{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T05:14:33Z","timestamp":1778130873044,"version":"3.51.4"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T00:00:00Z","timestamp":1778112000000},"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":"\n Objective<\/jats:title>\n The triglyceride glucose-body mass index (TyG-BMI) is recognized as a reliable indicator for assessing insulin resistance. The association between TyG-BMI and heart failure (HF) has been less studied, with inconsistent findings. We aimed to investigate the relationship between TyG-BMI and HF in among the Chinese populations with type 2 diabetes.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This retrospective cohort study included 4116 patients with type 2 diabetes, comprising 2941 men and 1175 women. TyG-BMI levels were determined utilizing the equation. The primary outcome was the diagnosis of HF, confirmed by cardiologists utilizing ICD-10-CM code I50. Cox proportional hazards models were utilized to evaluate the relationship between TyG-BMI and HF. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the discriminative ability of TyG-BMI, BMI, and the TyG index. Shapley Additive Explanations (SHAP) analysis was applied to interpret the contribution of each variable within the prediction model. Additionally, the Sprague-Dawley rats were used to illustrate alterations in glucose and lipid metabolic parameters in the context of impaired cardiac function.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Over a median follow-up of 3.01 years, 904 new cases of HF were identified. After adjusting for multiple factors, the hazard ratios (HRs) [95% confidence interval (CI)] of HF based on quartiles of TyG-BMI levels at baseline [&lt;175 (set as the reference), 175-208, 209-250, \u2265 250] were 1.00, 1.11(95% CI 0.89-1.45), 1.17 (95% CI 0.94-1.45), and 1.40 (95% CI 1.13-1.73), respectively. The TyG-BMI index exhibited robust predictive capability for incident HF, with an area under the curve (AUC) of 0.83, in contrast to 0.80 for BMI and 0.72 for the TyG index. Rats with impaired cardiac function exhibited elevated levels of blood glucose and lipids, as evidenced by animal research.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n In the overall population with type 2 diabetes, a higher TyG-BMI is associated with increased risk of HF. In comparison to TyG and BMI, the TyG-BMI index exhibits superior predictive value for incident HF.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fendo.2026.1798721","type":"journal-article","created":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T04:56:54Z","timestamp":1778129814000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Association between triglyceride glucose-body mass index and incident risk of heart failure among patients with type 2 diabetes: a real-world study"],"prefix":"10.3389","volume":"17","author":[{"given":"Zhe","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Cardiology, The First Affiliated Hospital of Jinzhou Medical University","place":["Jinzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Baoze","family":"Qu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The First Affiliated Hospital of Jinzhou Medical University","place":["Jinzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qiuning","family":"Wang","sequence":"additional","affiliation":[{"name":"School of Basic Medical Sciences, Jinzhou Medical University","place":["Jinzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,7]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1038\/s41569-024-01046-6","article-title":"Global epidemiology of heart failure","volume":"21","author":"Khan","year":"2024","journal-title":"Nat Rev Cardiol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1186\/s40364-025-00728-8","article-title":"Global, regional, and national burden of heart failure and its underlying causes, 1990-2021: results from the global burden of disease study 2021","volume":"13","author":"Ran","year":"2025","journal-title":"biomark Res"},{"key":"B3","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1016\/j.cardfail.2024.07.001","article-title":"HF STATS 2024: Heart failure epidemiology and outcomes statistics an updated 2024 report from the Heart Failure Society of America","volume":"31","author":"Bozkurt","year":"2025","journal-title":"J Card Fail"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1161\/circresaha.116.306206","article-title":"Insulin signaling and heart failure","volume":"118","author":"Riehle","year":"2016","journal-title":"Circ Res"},{"key":"B5","doi-asserted-by":"publisher","first-page":"686","DOI":"10.1093\/cvr\/cvab120","article-title":"Concurrent diabetes and heart failure: interplay and novel therapeutic approaches","volume":"118","author":"Karwi","year":"2022","journal-title":"Cardiovasc Res"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1016\/b978-0-323-99991-5.00002-4","article-title":"Cardiac energy metabolism in heart failure","volume":"128","author":"Lopaschuk","year":"2021","journal-title":"Circ Res"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.2337\/dc11-2339","article-title":"Defining insulin resistance from hyperinsulinemic-euglycemic clamps","volume":"35","author":"Tam","year":"2012","journal-title":"Diabetes Care"},{"key":"B8","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1186\/s12933-023-01794-8","article-title":"Association between triglyceride glucose-body mass index and cardiovascular outcomes in patients undergoing percutaneous coronary intervention: a retrospective study","volume":"22","author":"Cheng","year":"2023","journal-title":"Cardiovasc Diabetol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"299","DOI":"10.1186\/s12967-023-04159-7","article-title":"Assessing temporal differences in the predictive power of baseline TyG-related parameters for future diabetes: an analysis using time-dependent receiver operating characteristics","volume":"21","author":"Kuang","year":"2023","journal-title":"J Transl Med"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2024.1425024","article-title":"Value of triglyceride glucose-body mass index in predicting nonalcoholic fatty liver disease in individuals with type 2 diabetes mellitus","volume":"15","author":"Qian","year":"2024","journal-title":"Front Endocrinol"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2023.1028461","article-title":"Triglyceride glucose-body mass index and the risk of