Triglyceride-glucose related indices as predictors for major adverse cardiovascular events and overall mortality in type-2 diabetes mellitus patients

Table 1 Baseline characteristics of participants by quartiles of triglyceride glucose-waist height ratio, n (%)

	Overall	Q1 (n = 2524)	Q2 (n = 2523)	Q3 (n = 2523)	Q4 (n = 2524)	P value
TyG-WHtR	5.97 ± 0.92	4.83 ± 0.37	5.62 ± 0.17	6.24 ± 0.19	7.17 ± 0.50	< 0.001
Age (years)	62.80 ± 6.64	63.56 ± 7.04	63.10 ± 6.73	62.63 ± 6.50	61.92 ± 6.16	< 0.001
Sex						< 0.001
Male	6206 (61.48)	1706 (67.59)	1661 (65.83)	1525 (60.44)	1314 (52.06)
Female	3888 (38.52)	818 (32.41)	862 (34.17)	998 (39.56)	1210 (47.94)
Race						< 0.001
White	6302 (62.43)	1201 (47.58)	1489 (59.02)	1677 (66.47)	1935 (76.66)
Non-white	3792 (37.57)	1323 (52.42)	1034 (40.98)	846 (33.53)	589 (23.34)
Education						< 0.001
Less than high school graduate	1492 (14.79)	364 (14.44)	389 (15.42)	400 (15.87)	339 (13.44)
High school grad (or GED)	2662 (26.39)	668 (26.50)	657 (26.05)	645 (25.59)	692 (27.43)
Some college or technical school	3311 (32.82)	736 (29.19)	818 (32.43)	839 (33.28)	918 (36.39)
College graduate or more	2622 (25.99)	753 (29.87)	658 (26.09)	637 (25.27)	574 (22.75)
CVD History	3556 (35.23)	848 (33.60)	931 (36.90)	856 (33.93)	921 (36.49)	0.022
Duration of diabetes (years)	10.79 ± 7.58	11.70 ± 7.99	11.07 ± 7.68	10.30 ± 7.29	10.08 ± 7.26	< 0.001
Previous hypertension	7609 (75.38)	1847 (73.18)	1908 (75.62)	1899 (75.27)	1955 (77.46)	0.006
Previous hyperlipidemia	7065 (69.99)	1713 (67.87)	1792 (71.03)	1784 (70.71)	1776 (70.36)	0.058
Proteinuria	2001 (19.83)	443 (17.55)	443 (17.56)	527 (20.90)	588 (23.30)	< 0.001
Heart failure	484 (4.80)	102 (4.04)	94 (3.73)	107 (4.24)	181 (7.17)	< 0.001
Depression	2394 (23.72)	409 (16.20)	510 (20.21)	631 (25.02)	844 (33.45)	< 0.001
Living alone	2039 (20.20)	460 (18.23)	496 (19.67)	519 (20.57)	564 (22.35)	0.003
Smoking						< 0.001
Yes	5886 (58.31)	1391 (55.11)	1483 (58.78)	1474 (58.42)	1538 (60.94)
No	4208 (41.69)	1133 (44.89)	1040 (41.22)	1049 (41.58)	986 (39.06)
Alcohol						< 0.001
Yes	2414 (23.92)	637 (25.24)	655 (25.97)	612 (24.28)	510 (20.21)
No	7676 (76.08)	1887 (74.76)	1867 (74.03)	1909 (75.72)	2013 (79.79)
