{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T06:20:21Z","timestamp":1773037221796,"version":"3.50.1"},"reference-count":29,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T00:00:00Z","timestamp":1773014400000},"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>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The triglyceride\u2013glucose (TyG) index has been identified as a metabolic marker associated with adverse outcomes in sepsis, but its prognostic value in non-diabetic septic patients remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess the association between TyG levels and ICU mortality in non-diabetic sepsis and validate the findings in an external cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective analysis of 2,217 non-diabetic sepsis patients from the MIMIC-IV database was conducted using multivariate logistic regression, threshold effect analysis, restricted cubic spline (RCS) modeling, and subgroup analyses. External validation was performed in an independent ICU cohort of 185 non-diabetic sepsis patients from The Central Hospital of Enshi, stratified by the MIMIC-derived TyG cut-off of 9.163.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>ICU mortality in the MIMIC cohort was 12.2%. Compared with Q2, Q4 showed a significantly increased mortality risk (OR = 1.49, 95% CI: 1.12\u20131.97, P = 0.006). RCS analysis demonstrated a significant U-shaped association with a threshold at TyG = 9.163. Subgroup analyses confirmed consistent trends. In the external validation cohort, mortality was higher in the high-TyG group than in the low-TyG group (29.0% vs. 21.7%), showing a directionally consistent, though non-significant, trend (P = 0.23).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The TyG index is independently associated with ICU mortality in non-diabetic sepsis and exhibits a clear U-shaped pattern. The external validation cohort demonstrated a similar risk trend, supporting the broader applicability of TyG as a simple metabolic marker for risk stratification.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2026.1752068","type":"journal-article","created":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T05:29:52Z","timestamp":1773034192000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Prognostic value of the triglyceride\u2013glucose index for ICU mortality in non-diabetic sepsis: a restricted cubic spline analysis"],"prefix":"10.3389","volume":"17","author":[{"given":"Ming","family":"Min","sequence":"first","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture","place":["Enshi, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dan","family":"Gui","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture","place":["Enshi, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lijun","family":"Gong","sequence":"additional","affiliation":[{"name":"The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Hubei Minzu University","place":["Enshi, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qianfei","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture","place":["Enshi, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yaomei","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture","place":["Enshi, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanli","family":"Cao","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture","place":["Enshi, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peijun","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture","place":["Enshi, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,9]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1136\/postgradmedj-2016-134519","article-title":"The recognition and management of sepsis and septic shock: a guide for non-intensivists","volume":"93","author":"Keeley","year":"2017","journal-title":"Postgrad Med J"},{"key":"B2","doi-asserted-by":"publisher","first-page":"67","DOI":"10.20471\/acc.2022.61.s1.11","article-title":"SEPSIS DEFINITION: WHAT'S NEW IN THE TREATMENT GUIDELINES","volume":"61","author":"Srzi\u0107","year":"2022","journal-title":"Acta Clin Croat"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201504-0781OC","article-title":"Assessment of global incidence and mortality of hospital-treated sepsis. Current estimates and limitations","volume":"193","author":"Fleischmann","year":"2016","journal-title":"Am J Respir Crit Care Med"},{"key":"B4","doi-asserted-by":"publisher","first-page":"151593","DOI":"10.1016\/j.ijmm.2023.151593","article-title":"Association between hospital onset of infection and outcomes in sepsis patients - A propensity score matched cohort study based on health claims data in Germany","volume":"313","author":"Rose","year":"2023","journal-title":"Int J Med Microbiol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2017.04.015","article-title":"Sepsis and septic shock: Pathogenesis and treatment perspectives","volume":"40","author":"Minasyan","year":"2017","journal-title":"J Crit Care"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1016\/j.jemermed.2016.12.009","article-title":"Does early and appropriate antibiotic administration improve mortality in emergency department patients with severe sepsis or septic shock","volume":"53","author":"Sherwin","year":"2017","journal-title":"J Emerg Med"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.13836","article-title":"Incidence and trends of sepsis in US hospitals using clinical vs claims data, 2009-2014","volume":"318","author":"Rhee","year":"2017","journal-title":"Jama"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1109\/JBHI.2023.3253208","article-title":"Cross-hospital sepsis early detection via semi-supervised optimal transport with self-paced ensemble","volume":"27","author":"Ding","year":"2023","journal-title":"IEEE J BioMed Health Inform"},{"key":"B9","doi-asserted-by":"publisher","first-page":"232","DOI":"10.1186\/s12933-024-02343-7","article-title":"Association between triglyceride-glucose related indices and mortality among individuals with non-alcoholic fatty liver disease or metabolic dysfunction-associated steatotic liver disease","volume":"23","author":"Chen","year":"2024","journal-title":"Cardiovasc Diabetol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"986","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":"B11","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2023.1325557","article-title":"Positive association between different triglyceride glucose