Association between the triglyceride-high-density lipoprotein-glucose-body index and atrial fibrillation: a retrospective case-control study

Abstract

Background The triglyceride-glucose (TyG) index is a surrogate marker of insulin resistance and has been associated with atrial fibrillation (AF) risk, but it does not capture adiposity. The triglyceride-high-density lipoprotein-glucose-body (TyHGB) index, which integrates lipid profile, glucose metabolism, and body mass index, may provide a more comprehensive metabolic assessment. However, evidence regarding its association with AF remains limited. Methods This retrospective case-control study included 1,137 participants (314 non-AF controls, 414 paroxysmal AF, and 409 persistent AF). Multivariable logistic regression was performed using three hierarchical models. Restricted cubic splines were used to examine non-linear relationships. Receiver operating characteristic curves were generated to compare the predictive performance of TyHGB, TyG, and their combination. Results Both TyHGB and TyG were independently associated with AF risk across all models (all P < 0.001). In the fully adjusted model, each one-unit increase in TyHGB was associated with a 61% increase in the odds of AF (OR 1.61, 95% CI 1.41–1.85). Significant non-linear dose-response relationships were observed for both indices (P for non-linear < 0.001). The predictive performance of TyHGB was comparable to TyG (AUC 0.716 vs. 0.717, P = 0.902). The combined model achieved the highest AUC (0.723) and significantly outperformed TyG alone (P = 0.002), though it was not superior to TyHGB alone (P = 0.366). Conclusions TyHGB is a novel, simple, and low-cost metabolic index independently associated with AF risk, with predictive performance comparable to TyG. It may serve as a convenient complementary marker for metabolic risk assessment in clinical practice.