Frontiers in endocrinology · 2026
Triglyceride-glucose index and nocturnal oxygenation impairment in patients with obstructive sleep apnea.
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Pei Chong, Hao Lingli, Zhang Jingjing, Xu Kang, Yu Yiqiong, Hu Lei
Аннотация
BACKGROUND: In obstructive sleep apnea (OSA), respiratory events differ not only in frequency but also in the depth and duration of oxygen desaturation. The triglyceride-glucose (TyG) index is a routinely available marker related to insulin resistance, but its relationship with conventional nocturnal oxygenation-related parameters in OSA remains incompletely clarified. Objective: We examined the association of the TyG index with hypoxemia-related sleep parameters and explored whether these associations were influenced by monitoring modality and AHI-defined OSA severity.
METHODS: This single-center retrospective cross-sectional study screened 154 consecutive symptomatic adult inpatients from 2021 to 2025; after exclusion of 11 patients, 143 were included in the retrospective dataset. Diagnostic sleep monitoring was performed using in-laboratory polysomnography or Nox T3 portable monitoring. Laboratory measurements were obtained within 3 days before or after sleep monitoring. Severe nocturnal oxygen desaturation was defined as lowest SpO2 <80%, and severe AHI-defined OSA was defined as AHI ≥30 events/h.
RESULTS: TyG was available in 116 patients, and 101 had complete TyG, lowest SpO2, and AHI data. TyG was higher in patients with lowest SpO2 <80% than in those with lowest SpO2 ≥80% [9.252 (8.872, 9.577) vs. 8.780 (8.574, 8.963), P<0.001], and higher in patients with AHI ≥30 events/h than in those with AHI <30 events/h [9.242 (8.869, 9.624) vs. 8.823 (8.571, 9.121), P<0.001]. TyG correlated positively with AHI and CT90 and negatively with mean and lowest SpO2. The AUC was 0.760 for lowest SpO2 <80% and 0.715 for AHI ≥30 events/h. In models adjusted for age, sex, BMI, and monitoring modality, TyG remained associated with lowest SpO2 <80% and AHI ≥30 events/h. However, the association with lowest SpO2 <80% was attenuated after additional adjustment for AHI.
CONCLUSION: Higher TyG was associated with worse nocturnal oxygenation-related parameters and greater AHI-defined OSA severity, but these exploratory findings may partly reflect overall OSA severity. TyG may provide a simple metabolic clue for risk stratification, but it cannot replace formal sleep monitoring.
METHODS: This single-center retrospective cross-sectional study screened 154 consecutive symptomatic adult inpatients from 2021 to 2025; after exclusion of 11 patients, 143 were included in the retrospective dataset. Diagnostic sleep monitoring was performed using in-laboratory polysomnography or Nox T3 portable monitoring. Laboratory measurements were obtained within 3 days before or after sleep monitoring. Severe nocturnal oxygen desaturation was defined as lowest SpO2 <80%, and severe AHI-defined OSA was defined as AHI ≥30 events/h.
RESULTS: TyG was available in 116 patients, and 101 had complete TyG, lowest SpO2, and AHI data. TyG was higher in patients with lowest SpO2 <80% than in those with lowest SpO2 ≥80% [9.252 (8.872, 9.577) vs. 8.780 (8.574, 8.963), P<0.001], and higher in patients with AHI ≥30 events/h than in those with AHI <30 events/h [9.242 (8.869, 9.624) vs. 8.823 (8.571, 9.121), P<0.001]. TyG correlated positively with AHI and CT90 and negatively with mean and lowest SpO2. The AUC was 0.760 for lowest SpO2 <80% and 0.715 for AHI ≥30 events/h. In models adjusted for age, sex, BMI, and monitoring modality, TyG remained associated with lowest SpO2 <80% and AHI ≥30 events/h. However, the association with lowest SpO2 <80% was attenuated after additional adjustment for AHI.
CONCLUSION: Higher TyG was associated with worse nocturnal oxygenation-related parameters and greater AHI-defined OSA severity, but these exploratory findings may partly reflect overall OSA severity. TyG may provide a simple metabolic clue for risk stratification, but it cannot replace formal sleep monitoring.