{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T03:06:25Z","timestamp":1792551985220,"version":"4.5.0"},"reference-count":49,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,1,31]],"date-time":"2025-01-31T00:00:00Z","timestamp":1738281600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The association between triglyceride-glucose (TYG) and its composite obesity indexes and cardio-renal disease in the American population remains insufficiently researched.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study examined a cohort of 11,491 American adults aged 20 years and older from the 2003-2018 National Health and Nutrition Examination Survey (NHANES). To explore the associations between TYG, TyG-Waist-to-Height Ratio (TyG-WHtR), TyG-Body Mass Index (TyG-BMI), TyG-Waist Circumference (TyG-WC), and chronic kidney disease (CKD), cardiovascular disease (CVD), and cardiorenal syndrome (CRS), we utilized weighted multivariate logistic regression, restricted cubic spline (RCS), Receiver operating characteristic (ROC), and subgroup analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Adjusted for confounding factors, there are positive associations between the likelihood of CKD, CVD, and CRS, as well as TYG and its composite obesity indexes. The TYG index was correlated most strongly with CKD (OR 1.42, 95% CI 1.11, 1.82; P = 0.007), while TyG-WHtR had the strongest correlations with CVD (OR 1.63, 95% CI 1.19, 2.22; P = 0.003) and CRS (OR 1.44, 95% CI 1.00, 2.08; P = 0.055). A nonlinear connection was found by RCS analysis between TYG and its composite obesity indexes with CKD (P for overall &amp;lt; 0.001, P for nonlinear &amp;lt; 0.05), while the association with CVD and CRS was predominantly linear (P for overall &amp;lt; 0.001, P for nonlinear &amp;gt; 0.05). Based on ROC curves, TyG-WHtR and TyG-WC emerged as more reliable diagnostic tools than TYG for cardiac and renal diseases. According to subgroup analyses, TyG and its composite obesity measurements were more strongly associated with CKD in younger individuals (\u2264 50), males, and those with diabetes mellitus (P for interaction 0.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The TyG-WHtR and TyG-WC are associated with an increased risk of cardiac and renal disease, indicating enhanced diagnostic accuracy. These metrics provide an effective tool for identifying early cardiorenal disease and improving risk stratification.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2025.1505808","type":"journal-article","created":{"date-parts":[[2025,1,31]],"date-time":"2025-01-31T05:10:54Z","timestamp":1738300254000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":14,"title":["Association between triglyceride-glucose index and its composite obesity indexes and cardio-renal disease: analysis of the NHANES 2013-2018 cycle"],"prefix":"10.3389","volume":"16","author":[{"given":"Yu","family":"Wu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chengsen","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiandong","family":"Cao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,1,31]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(24)00367-2","article-title":"Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021","volume":"403","year":"2024","journal-title":"Lancet (London England)"},{"key":"B2","doi-asserted-by":"publisher","first-page":"696","DOI":"10.1038\/s41581-022-00616-6","article-title":"Epidemiology and risk of cardiovascular disease in populations with chronic kidney disease","volume":"18","author":"Matsushita","year":"2022","journal-title":"Nat Rev Nephrol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2019060574","article-title":"Incident hospitalization with major cardiovascular diseases and subsequent risk of ESKD: implications for cardiorenal syndrome","volume":"31","author":"Ishigami","year":"2020","journal-title":"J Am Soc Nephrol"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.0000000000000064","article-title":"Cardiorenal syndrome in the hospital","volume":"18","author":"McCallum","year":"2023","journal-title":"Clin J Am Soc Nephrol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1152\/physrev.00063.2017","article-title":"Mechanisms of insulin action and insulin resistance","volume":"98","author":"Petersen","year":"2018","journal-title":"Physiol Rev"},{"key":"B6","doi-asserted-by":"publisher","first-page":"15","DOI":"10.4093\/dmj.2021.0280","article-title":"Insulin resistance: from mechanisms to therapeutic