index-related indicators and psoriasis: evidence from NHANES","volume":"14","author":"Huang","year":"2023","journal-title":"Front Immunol"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2021.03.056","article-title":"Association of triglyceride-glucose index and lung health: A population-based study","volume":"160","author":"Wu","year":"2021","journal-title":"Chest"},{"key":"B13","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1186\/s12933-025-02697-6","article-title":"Association between triglyceride-glucose index and mortality in critically ill patients with atrial fibrillation: a retrospective cohort study","volume":"24","author":"Ding","year":"2025","journal-title":"Cardiovasc Diabetol"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-21-0937","article-title":"Long-term outcome in patients with acute ischemic stroke and heart failure","volume":"87","author":"Takahashi","year":"2023","journal-title":"Circ J"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.2147\/COPD.S477268","article-title":"Elevated triglyceride-glucose (TyG) index predicts poor clinical outcomes in critically ill AECOPD patients: A retrospective study","volume":"19","author":"Wang","year":"2024","journal-title":"Int J Chron Obstruct Pulmon Dis"},{"key":"B16","doi-asserted-by":"publisher","first-page":"399","DOI":"10.1016\/j.numecd.2022.11.004","article-title":"Triglyceride-glucose index and short-term functional outcome and in-hospital mortality in patients with ischemic stroke","volume":"33","author":"Miao","year":"2023","journal-title":"Nutr Metab Cardiovasc Dis"},{"key":"B17","doi-asserted-by":"publisher","first-page":"297","DOI":"10.1186\/s12944-025-02743-y","article-title":"Association between triglyceride-glucose index trajectories and in-hospital mortality in sepsis: a cohort study based on the MIMIC-IV database","volume":"24","author":"Yao","year":"2025","journal-title":"Lipids Health Dis"},{"key":"B18","doi-asserted-by":"publisher","first-page":"1375","DOI":"10.3390\/nu15061375","article-title":"The effects of probiotics\/synbiotics on glucose and lipid metabolism in women with gestational diabetes mellitus: A meta-analysis of randomized controlled trials","volume":"15","author":"Mu","year":"2023","journal-title":"Nutrients"},{"key":"B19","doi-asserted-by":"publisher","first-page":"389","DOI":"10.1186\/s40001-024-01992-4","article-title":"Association between different triglyceride-glucose index combinations with obesity indicators and arthritis: results from two nationally representative population-based study","volume":"29","author":"Zhang","year":"2024","journal-title":"Eur J Med Res"},{"key":"B20","doi-asserted-by":"publisher","first-page":"113","DOI":"10.11604\/pamj.2023.46.113.41795","article-title":"Association of triglyceride-glucose index with vascular risk factors and clinical outcomes among COVID-19 patients: a retrospective cross-sectional study in Mengo Hospital, Kampala, Uganda","volume":"46","author":"Lumu","year":"2023","journal-title":"Pan Afr Med J"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2023.07.004","article-title":"Biomarkers of glucose homeostasis as mediators of the relationship of body mass index and waist circumference with COVID-19 outcomes among postmenopausal women: The Women's Health Initiative","volume":"42","author":"Beydoun","year":"2023","journal-title":"Clin Nutr"},{"key":"B22","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1186\/s12933-024-02231-0","article-title":"Long-term survival in stroke patients: insights into triglyceride-glucose body mass index from ICU data","volume":"23","author":"Huang","year":"2024","journal-title":"Cardiovasc Diabetol"},{"key":"B23","doi-asserted-by":"publisher","first-page":"16153","DOI":"10.1038\/s41598-025-00254-5","article-title":"The association between triglyceride glucose-body mass index and mortality in critically ill patients with respiratory failure: insights from ICU data","volume":"15","author":"Sun","year":"2025","journal-title":"Sci Rep"},{"key":"B24","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1186\/s12876-025-03663-y","article-title":"Association between the development of sepsis and the triglyceride-glucose index in acute pancreatitis patients: a retrospective investigation utilizing the MIMIC-IV database","volume":"25","author":"Xu","year":"2025","journal-title":"BMC Gastroenterol"},{"key":"B25","doi-asserted-by":"publisher","first-page":"103334","DOI":"10.1016\/j.redox.2024.103334","article-title":"Associations of dietary inflammation index and composite dietary antioxidant index with preserved ratio impaired spirometry in US adults and the mediating roles of triglyceride-glucose index: NHANES 2007-2012","volume":"76","author":"Zheng","year":"2024","journal-title":"Redox Biol"},{"key":"B26","doi-asserted-by":"publisher","first-page":"307","DOI":"10.1186\/s12933-023-02041-w","article-title":"Association between triglyceride-glucose index and in-hospital mortality in critically ill patients with sepsis: analysis of the MIMIC-IV database","volume":"22","author":"Zheng","year":"2023","journal-title":"Cardiovasc Diabetol"},{"key":"B27","doi-asserted-by":"publisher","first-page":"668","DOI":"10.1186\/s12888-025-06885-2","article-title":"Establishment and validation of a model for predicting depression risk in stroke patients","volume":"25","author":"Lin","year":"2025","journal-title":"BMC Psychiatry"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1016\/j.orcp.2024.11.001","article-title":"Can adiposity measures enhance the predictive power of the triglyceride-glucose index for metabolic syndrome in adults in the United States","volume":"18","author":"Glasgow","year":"2024","journal-title":"Obes Res Clin Pract"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1111\/nicc.13287","article-title":"The triglyceride glucose index and delirium risk in sepsis patients: A causal inference study","volume":"30","author":"Li","year":"2025","journal-title":"Nurs Crit Care"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2026.1752068\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T05:29:53Z","timestamp":1773034193000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2026.1752068\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,9]]},"references-count":29,"alternative-id":["10.3389\/fendo.2026.1752068"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2026.1752068","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,9]]},"article-number":"1752068"}}