higher TyG-FI scores were more than four times as likely to already have cardiovascular disease and had a 77% higher risk of dying from cardiovascular causes compared to those with lower scores. The study also found that TyG-FI identified heart disease risk better than the triglyceride-glucose index alone, particularly for detecting existing cardiovascular disease (an accuracy score of 0.80 versus 0.73). An additional finding suggested the link between TyG-FI and heart disease may be especially strong in people aged 65 and younger with RA, though this result was exploratory. These findings are notable because people with RA face higher-than-average cardiovascular risks that standard risk tools may not fully capture, partly because RA involves both chronic inflammation and metabolic changes. This research suggests that combining insulin resistance and frailty into a single index could provide a more complete picture of cardiovascular risk in RA patients than either measure alone. However, the authors caution that more research is needed to confirm these findings in other populations, assess how well the tool is calibrated, and determine whether using it in clinical practice would actually improve patient outcomes before it is considered for routine use.
Xu Y, Zhao H, Gao Y, Han J, Wu Z, Zhang L, et al.. (2026). Comparison analysis of the triglyceride-glucose index, triglyceride-glucose and frailty index in cardiovascular disease and mortality association among patients with rheumatoid arthritis: A population-based cohort study.. Medicine. https://doi.org/10.1097/MD.0000000000051143