The impact of the triglyceride-glucose index on the risk of respiratory failure in patients with COPD: a study from the MIMIC database and Chinese cohorts

BACKGROUND: The Triglyceride-Glucose (TyG) index, a reliable marker for insulin resistance, is now employed to assess the onset and prognosis of various conditions like acute coronary syndrome, chronic kidney disease, and ischemic stroke. However, whether the TyG index can be used to assess respiratory failure (RF) risk among Chronic obstructive pulmonary disease (COPD) patients remains uncertain. The present study aims to delve into the link between the TyG index and the risk of RF in COPD patients. METHODS: Individuals with COPD were retrospectively acquired from the MIMIC-IV 2.2 (The Medical Information Mart for Intensive Care IV, version 2.2) database. The association between the TyG index and the probability of RF among COPD patients was evaluated using Cox proportional hazards models and restricted cubic spline (RCS) curves. Cumulative incidence curves were generated to appraise the RF risk across the quartile groups. Finally, 1188 patients were recruited from the First Hospital of Jiaxing City to externally validate the Cox modeling results for the primary outcome. RESULTS: This study incorporated a total of 1,232 participants from MIMIC database. Among these individuals, 134 cases (10.9%) experienced RF. According to Cox regression analysis, a one-unit increment in the TyG index was linked to a 1.821-fold elevated risk of RF in the COPD population (HR, 1.821[95% CI 1.349-2.459], P < 0.001). High TyG index levels were significantly linked to a higher RF risk (HR, 3.510 [95% CI 1.885-6.535], P < 0.001). RCS curve analysis also signaled a linear correlation between the TyG index and RF risk (P-Nonlinear = 0.074). CONCLUSION: There exists a certain correlation between high-level TyG index and the risk of RF occurrence in COPD patients, indicating promising prospects for utilizing the TyG index to assess the severity of COPD patients.