progression to diabetes from prediabetes: a 5-year cohort study in Chinese adults","volume":"11","author":"Han","year":"2023","journal-title":"Front Public Health"},{"key":"B12","doi-asserted-by":"publisher","first-page":"284","DOI":"10.1186\/s12933-025-02813-6","article-title":"Derivatives of the triglyceride-glucose index and their association with incident hypertension in prehypertensive individuals: a 4-year cohort study augmented by mendelian randomization","volume":"24","author":"Wang","year":"2025","journal-title":"Cardiovasc Diabetol"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-150-9-200905050-00006","article-title":"A new equation to estimate glomerular filtration rate","volume":"150","author":"Levey","year":"2009","journal-title":"Ann Intern Med"},{"key":"B14","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1016\/j.ejim.2024.08.026","article-title":"Triglyceride glucose (TyG) index: a promising biomarker for diagnosis and treatment of different diseases","volume":"131","author":"Sun","year":"2025","journal-title":"Eur J Intern Med"},{"key":"B15","doi-asserted-by":"publisher","first-page":"229","DOI":"10.1186\/s12933-022-01658-7","article-title":"Triglyceride-glucose index and\u00a0the risk of heart failure: evidence from two large cohorts and a mendelian randomization analysis","volume":"21","author":"Li","year":"2022","journal-title":"Cardiovasc Diabetol"},{"key":"B16","doi-asserted-by":"publisher","first-page":"263","DOI":"10.1186\/s12933-023-02001-4","article-title":"High triglyceride-glucose (TyG) index is associated with poor prognosis of heart failure with preserved ejection fraction","volume":"22","author":"Zhou","year":"2023","journal-title":"Cardiovasc Diabetol"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.2147\/dmso.s457598","article-title":"Predictive effect of alternative insulin resistance indexes on adverse cardiovascular events in patients with metabolic syndrome with heart failure","volume":"17","author":"Xie","year":"2024","journal-title":"Diabetes Metab Syndr Obes Targets Ther"},{"key":"B18","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1186\/s12933-022-01507-7","article-title":"Prognostic value of triglyceride glucose (TyG) index in patients with acute decompensated heart failure","volume":"21","author":"Huang","year":"2022","journal-title":"Cardiovasc Diabetol"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0149731","article-title":"Triglyceride glucose-body mass index is a simple and clinically useful surrogate marker for insulin resistance in nondiabetic individuals","volume":"11","author":"Er","year":"2016","journal-title":"PloS One"},{"key":"B20","article-title":"Association between triglyceride glucose-body mass index and heart failure in subjects with diabetes mellitus or prediabetes mellitus: a cross-sectional study","volume":"14","author":"Yang","year":""},{"key":"B21","doi-asserted-by":"publisher","first-page":"863","DOI":"10.1186\/s12889-025-22046-2","article-title":"The association between derived TyG index and the risk of heart failure in the elderly population: a prospective cohort study from 2017 to 2023","volume":"25","author":"Dui","year":"2025","journal-title":"BMC Public Health"},{"key":"B22","doi-asserted-by":"publisher","first-page":"822","DOI":"10.1186\/s12889-025-22018-6","article-title":"Association between the triglyceride glucose-body mass index and mortality risk in cardiovascular disease populations: a longitudinal cohort study","volume":"25","author":"Chen","year":"2025","journal-title":"BMC Public Health"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1016\/j.numecd.2023.09.027","article-title":"Effects of triglyceride glucose (TyG) and TyG-body mass index on sex-based differences in the early-onset heart failure of ST-elevation myocardial infarction","volume":"34","author":"Chen","year":"2024","journal-title":"Nutr Metab Cardiovasc Dis NMCD"},{"key":"B24","doi-asserted-by":"publisher","first-page":"309","DOI":"10.1186\/s12933-023-02047-4","article-title":"Association between triglyceride glucose-body mass and one-year all-cause mortality of patients with heart failure: a retrospective study utilizing the MIMIC-IV database","volume":"22","author":"Dou","year":"2023","journal-title":"Cardiovasc Diabetol"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1038\/s43587-022-00201-3","article-title":"The obesity paradox is mostly driven by decreased noncardiovascular disease mortality in the oldest old in China: a 20-year prospective cohort study","volume":"2","author":"Lv","year":"2022","journal-title":"Nat Aging"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1093\/cvr\/cvac152","article-title":"Diabetic cardiomyopathy: the need for adjusting experimental models to meet clinical reality","volume":"119","author":"Lezoualc'h","year":"2023","journal-title":"Cardiovasc Res"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1161\/circresaha.118.310082","article-title":"Calcium signaling and reactive oxygen species in mitochondria","volume":"122","author":"Bertero","year":"2018","journal-title":"Circ Res"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1016\/j.apsb.2021.10.005","article-title":"Ferroptosis is essential for diabetic cardiomyopathy and is prevented by sulforaphane via AMPK\/NRF2 pathways","volume":"12","author":"Wang","year":"2022","journal-title":"Acta Pharm Sin B"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1186\/1475-2840-11-73","article-title":"Cardiac fibrosis and dysfunction in experimental diabetic cardiomyopathy are ameliorated by alpha-lipoic acid","volume":"11","author":"Li","year":"2012","journal-title":"Cardiovasc Diabetol"},{"key":"B30","doi-asserted-by":"publisher","first-page":"256","DOI":"10.1038\/s41420-023-01553-4","article-title":"Diabetic cardiomyopathy: early diagnostic biomarkers, pathogenetic mechanisms, and therapeutic interventions","volume":"9","author":"Huo","year":"2023","journal-title":"Cell Death Discov"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2026.1798721\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T04:56:55Z","timestamp":1778129815000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2026.1798721\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,7]]},"references-count":30,"alternative-id":["10.3389\/fendo.2026.1798721"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2026.1798721","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,7]]},"article-number":"1798721"}}