BMI (kg/m2)	32.21 ± 5.40	27.09 ± 3.43	30.63 ± 3.63	33.62 ± 3.91	37.49 ± 4.21	< 0.001
SBP (mmHg)	136.36 ± 17.10	136.11 ± 17.04	136.41 ± 16.81	136.64 ± 17.21	136.30 ± 17.36	0.823
DBP (mmHg)	74.89 ± 10.66	73.41 ± 10.67	74.31 ± 10.31	75.66 ± 10.66	76.18 ± 10.78	< 0.001
Heart rate, bpm	72.66 ± 11.74	70.82 ± 11.31	71.81 ± 11.58	73.47 ± 11.82	74.54 ± 11.90	< 0.001
FPG (mg/dL)	175.21 ± 56.16	154.52 ± 52.23	168.84 ± 51.57	179.59 ± 54.19	197.88 ± 57.38	< 0.001
HbA1C (%)	8.30 ± 1.06	8.16 ± 1.06	8.24 ± 1.02	8.32 ± 1.03	8.48 ± 1.09	< 0.001
TC (mg/dL)	183.29 ± 41.85	173.74 ± 37.60	179.77 ± 39.06	184.93 ± 40.26	194.72 ± 47.02	< 0.001
TG (mg/dL)	190.26 ± 148.59	113.74 ± 57.49	166.67 ± 93.30	201.97 ± 120.21	278.64 ± 217.96	< 0.001
VLDL-C (mg/dL)	36.56 ± 24.38	22.69 ± 11.33	32.88 ± 16.77	39.16 ± 20.68	51.52 ± 33.22	< 0.001
LDL-C (mg/dL)	104.86 ± 33.89	104.48 ± 31.87	105.21 ± 33.52	104.97 ± 33.83	104.77 ± 36.22	0.717
eGFR (mL/minute/1.73 m2)	91.05 ± 27.18	90.82 ± 24.23	91.06 ± 29.91	91.03 ± 27.48	91.30 ± 26.79	0.941
WC (cm)	106.74 ± 13.64	92.87 ± 8.68	102.75 ± 8.36	110.47 ± 8.81	120.85 ± 9.98	< 0.001
WHtR	0.63 ± 0.08	0.54 ± 0.04	0.60 ± 0.04	0.65 ± 0.04	0.72 ± 0.05	< 0.001
Medications
ARB/ACEI	6992 (69.27)	1678 (66.48)	1738 (68.89)	1754 (69.52)	1822 (72.19)	< 0.001
CCB	1929 (19.11)	457 (18.11)	469 (18.59)	488 (19.34)	515 (20.40)	0.178
β-Blockers	3041 (30.21)	641 (25.45)	725 (28.84)	807 (32.07)	868 (34.47)	< 0.001
Biguanides	6455 (63.96)	1563 (61.93)	1618 (64.13)	1644 (65.19)	1630 (64.58)	0.085
Thiazolidinediones	2228 (22.07)	527 (20.88)	503 (19.94)	598 (23.71)	600 (23.77)	< 0.001
Sulfonylureas	5401 (53.51)	1374 (54.44)	1372 (54.38)	1329 (52.70)	1326 (52.54)	0.351
Insulins	3522 (34.89)	822 (32.57)	858 (34.01)	908 (35.99)	934 (37.00)	0.004
Statins	6417 (63.81)	1644 (65.39)	1636 (65.23)	1601 (63.58)	1536 (61.03)	0.004
Aspirin	5497 (54.70)	1341 (53.36)	1344 (53.61)	1436 (57.12)	1376 (54.71)	0.030
Cholesterol absorption inhibitors	205 (2.04)	46 (1.83)	58 (2.31)	52 (2.07)	49 (1.95)	0.658
MACEs	1791 (17.74)	367 (14.54)	458 (18.15)	467 (18.51)	499 (19.77)	< 0.001
Total mortality	1914 (18.96)	420 (16.64)	457 (18.11)	484 (19.18)	553 (21.91)	< 0.001