strategies","volume":"46","author":"Lee","year":"2022","journal-title":"Diabetes Metab J"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1016\/j.metabol.2021.154766","article-title":"Insulin resistance, cardiovascular stiffening and cardiovascular disease","volume":"119","author":"Hill","year":"2021","journal-title":"Metabolism"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/978-3-319-48382-5_1","article-title":"The definition and prevalence of obesity and metabolic syndrome","volume":"960","author":"Engin","year":"2017","journal-title":"Adv Exp Med Biol"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1007\/s11886-016-0755-4","article-title":"Genetics of insulin resistance and the metabolic syndrome","volume":"18","author":"Brown","year":"2016","journal-title":"Curr Cardiol Rep"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1016\/j.dsx.2022.102581","article-title":"Challenges in the diagnosis of insulin resistance: Focusing on the role of HOMA-IR and Tryglyceride\/glucose index","volume":"16","author":"Tahapary","year":"2022","journal-title":"Diabetes Metab Syndr"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.47391\/JPMA.22-63","article-title":"Triglyceride Glucose (TyG) Index: A surrogate biomarker of insulin resistance","volume":"72","author":"Ramdas Nayak","year":"2022","journal-title":"J Pak Med Assoc"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2022.1018083","article-title":"The non-linear relationship between triglyceride-glucose index and risk of chronic kidney disease in hypertensive patients with abnormal glucose metabolism: A cohort study","volume":"9","author":"Zhu","year":"2022","journal-title":"Front Med (Lausanne)"},{"key":"B13","doi-asserted-by":"publisher","first-page":"168","DOI":"10.1186\/s12933-022-01606-5","article-title":"Association between the triglyceride-glucose index and severity of coronary artery disease","volume":"21","author":"Wang","year":"2022","journal-title":"Cardiovasc Diabetol"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1007\/s10157-019-01729-2","article-title":"Triglyceride-glucose index is a predictor of incident chronic kidney disease: a population-based longitudinal study","volume":"23","author":"Okamura","year":"2019","journal-title":"Clin Exp Nephrol"},{"key":"B15","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1186\/s12933-023-01762-2","article-title":"Triglyceride-glucose index and triglyceride to high-density lipoprotein cholesterol ratio as potential cardiovascular disease risk factors: an analysis of UK biobank data","volume":"22","author":"Che","year":"2023","journal-title":"Cardiovasc Diabetol"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.120.316101","article-title":"Obesity phenotypes, diabetes, and cardiovascular diseases","volume":"126","author":"Pich\u00e9","year":"2020","journal-title":"Circ Res"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1038\/s41581-019-0145-4","article-title":"Obesity, kidney dysfunction and hypertension: mechanistic links","volume":"15","author":"Hall","year":"2019","journal-title":"Nat Rev Nephrol"},{"key":"B18","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1186\/s12933-024-02278-z","article-title":"Comparison of triglyceride glucose index and modified triglyceride glucose indices in prediction of cardiovascular diseases in middle aged and older Chinese adults","volume":"23","author":"Cui","year":"2024","journal-title":"Cardiovasc Diabetol"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1007\/s12020-021-02815-w","article-title":"Triglyceride glucose-waist to height ratio: a novel and effective marker for identifying hepatic steatosis in individuals with type 2 diabetes mellitus","volume":"74","author":"Malek","year":"2021","journal-title":"Endocrine"},{"key":"B20","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1186\/s12933-023-02114-w","article-title":"Association between the cumulative average triglyceride glucose-body mass index and cardiovascular disease incidence among the middle-aged and older population: a prospective nationwide cohort study in China","volume":"23","author":"Li","year":"2024","journal-title":"Cardiovasc Diabetol"},{"key":"B21","doi-asserted-by":"publisher","first-page":"150","DOI":"10.1186\/s12944-024-02147-4","article-title":"Association of the triglyceride-glucose index and its related parameters with frailty","volume":"23","author":"Yin","year":"2024","journal-title":"Lipids Health Dis"},{"key":"B22","doi-asserted-by":"publisher","first-page":"e030564","DOI":"10.1161\/JAHA.123.030564","article-title":"Associations