{"id":"c2d4b9fda658","type":"article","url":"https://hartvaat.nl/2026/10/16/tyg-fi-index-verbetert-voorspelling-van-hart-en-vaatziekten-en-sterfte-bij-reuma/","title":"TyG-FI-index verbetert voorspelling van hart- en vaatziekten en sterfte bij reumatoïde artritis","title_en":"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.","category":"cholesterol","category_label":"Cholesterol","professions":["cardioloog","huisarts","internist"],"tags":[],"journal":"Medicine","doi":"10.1097/MD.0000000000051143","source_url":"https://doi.org/10.1097/MD.0000000000051143","authors":["Yangyu Xu","Hong Zhao","Yuxiang Gao","Jiannan Han","Zewen Wu","Liyun Zhang","Junkang Zhao"],"significance":4,"published":"2026-10-24","source_date":"2026-10-16","image":"https://hartvaat.nl/global/img/6e2cc0469790.webp","kennis":["https://hartvaat.nl/kennis/lipiden/lpa-meten-wanneer-waarom/","https://hartvaat.nl/kennis/lipiden/stijve-arterieen-arteriosclerose/"],"congress":"","summary_en":"In a cohort of 1,090 US adults with rheumatoid arthritis, the TyG-FI index—combining a surrogate marker for insulin resistance with a frailty score—was strongly associated with prevalent cardiovascular disease (OR 4.50) and cardiovascular mortality (HR 1.77). Adding this composite index to risk models improved discrimination, raising the AUC from 0.73 to 0.80 for CVD and from 0.80 to 0.81 for mortality. While promising for risk stratification in this high-risk population, the index requires external validation and assessment of clinical utility before routine implementation.","created":"2026-10-18T01:03:39Z","updated":"2026-10-18T01:03:42Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"In een cohort van 1090 volwassenen met reumatoïde artritis (NHANES 1999-2018) bleek de TyG-FI-index, een combinatie van een surrogaatmarker voor insulineresistentie en een kwetsbaarheidsindex, sterk geassocieerd met prevalentie van hart- en vaatziekten (OR 4,50) en cardiovasculaire sterfte (HR 1,77). De toevoegende voorspellende waarde van deze index was zichtbaar in de AUC-cijfers, die opliepen van 0,73 naar 0,80 voor prevalentie en van 0,80 naar 0,81 voor sterfte. Voor klinische toepassing zijn echter nog validatie en onderzoek naar de kalibratie en externe geldigheid nodig.","abstract_original":"Cardiovascular disease (CVD) is a major cause of excess mortality among patients with rheumatoid arthritis (RA). Conventional risk assessment may not fully capture the metabolic abnormalities and physiological vulnerability associated with RA. We investigated whether the triglyceride-glucose-frailty index (TyG-FI), which combines a surrogate marker of insulin resistance with accumulated health deficits, was associated with prevalent CVD and cardiovascular mortality among adults with RA. We analyzed 1090 adults with self-reported RA from 10 cycles of the National Health and Nutrition Examination Survey conducted between 1999 and 2018. TyG-FI was calculated as the product of the triglyceride-glucose index and a 49-item deficit-accumulation frailty index. Multivariable logistic regression was used to examine the association with prevalent CVD, whereas Cox proportional hazards regression was used to examine cardiovascular mortality. Restricted cubic splines, subgroup analyses, sensitivity analyses, and discrimination analyses were conducted as secondary analyses. In the fully adjusted models, each 1-unit higher TyG-FI was associated with higher odds of prevalent CVD (odds ratio, 4.50; 95% confidence interval, 3.20-6.33) and a higher hazard of cardiovascular mortality (hazard ratio, 1.77; 95% confidence interval, 1.16-2.70). The reported areas under the receiver operating characteristic curve were 0.80 for prevalent CVD and 0.81 for cardiovascular mortality in models incorporating TyG-FI, compared with 0.73 and 0.80, respectively, in models incorporating TyG. An exploratory subgroup analysis suggested a stronger association between TyG-FI and prevalent CVD among participants aged ≤65 years (P for interaction = .044). Higher TyG-FI was associated with prevalent CVD and cardiovascular mortality among US adults with self-reported RA. TyG-FI may capture complementary metabolic and frailty-related information; however, its incremental predictive value, calibration, clinical utility, and external validity require further evaluation before clinical implementation."}