Data are shown as mean ± SD, median (Q1-Q4), or as n (%). P value for the test of the difference across quartiles of TyG-WHtR index were obtained by using the χ² test (categorical variables), ANOVA (continuous variables), or Kruskal-Wallis test (nonparametric comparisons). TyG: Triglyceride glucose; WHtR: Waist height ratio; WC: Waist circumference; GED: General education development; CVD: Cardiovascular disease; BMI: Body mass index; SBP: Systolic blood pressure; DBP: Diastolic blood pressure; FPG: Fasting plasma glucose; HbA1C: Glycated hemoglobin; TC: Total cholesterol; TG: Triglycerides; LDL-C: Low-density lipoprotein cholesterol; eGFR: Estimated glomerular filtration rate; ARB: Angiotensin receptor blocker; ACEI: Angiotensin converting enzyme inhibitors; CCB: Calcium channel blockers; MACEs: Major adverse cardiovascular events.

Table 2 Baseline characteristics of participants by quartiles of triglyceride glucose-waist circumference, n (%)

	Overall	Q1 (n = 2524)	Q2 (n = 2523)	Q3 (n = 2523)	Q4 (n = 2524)	P value
TyG-WC	1014.05 ± 160.17	815.26 ± 67.01	955.95 ± 31.22	1062.40 ± 31.75	1222.59 ± 85.99	< 0.001
Age (years)	62.80 ± 6.64	63.61 ± 7.09	63.26 ± 6.68	62.68 ± 6.54	61.66 ± 6.07	< 0.001
Sex						< 0.001
Male	6206 (61.48)	1323 (52.42)	1527 (60.52)	1617 (64.09)	1739 (68.90)
Female	3888 (38.52)	1201 (47.58)	996 (39.48)	906 (35.91)	785 (31.10)
Race						< 0.001
White	6302 (62.43)	1075 (42.59)	1445 (57.27)	1778 (70.47)	2004 (79.40)
Non-white	3792 (37.57)	1449 (57.41)	1078 (42.73)	745 (29.53)	520 (20.60)
Education						< 0.001
Less than high school graduate	1492 (14.79)	420 (16.66)	415 (16.46)	370 (14.67)	287 (11.38)
High school grad (or GED)	2662 (26.39)	713 (28.28)	640 (25.39)	646 (25.61)	663 (26.28)
Some college or technical school	3311 (32.82)	715 (28.36)	799 (31.69)	850 (33.70)	947 (37.53)
College graduate or more	2622 (25.99)	673 (26.70)	667 (26.46)	656 (26.01)	626 (24.81)
CVD history	3556 (35.23)	821 (32.53)	872 (34.56)	924 (36.62)	939 (37.20)	0.002
Duration of diabetes (years)	10.79 ± 7.58	11.82 ± 8.06	11.11 ± 7.72	10.37 ± 7.21	9.86 ± 7.17	< 0.001
Previous hypertension	7609 (75.38)	1895 (75.08)	1896 (75.15)	1868 (74.04)	1950 (77.26)	0.059
Previous hyperlipidemia	7065 (69.99)	1712 (67.83)	1774 (70.31)	1786 (70.79)	1793 (71.04)	0.050
Proteinuria	2001 (19.83)	432 (17.12)	460 (18.23)	519 (20.58)	590 (23.38)	< 0.001
Heart failure	484 (4.80)	107 (4.24)	85 (3.37)	121 (4.80)	171 (6.77)	< 0.001
Depression	2394 (23.72)	433 (17.16)	519 (20.57)	631 (25.03)	811 (32.13)	< 0.001