between life\u2019s essential 8 and chronic kidney disease","volume":"12","author":"Ren","year":"2023","journal-title":"J Am Heart Assoc"},{"key":"B23","doi-asserted-by":"publisher","first-page":"279","DOI":"10.1186\/s12933-023-02030-z","article-title":"The triglyceride-glucose index is a predictor for cardiovascular and all-cause mortality in CVD patients with diabetes or pre-diabetes: evidence from NHANES 2001-2018","volume":"22","author":"Zhang","year":"2023","journal-title":"Cardiovasc Diabetol"},{"key":"B24","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1186\/s12944-024-02149-2","article-title":"Independent and joint associations of monocyte to high-density lipoprotein-cholesterol ratio and body mass index with cardiorenal syndrome: insights from NHANES 2003-2020","volume":"23","author":"Lin","year":"2024","journal-title":"Lipids Health Dis"},{"key":"B25","doi-asserted-by":"publisher","first-page":"e19023","DOI":"10.1097\/MD.0000000000019023","article-title":"Identifying the insulin resistance index in nondiabetic Chinese subjects","volume":"99","author":"Tuo","year":"2020","journal-title":"Med (Baltimore)"},{"key":"B26","doi-asserted-by":"publisher","first-page":"e0212963","DOI":"10.1371\/journal.pone.0212963","article-title":"Comparison of triglyceride glucose index, and related parameters to predict insulin resistance in Korean adults: An analysis of the 2007-2010 Korean National Health and Nutrition Examination Survey","volume":"14","author":"Lim","year":"2019","journal-title":"PloS One"},{"key":"B27","doi-asserted-by":"publisher","first-page":"170","DOI":"10.1186\/s12933-023-01906-4","article-title":"Triglyceride-glucose index and coronary artery disease: a systematic review and meta-analysis of risk, severity, and prognosis","volume":"22","author":"Liang","year":"2023","journal-title":"Cardiovasc Diabetol"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1016\/j.numecd.2023.03.026","article-title":"Association between triglyceride-glucose index and chronic kidney disease: A cohort study and meta-analysis","volume":"33","author":"Ren","year":"2023","journal-title":"Nutr Metab Cardiovasc Dis"},{"key":"B29","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1186\/s12933-024-02122-4","article-title":"Interacting and joint effects of triglyceride-glucose index (TyG) and body mass index on stroke risk and the mediating role of TyG in middle-aged and older Chinese adults: a nationwide prospective cohort study","volume":"23","author":"Huo","year":"2024","journal-title":"Cardiovasc Diabetol"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1007\/s11255-022-03433-9","article-title":"Association between the triglyceride-glucose index and chronic kidney disease in adults","volume":"55","author":"Liu","year":"2023","journal-title":"Int Urol Nephrol"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1186\/s12933-023-02115-9","article-title":"The association between triglyceride-glucose index and its combination with obesity indicators and cardiovascular disease: NHANES 2003-2018","volume":"23","author":"Dang","year":"2024","journal-title":"Cardiovasc Diabetol"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.4235\/agmr.23.0096","article-title":"The triglyceride-glucose index is independently associated with chronic kidney disease in the geriatric population, regardless of obesity and sex","volume":"27","author":"Kim","year":"2023","journal-title":"Ann Geriatr Med Res"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1080\/0886022X.2024.2320261","article-title":"The clinical evaluation of the triglyceride-glucose index as a risk factor for coronary artery disease and severity of coronary artery stenosis in patients with chronic kidney disease","volume":"46","author":"Liu","year":"2024","journal-title":"Ren Fail"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.2147\/DMSO.S469260","article-title":"Comparison of tyG and newly tyG related indicators for chronic kidney diseases estimation in a chinese population","volume":"17","author":"Chen","year":"2024","journal-title":"Diabetes Metab Syndr Obes"},{"key":"B35","doi-asserted-by":"publisher","first-page":"208","DOI":"10.1186\/s12933-024-02290-3","article-title":"Association of triglyceride-glucose index and its related parameters with atherosclerotic cardiovascular disease: evidence from a 15-year follow-up of Kailuan cohort","volume":"23","author":"Xia","year":"2024","journal-title":"Cardiovasc Diabetol"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.2147\/NSS.S362101","article-title":"Association