Association between triglyceride glucose index and deep vein thrombosis following total knee arthroplasty: a retrospective case-control study

Total knee arthroplasty (TKA), a frequently performed procedure for treating severe knee arthritis, is associated with notable postoperative risks, particularly deep vein thrombosis (DVT). The triglyceride-glucose (TyG) index, a marker of insulin resistance, has been linked to cardiovascular and metabolic disorders, yet its role in predicting DVT following TKA remains underexplored. This study aimed to assess the relationship between the TyG index and DVT incidence in patients undergoing TKA. A retrospective case-control analysis was performed on patients who underwent TKA at the First Affiliated Hospital of Soochow University from January 2020 to January 2022. The TyG index, calculated using fasting triglyceride and glucose levels, was used to categorize patients into tertiles. Multivariate logistic regression models, smooth curve fitting, and threshold effect analyses were applied to investigate the TyG-DVT relationship. The predictive capacity of TyG for DVT was further examined via receiver operating characteristic (ROC) curve analysis. Higher TyG index values were strongly linked to an elevated risk of DVT post-TKA. In the fully adjusted model, the odds ratio for the highest TyG tertile (T3) was 36.82 (95% CI: 3.24–418.16, P = 0.0036). A threshold effect emerged at a TyG index value of approximately 9.36, where DVT risk surged rapidly below this point and plateaued above it. The area under the ROC curve for TyG in predicting DVT was 0.7283, reflecting moderate predictive power. The TyG index shows potential as a valuable marker for identifying DVT risk in TKA patients, offering a means for early detection of high-risk individuals and enabling timely interventions to mitigate thrombotic complications.