Living alone	2039 (20.20)	516 (20.44)	514 (20.38)	497 (19.70)	512 (20.29)	0.908
Smoking						< 0.001
Yes	5886 (58.31)	1257 (49.80)	1449 (57.43)	1532 (60.72)	1648 (65.29)
No	4208 (41.69)	1267 (50.20)	1074 (42.57)	991 (39.28)	876 (34.71)
Alcohol						0.002
Yes	2414 (23.92)	540 (21.39)	629 (24.94)	650 (25.78)	595 (23.58)
No	7676 (76.08)	1984 (78.61)	1893 (75.06)	1871 (74.22)	1928 (76.42)
BMI (kg/m2)	32.21 ± 5.40	27.32 ± 3.80	30.80 ± 3.91	33.52 ± 4.07	37.20 ± 4.21	< 0.001
SBP (mmHg)	136.36 ± 17.10	136.82 ± 17.10	136.56 ± 17.39	136.27 ± 17.23	135.81 ± 16.67	0.156
DBP (mmHg)	74.89 ± 10.66	73.40 ± 10.60	74.49 ± 10.41	75.37 ± 10.78	76.29 ± 10.64	< 0.001
Heart rate, bpm	72.66 ± 11.74	71.20 ± 11.25	72.08 ± 11.71	72.87 ± 11.73	74.50 ± 12.01	< 0.001
FPG (mg/dL)	175.21 ± 56.16	154.21 ± 53.15	168.08 ± 50.86	179.83 ± 52.30	198.70 ± 58.37	< 0.001
HbA1c (%)	8.30 ± 1.06	8.18 ± 1.05	8.25 ± 1.04	8.29 ± 1.04	8.47 ± 1.07	< 0.001
TC (mg/dL)	183.29 ± 41.85	176.93 ± 38.09	180.96 ± 40.52	183.75 ± 41.18	191.52 ± 45.89	< 0.001
TG (mg/dL)	190.26 ± 148.59	116.86 ± 69.17	162.72 ± 90.13	201.83 ± 119.22	279.62 ± 216.65	< 0.001
VLDL-C (mg/dL)	36.56 ± 24.38	23.21 ± 12.74	32.12 ± 16.35	39.43 ± 21.35	51.50 ± 32.60	< 0.001
LDL-C (mg/dL)	104.86 ± 33.89	105.98 ± 32.30	106.31 ± 34.13	104.31 ± 33.70	102.85 ± 35.27	< 0.001
eGFR (mL/minute/1.73 m2)	91.05 ± 27.18	91.55 ± 29.26	90.87 ± 29.19	89.95 ± 23.73	91.84 ± 26.11	0.074
WC (cm)	106.74 ± 13.64	91.52 ± 7.73	102.48 ± 6.70	110.63 ± 7.10	122.32 ± 8.99	< 0.001
WHtR	0.63 ± 0.08	0.55 ± 0.05	0.61 ± 0.05	0.65 ± 0.05	0.71 ± 0.06	< 0.001
Medications
ARB/ACEI	6992 (69.27)	1674 (66.32)	1736 (68.81)	1752 (69.44)	1830 (72.50)	< 0.001
CCB	1929 (19.11)	475 (18.82)	493 (19.54)	457 (18.11)	504 (19.97)	0.353
β-Blockers	3041 (30.21)	647 (25.71)	715 (28.37)	795 (31.64)	884 (35.12)	< 0.001
Biguanides	6455 (63.96)	1542 (61.09)	1638 (64.92)	1618 (64.16)	1657 (65.65)	0.004
Thiazolidinediones	2228 (22.07)	513 (20.32)	516 (20.45)	572 (22.68)	627 (24.84)	< 0.001
Sulfonylureas	5401 (53.51)	1370 (54.28)	1335 (52.91)	1342 (53.21)	1354 (53.65)	0.784
Insulins	3522 (34.89)	834 (33.04)	878 (34.80)	888 (35.20)	922 (36.53)	0.075
Statins	6417 (63.81)	1630 (64.91)	1595 (63.37)	1622 (64.57)	1570 (62.38)	0.221
Aspirin	5497 (54.70)	1302 (51.89)	1343 (53.38)	1432 (57.05)	1420 (56.48)	< 0.001
Cholesterol absorption inhibitors	205 (2.04)	50 (1.99)	55 (2.19)	51 (2.03)	49 (1.95)	0.940
MACEs	1791 (17.74)	366 (14.50)	426 (16.88)	484 (19.18)	515 (20.40)	< 0.001
Total mortality	1914 (18.96)	406 (16.09)	447 (17.72)	484 (19.18)	577 (22.86)	< 0.001