between triglyceride glucose index-waist circumference and risk of first myocardial infarction in chinese hypertensive patients with obstructive sleep apnoea: an observational cohort study","volume":"14","author":"Hu","year":"2022","journal-title":"Nat Sci Sleep"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2024.1471535","article-title":"The association of triglyceride-glucose index and combined obesity indicators with chest pain and risk of cardiovascular disease in American population with pre-diabetes or diabetes","volume":"15","author":"Zheng","year":"2024","journal-title":"Front Endocrinol (Lausanne)"},{"key":"B38","doi-asserted-by":"publisher","first-page":"1994","DOI":"10.1016\/j.numecd.2024.04.003","article-title":"Triglyceride-glucose index and mortality risk in individuals with or without chronic kidney disease: Insights from a national survey of United States adults, 1999-2018","volume":"34","author":"Qin","year":"2024","journal-title":"Nutr Metab Cardiovasc Dis"},{"key":"B39","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1186\/s12933-020-01121-5","article-title":"The impact of triglyceride-glucose index on incident cardiovascular events during 16 years of follow-up: Tehran Lipid and Glucose Study","volume":"19","author":"Barzegar","year":"2020","journal-title":"Cardiovasc Diabetol"},{"key":"B40","doi-asserted-by":"publisher","first-page":"122","DOI":"10.1186\/s12933-018-0762-4","article-title":"Association between insulin resistance and the development of cardiovascular disease","volume":"17","author":"Ormazabal","year":"2018","journal-title":"Cardiovasc Diabetol"},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpcardiol.2023.102344","article-title":"Cardiovascular-Kidney-Metabolic (CKM) syndrome: A state-of-the-art review","volume":"49","author":"Sebastian","year":"2024","journal-title":"Curr Probl Cardiol"},{"key":"B42","doi-asserted-by":"publisher","first-page":"998","DOI":"10.1161\/CIRCULATIONAHA.119.045409","article-title":"Altered hemodynamics and end-organ damage in heart failure: impact on the lung and kidney","volume":"142","author":"Verbrugge","year":"2020","journal-title":"Circulation"},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.1152\/ajpregu.00026.2019","article-title":"Neurohumoral interactions contributing to renal vasoconstriction and decreased renal blood flow in heart failure","volume":"317","author":"Ramchandra","year":"2019","journal-title":"Am J Physiol Regul Integr Comp Physiol"},{"key":"B44","doi-asserted-by":"publisher","DOI":"10.1016\/j.freeradbiomed.2007.03.027","article-title":"Nox enzymes, ROS, and chronic disease: an example of antagonistic pleiotropy","volume":"43","author":"Lambeth","year":"2007","journal-title":"Free Radic Biol Med"},{"key":"B45","doi-asserted-by":"publisher","DOI":"10.4239\/wjd.v14.i4.352","article-title":"Role of antidiabetic agents in type 2 diabetes patients with chronic kidney disease","volume":"14","author":"Lin","year":"2023","journal-title":"World J Diabetes"},{"key":"B46","doi-asserted-by":"publisher","DOI":"10.1007\/s11906-012-0279-2","article-title":"Oxidative stress in the cardiorenal metabolic syndrome","volume":"14","author":"Whaley-Connell","year":"2012","journal-title":"Curr Hypertens Rep"},{"key":"B47","doi-asserted-by":"publisher","DOI":"10.1016\/j.mcna.2016.08.009","article-title":"The renin angiotensin aldosterone system in obesity and hypertension: roles in the cardiorenal metabolic syndrome","volume":"101","author":"Cabandugama","year":"2017","journal-title":"Med Clin North Am"},{"key":"B48","doi-asserted-by":"publisher","first-page":"7","DOI":"10.15280\/jlm.2015.5.1.7","article-title":"Comorbidities and metabolic derangement of NAFLD","volume":"5","author":"Bang","year":"2015","journal-title":"J Lifestyle Med"},{"key":"B49","doi-asserted-by":"publisher","DOI":"10.4239\/wjd.v11.i8.322","article-title":"Range of adiposity and cardiorenal syndrome","volume":"11","author":"Pazos","year":"2020","journal-title":"World J Diabetes"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2025.1505808\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,31]],"date-time":"2025-01-31T05:11:00Z","timestamp":1738300260000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2025.1505808\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,31]]},"references-count":49,"alternative-id":["10.3389\/fendo.2025.1505808"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2025.1505808","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,31]]},"article-number":"1505808"}}