ACMJ
Anatolian Current Medical Journal

Anatolian Current Medical Journal (ACMJ) is an unbiased, peer-reviewed, and open access international medical journal. The Journal publishes interesting clinical and experimental research conducted in all fields of medicine, interesting case reports, and clinical images, invited reviews, editorials, letters, comments, and related knowledge.

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Original Article
Correlation between triglyceride-glucose index and length of intensive care unit stay in sepsis
Abstract
Aims: The aim of this study is to retrospectively evaluate the impact of the triglyceride-glucose (TyG) index on mortality and length of stay in septic patients in a tertiary intensive care unit.
Methods: This retrospective, descriptive cohort study diagnosed with sepsis. The study involved 208 patients. The primary aim was to assess the prognostic value of TyG for predicting mortality at 28 days following hospital admission in these patients. In addition, the study evaluated ICU all-cause mortality as a primary endpoint, with secondary endpoints encompassing the length of ICU stay.
Results: The prognostic value of the TyG in predicting mortality among sepsis patients was assessed using ROC curve analysis. The analysis yielded an area under the curve (AUC) of 0.798 (95% confidence interval: 0.729–0.867, p<0.001), indicating good discriminatory ability. An optimal cut-off value of 9.10 was identified, which provided a sensitivity of 82% and a specificity of 75% for mortality prediction. In the multivariate model, HbA1c and TyG index also retained their independent associations with mortality (HbA1c: OR: 1.65, 95% CI: 1.25–2.18, p=0.002; TyG index: OR: 2.20, 95% CI: 1.40–3.40, p=0.001) and prolonged ICU stay (HbA1c: OR: 1.35, 95% CI: 1.05–1.75, p = 0.020; TyG index: OR: 1.75, 95% CI: 1.15–2.68, p=0.010). The TyG index, an indicator of insulin resistance, demonstrated a strong association with prolonged ICU stay (OR: 1.80, 95% CI: 1.20–2.70, p=0.004). These results support the potential utility of the TyG index as a valuable biomarker for risk stratification in sepsis patients.
Conclusion: Our study reveals that the TyG index holds potential as a biomarker for forecasting mortality and extended ICU stays in sepsis patients. Given its simplicity and cost-effectiveness, the TyG index could potentially be incorporated into clinical practice to guide management decisions in sepsis.

