{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T02:00:33Z","timestamp":1785463233610,"version":"3.56.0"},"reference-count":34,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T00:00:00Z","timestamp":1767139200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T00:00:00Z","timestamp":1767139200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp;amp; Obste"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The triglyceride\u2010glucose body mass index (TyG\u2010BMI) is a novel indicator combining an insulin resistance proxy (TyG index) with adiposity. It remains unclear how TyG\u2010BMI relates to long\u2010term mortality risk in postmenopausal women, a group prone to metabolic changes after menopause. This study investigated the association between TyG\u2010BMI and all\u2010cause mortality, with secondary outcomes of cardiovascular disease (CVD) mortality and cancer mortality, in a nationally representative cohort of US postmenopausal women.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We analyzed data from 3844 postmenopausal women (mean age 64.8\u2009\u00b1\u200910.8\u2009years) in the 2001\u20132014 National Health and Nutrition Examination Survey (NHANES) who had baseline fasting triglycerides, glucose, and body mass index (BMI) measured. The TyG\u2010BMI index was calculated as ln[fasting triglycerides (mg\/dL)\u2009\u00d7\u2009fasting glucose (mg\/dL)\/2]\u2009\u00d7\u2009BMI (kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ). Mortality outcomes (all\u2010cause, CVD, and cancer mortality) were ascertained through linkage to National Death Index records, with median follow\u2010up of 119\u2009months (approximately 9.9\u2009years). Cox proportional hazards models were used to estimate hazard ratios (HRs) for mortality per standard deviation (SD) increase in TyG\u2010BMI, adjusting for age, ethnicity, poverty\u2010income ratio, smoking, alcohol use, and total physical activity (MET\u2010min\/week). We used restricted cubic splines to assess nonlinearity and a two\u2010piece Cox model to estimate threshold effects, with log\u2010likelihood ratio tests to confirm nonlinear associations. Sensitivity analyses were conducted to test the robustness of findings.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Over follow\u2010up, 1033 participants died (26.9%), including 336 CVD deaths (8.7%) and a similar order of magnitude of cancer deaths. The baseline TyG\u2010BMI averaged 260.7\u2009\u00b1\u200967.0. We observed a nonlinear (U\u2010shaped) relationship between TyG\u2010BMI and all\u2010cause mortality (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.0001 for nonlinearity). An inflection point was identified at a TyG\u2010BMI of approximately 289. Below this point, higher TyG\u2010BMI was associated with lower mortality risk: for each 1 SD (67.0\u2010unit) increase in TyG\u2010BMI, the adjusted HR for all\u2010cause mortality was 0.77 (95% confidence interval [CI] 0.69\u20130.86,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.0001). Above the threshold of 289, higher TyG\u2010BMI was associated with higher mortality risk: per SD increase HR\u2009=\u20091.28 (95% CI 1.13\u20131.46,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.0002). In secondary outcome analyses, TyG\u2010BMI showed a similar nonlinear pattern with CVD mortality (U\u2010shaped association, with low TyG\u2010BMI linked to higher CVD death risk and an increasing hazard at the upper end), although estimates were less precise due to fewer events. By contrast, no significant positive association was observed between TyG\u2010BMI and cancer mortality; if anything, higher TyG\u2010BMI tended to correspond to a slight reduction in cancer mortality risk, although this trend did not reach statistical significance. All results were consistent in sensitivity analyses.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this cohort of US postmenopausal women, TyG\u2010BMI exhibited a U\u2010shaped association with all\u2010cause mortality. Both low and high TyG\u2010BMI values conferred elevated mortality risk, especially from cardiovascular causes, while intermediate TyG\u2010BMI levels were associated with the lowest risk. These findings suggest that maintaining a balanced TyG\u2010BMI, reflecting neither extreme leanness with low metabolic reserves nor excessive insulin\u2010resistant adiposity, might be important for longevity in older women.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ijgo.70778","type":"journal-article","created":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T06:55:01Z","timestamp":1767250501000},"page":"1569-1579","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Nonlinear association of triglyceride\u2010glucose body mass index with all\u2010cause mortality in postmenopausal women, a retrospective cohort study: Evidence from the 2001 to 2014 National Health and nutrition examination 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