TyG index as an independent risk factor for abdominal aortic aneurysm: a multicenter study

The triglyceride–glucose (TyG) index, a reliable surrogate marker of insulin resistance, has been established as a predictor for various cardiovascular diseases. This study aimed to investigate its previously unexplored association with the incidence of abdominal aortic aneurysm (AAA). In this multicenter retrospective study, we analyzed data from 2513 patients (mean age 71.5 ± 6.9 years) who underwent surgical treatment for AAA between January 2018 and June 2023 (open surgery, 504 cases; endovascular aneurysm repair, 2009 cases). A control group of 6290 age-matched healthy individuals was included. Propensity score matching (1:1) yielded 1998 pairs for analysis. Patient survival was assessed through telephone interviews or outpatient visits, with a median follow-up duration of 36.4 months (interquartile range: 24.1–52.8 months). Multivariable regression was used to identify risk factors. After matching, the AAA group had a significantly higher TyG index compared to controls (7.570 ± 0.31 vs. 6.803 ± 0.28, P < 0.001). Multivariable analysis identified a high TyG index as an independent risk factor for AAA (HR = 3.344, 95% CI 1.839–6.080, P < 0.001), alongside smoking and hypertension. Furthermore, a high TyG index was associated with poorer long-term overall survival in AAA patients ( P = 0.025). The TyG index is a significant and independent risk factor for the incidence of AAA. It also serves as a prognostic indicator for survival. Our findings suggest the critical role of metabolic health in AAA pathogenesis and propose the TyG index as a feasible, novel biomarker for risk assessment.