Keywords : Triglyceride-glucose index, sepsis, insulin resistance, mortality

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1. Fleischmann C, Scherag A, Adhikari NKJ, et al. Assessment of global incidence and mortality of hospital treated sepsis current. Estimates and limitations. Am J Respir Crit Care Med 2016;193(3):259-272. doi:10.1164/rccm.201504-0781OC
2. Li S, Guo B, Chen H, et al. The role of the triglyceride (triacylglycerol) glucose index in the development of cardiovascular events: a retrospective cohort analysis. Sci Rep. 2019;9(1):7320. doi:10.1038/s 41598-019-43776-5
3. Hunter SJ, Garvey WT. Insulin action and insulin resistance: diseases involving defects in insulin receptors, signal transduction, and the glucose transport effector system. Am J Med. 1998;105(4):331-345. doi: 10.1016/s0002-9343(98)00300-3
4. Ginsberg HN. Insulin resistance and cardiovascular disease. J Clin Investig. 2000;106(4):453-458. doi:10.1172/jci10762
5. Yin JL, Yang J, Song XJ, et al. Triglyceride-glucose index and health outcomes: an umbrella review of systematic reviews with meta-analyses of observational studies.Cardiovasc Diabetol. 2024;23(1):177. doi:10. 1186/s12933-024-02241-y
6. Behnoush AH, Mousavi A, Ghondaghsaz E, Shojaei S, Cannavo A, Khalaji A. The importance of assessing the triglyceride-glucose index (TyG) in patients with depression: a systematic review.Neurosci Biobehav Rev. 2024;159:105582. doi:10.1016/j.neubiorev.2024.105582
7. Fang Y, Xiong B, Shang X, et al. Triglyceride-glucose index predicts sepsis-associated acute kidney injury and length of stay in sepsis: a MIMIC-IV cohort study. Heliyon. 2024;10(7):e29257. doi:10.1016/j.heliyon.2024.e29257
8. Zheng R, Qian S, Shi Y, Lou C, Xu H, Pan J. Association between triglyceride-glucose index and in-hospital mortality in critically ill patients with sepsis: analysis of the MIMIC-IV database.Cardiovasc Diabetol. 2023;22(1):307. doi:10.1186/s12933-023-02041-w
9. Singer M, Deutschman CS, Seymour CW, et al. The third international consensus definitions for sepsis and septic shock (sepsis-3). JAMA. 2016; 315(8):801-810. doi:10.1001/jama.2016.0287
10. Du T, Yuan G, Zhang M, Zhou X, Sun X, Yu X. Clinical usefulness of lipid ratios, visceral adiposity indicators, and the triglycerides and glucose index as risk markers of insulin resistance. Cardiovasc Diabetol. 2014;20(13):146. doi:10.1186/s12933-014-0146-3
11. Wang J, Zhao H, Liu Q, Zhang M. Association between triglyceride-glucose index and ICU outcomes in septic patients. Cardiovasc Diabetol. 2023;22(1):89. doi:10.1186/s12933-023-01657-x
12. Liao Y, Zhang R, Shi S, et al. Triglyceride-glucose index linked to all-cause mortality in critically ill patients: a cohort of 3026 patients. Cardiovasc Diabetol. 2022;21(1):128. doi:1186/s12933-022-01563-z.10
13. Zhang Y, Li J, Tan W. Dynamic trajectories of the TyG index in critically ill patients. Critical Care Med. 2023;51(2):145-153. doi:10.1097/CCM. 0000000000005681
14. Vermeer SE, Sandee W, Algra A, et al. Impaired glucose tolerance increases stroke risk in nondiabetic patients with transient ischemic attack or minor ischemic stroke. 2006;37(6):1413-1417. doi:10.1161/01.STR.0000221766.73692.0b
15. Zhang P, Pan S, Yuan S, Shang Y, Shu H. Abnormal glucose metabolism in virus associated sepsis. Front Cell Infect Microbiol. 2023;13:1120769. doi:10.3389/fcimb.2023.1120769
16. Muniyappa R, Sowers JR. Role of insulin resistance in endothelial dysfunction. Rev Endocr Metab Disord. 2013;14(1):5-12. doi:10.1007/s11154-012-9229-1
17. van den Berghe G, Wouters P, Weekers F. Intensive insulin therapy in critically ill patients. N Engl J Med. 2001;345(19):1359-1367. doi:10.1056/NEJMoa011300
18. Carlson GL. Insulin resistance and glucose-induced thermogenesis in critical illness. Proc Nutr Soc. 2001;60(3):381-388. doi:10.1079/pns200193
19. Di Pino A, DeFronzo RA. Insulin resistance and atherosclerosis: implications for insulin-sensitizing agents. Endocr Rev. 2019;40(6):1447-1467. doi:10.1210/er.2018-00141
20. Zhang S, Fan T, Wang L, Chen N, Ma L. Impact of the triglyceride-glucose index on 28-day mortality in non-diabetic critically Ill patients with sepsis: a retrospective cohort analysis.BMC Infect Dis. 2024;24(1): 785. doi:10.1186/s12879-024-09711-4
21. Lou J, Xiang Z, Zhu X, et al. A retrospective study utilized MIMIC-IV database to explore the potential association between triglyceride-glucose index and mortality in critically ill patients with sepsis.Sci Rep. 2024;14(1):24081. doi:10.1038/s41598-024-75050-8
22. Yang Y, Huang X, Wang Y, et. al. The impact of triglyceride-glucose index on ischemic stroke: a systematic review and meta-analysis. Cardiovasc Diabetol. 2023;22(1):2. doi:10.1186/s12933-022-01732-0
23. Nayak SS, Kuriyakose D, Polisetty LD, et. al. Diagnostic and prognostic value of triglyceride glucose index: a comprehensive evaluation of meta-analysis. Cardiovasc Diabetol. 2024;23(1):310. doi:10.1186/s12933-024-02392-y
24. Li X, Chen Y, Zhang L, Wang H. (2022). The predictive value of the triglyceride-glucose index for ICU mortality in sepsis. BMC Infect Dis. 2022;22(1):345. doi:10.1186/s12879-022-07345-4
25. Rivas AM, Nugent K. Hyperglycemia, insulin, and insulin resistance in sepsis. Am J Med Sci. 2021;361(3):297-302. doi:10.1016/j.amjms.2020.11.007
Article available in :
Volume 7, Issue 2, 2025
Page : 253-260
https://doi.org/10.38053/acmj.1644974
Article Information
Received : 22 Şub 2025
Accepted : 21 Mar 2025
Published : 21 Mar 2025
Corresponding Author :

Dursun Elmas: Division of Intensive Care, Department of Internal Medicine, Konya City Hospital, Konya, Turkiye

[email protected]
Citation : Elmas D, İnce MS. Correlation between triglyceride-glucose index and length of intensive care unit stay in sepsis. Anatolian Curr Med J. 2025;7(2):253-260.

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