Clinica chimica acta; international journal of clinical chemistry · 2026
Association of the triglyceride-glucose index with tumor burden in newly diagnosed multiple myeloma: A retrospective cross-sectional study.
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Zhang Jing, Xu Dan, Luo Ran, Shu Wentao, Zeng Dongfeng, Bu Xiaona
Аннотация
BACKGROUND: The triglyceride-glucose (TyG) index is a validated surrogate marker of insulin resistance and has been associated with adverse outcomes in several metabolic and solid malignant diseases. However, its clinical relevance in multiple myeloma (MM) remains unclear. We aimed to investigate the association of the TyG index with disease burden and organ dysfunction in patients with newly diagnosed MM.
METHODS: We retrospectively analyzed 165 consecutive patients with newly diagnosed MM. The TyG index was calculated using fasting triglyceride and glucose levels, and patients were categorized into high- and low-TyG groups using a cutoff value of 8.5. Baseline clinical characteristics, MM-related biomarkers, and parameters of cardiac and renal involvement were compared between groups. Multivariable linear and logistic regression analyses, restricted cubic spline analysis, and receiver operating characteristic (ROC) analysis with repeated stratified 5-fold cross-validation were performed to assess the independent association of the TyG index with tumor burden.
RESULTS: Patients in high-TyG group (n = 82) had significantly higher bone marrow plasma cell percentage [43.8 (25.0, 60.0) vs. 21.5 (11.5, 28.0), P < 0.001], serum β2-microglobulin levels [8.4 (4.4, 18.2) vs. 5.2 (3.0, 9.8) mg/L, P = 0.002], and M-protein proportions [39.5 (20.4, 48.4) vs. 25.1 (10.9, 41.0), P = 0.006] than those in the low-TyG group (n = 83). Patients in high-TyG group also showed worse renal function, with higher serum creatinine (P = 0.006) and lower eGFR (P = 0.008). In multivariable linear regression, the TyG index remained independently associated with bone marrow plasma cell percentage (adjusted β = 19.30, 95% CI 14.30-24.29, P < 0.001). In fully adjusted logistic regression, a high TyG index was independently associated with high tumor burden, defined as bone marrow plasma cells ≥30% (OR: 18.51, 95% CI 7.73-44.35, P < 0.001). RCS analysis showed a significant overall and nonlinear association between TyG and high tumor burden (P-overall <0.001; P-nonlinear = 0.031). The apparent AUC of TyG for identifying high tumor burden was 0.788 (95% CI 0.714-0.862, P < 0.001), and the mean cross-validated AUC was 0.783.
CONCLUSION: The TyG index may serve as an accessible metabolic marker associated with disease burden in newly diagnosed MM. The TyG index may help identify patients with a higher likelihood of substantial marrow plasma cell infiltration. Prospective and multi-center studies are warranted to validate its prognostic utility.
METHODS: We retrospectively analyzed 165 consecutive patients with newly diagnosed MM. The TyG index was calculated using fasting triglyceride and glucose levels, and patients were categorized into high- and low-TyG groups using a cutoff value of 8.5. Baseline clinical characteristics, MM-related biomarkers, and parameters of cardiac and renal involvement were compared between groups. Multivariable linear and logistic regression analyses, restricted cubic spline analysis, and receiver operating characteristic (ROC) analysis with repeated stratified 5-fold cross-validation were performed to assess the independent association of the TyG index with tumor burden.
RESULTS: Patients in high-TyG group (n = 82) had significantly higher bone marrow plasma cell percentage [43.8 (25.0, 60.0) vs. 21.5 (11.5, 28.0), P < 0.001], serum β2-microglobulin levels [8.4 (4.4, 18.2) vs. 5.2 (3.0, 9.8) mg/L, P = 0.002], and M-protein proportions [39.5 (20.4, 48.4) vs. 25.1 (10.9, 41.0), P = 0.006] than those in the low-TyG group (n = 83). Patients in high-TyG group also showed worse renal function, with higher serum creatinine (P = 0.006) and lower eGFR (P = 0.008). In multivariable linear regression, the TyG index remained independently associated with bone marrow plasma cell percentage (adjusted β = 19.30, 95% CI 14.30-24.29, P < 0.001). In fully adjusted logistic regression, a high TyG index was independently associated with high tumor burden, defined as bone marrow plasma cells ≥30% (OR: 18.51, 95% CI 7.73-44.35, P < 0.001). RCS analysis showed a significant overall and nonlinear association between TyG and high tumor burden (P-overall <0.001; P-nonlinear = 0.031). The apparent AUC of TyG for identifying high tumor burden was 0.788 (95% CI 0.714-0.862, P < 0.001), and the mean cross-validated AUC was 0.783.
CONCLUSION: The TyG index may serve as an accessible metabolic marker associated with disease burden in newly diagnosed MM. The TyG index may help identify patients with a higher likelihood of substantial marrow plasma cell infiltration. Prospective and multi-center studies are warranted to validate its prognostic utility.