Data are shown as mean ± SD, median (Q1-Q4), or as n (%). P value for the test of the difference across quartiles of TyG-WC index were obtained by using the χ² test (categorical variables), ANOVA (continuous variables), or Kruskal-Wallis test (nonparametric comparisons). TyG: Triglyceride glucose; WHtR: Waist height ratio; WC: Waist circumference; GED: General education development; CVD: Cardiovascular disease; BMI: Body mass index; SBP: Systolic blood pressure; DBP: Diastolic blood pressure; FPG: Fasting plasma glucose; HbA1C: Glycated hemoglobin; TC: Total cholesterol; TG: Triglycerides; LDL-C: Low-density lipoprotein cholesterol; eGFR: Estimated glomerular filtration rate; ARB: Angiotensin receptor blocker; ACEI: Angiotensin converting enzyme inhibitors; CCB: Calcium channel blockers; MACEs: Major adverse cardiovascular events.

Table 3 Risk of major adverse cardiovascular events and total mortality based on triglyceride glucose-waist height ratio

Outcome	Events/n	Non-adjusted		Model 1		Model 2		Model 3
		HR (95%CI)	P value	HR (95%CI)	P value	HR (95%CI)	P value	HR (95%CI)	P value
MACEs
TyG-WHtR		1.147 (1.091, 1.206)	< 0.0001	1.184 (1.123, 1.249)	< 0.0001	1.146 (1.081, 1.214)	< 0.0001	1.128 (1.064, 1.196)	< 0.0001
Q1	367/2524	Reference		Reference		Reference		Reference
Q2	458/2523	1.273 (1.110, 1.461)	0.0006	1.216 (1.059, 1.397)	0.0056	1.196 (1.040, 1.376)	0.0121	1.179 (1.025, 1.357)	0.0211
Q3	467/2523	1.303 (1.137, 1.494)	0.0001	1.336 (1.162, 1.536)	< 0.0001	1.291 (1.120, 1.488)	0.0004	1.266 (1.097, 1.460)	0.0012
Q4	499/2524	1.442 (1.260, 1.650)	< 0.0001	1.526 (1.326, 1.757)	< 0.0001	1.408 (1.212, 1.635)	< 0.0001	1.353 (1.164, 1.574)	< 0.0001
Per 1 SD		1.135 (1.084, 1.188)	< 0.0001	1.169 (1.113, 1.227)	< 0.0001	1.134 (1.075, 1.196)	< 0.0001	1.117 (1.059, 1.180)	< 0.0001
P for trend			< 0.0001		< 0.0001		< 0.0001		< 0.0001
Total mortality
TyG-WHtR		1.141 (1.088, 1.198)	< 0.0001	1.230 (1.168, 1.295)	< 0.0001	1.177 (1.113, 1.246)	< 0.0001	1.163 (1.099, 1.231)	< 0.0001
Q1	420/2524	Reference		Reference		Reference		Reference
Q2	457/2523	1.09 (0.96, 1.25)	0.1802	1.07 (0.94, 1.23)	0.2912	1.06 (0.92, 1.21)	0.4310	1.04 (0.91, 1.19)	0.5849
Q3	484/2523	1.175 (1.031, 1.339)	0.0156	1.266 (1.108, 1.446)	0.0005	1.214 (1.060, 1.391)	0.0052	1.187 (1.035, 1.361)	0.0140
Q4	553/2524	1.399 (1.232, 1.588)	< 0.0001	1.625 (1.423, 1.855)	< 0.0001	1.474 (1.279, 1.698)	< 0.0001	1.420 (1.231, 1.638)	< 0.0001
Per 1 SD		1.130 (1.080, 1.181)	< 0.0001	1.210 (1.154, 1.269)	< 0.0001	1.162 (1.104, 1.224)	< 0.0001	1.149 (1.091, 1.211)	< 0.0001
P for trend			< 0.0001		< 0.0001		< 0.0001		< 0.0001

Data are expressed as hazard ratio and 95%CI (reported in parentheses) as assessed by multivariable Cox regression analysis. Model 1 adjusted for sex, race, age, education, history of cardiovascular disease, previous hypertension and previous hyperlipidemia systolic blood pressure, diastolic blood pressure. Model 2 adjusted for model 1 covariables plus duration of diabetes, proteinuria, heart failure, depression, smoking, glycated hemoglobin, total cholesterol, low-density lipoprotein cholesterol and estimated glomerular filtration rate. Model 3 adjusted for model 2 covariables plus the medications use, calcium channel blockers, beta-blockers, biguanides, thiazolidinediones, insulins, aspirin, statins, cholesterol absorption inhibitors. TyG: Triglyceride glucose; WHtR: Waist height ratio; MACEs: Major Adverse cardiovascular events; HR: Hazard ratio.

Table 4 Risk of major adverse cardiovascular events and total mortality based on triglyceride glucose-waist circumference

Outcome	Events/n	Non-adjusted		Model 1		Model 2		Model 3
		HR (95%CI)	P value	HR (95%CI)	P value	HR (95%CI)	P value	HR (95%CI)	P value
MACEs
TyG-WC (per 100 units)		1.102 (1.070, 1.134)	< 0.0001	1.100 (1.067, 1.135)	< 0.0001	1.080 (1.044, 1.117)	< 0.0001	1.070 (1.034, 1.108)	0.0001
Q1	366/2524	Reference		Reference		Reference		Reference
Q2	426/2523	1.176 (1.023, 1.353)	0.0226	1.13 (0.98, 1.31)	0.0838	1.10 (0.96, 1.27)	0.1712	1.09 (0.94, 1.25)	0.2551
Q3	484/2523	1.354 (1.182, 1.551)	< 0.0001	1.300 (1.131, 1.496)	0.0002	1.245 (1.080, 1.436)	0.0026	1.225 (1.061, 1.413)	0.0056
Q4	515/2524	1.481 (1.295, 1.693)	< 0.0001	1.471 (1.276, 1.695)	< 0.0001	1.370 (1.179, 1.592)	< 0.0001	1.314 (1.129, 1.529)	0.0004
Per 1 SD		1.168 (1.115, 1.223)	< 0.0001	1.165 (1.109, 1.225)	< 0.0001	1.131 (1.071, 1.194)	< 0.0001	1.115 (1.056, 1.178)	0.0001
P for trend			< 0.0001		< 0.0001		< 0.0001		< 0.0001
Total mortality
TyG-WC (per 100 units)		1.105 (1.075, 1.136)	< 0.0001	1.136 (1.102, 1.171)	< 0.0001	1.109 (1.073, 1.146)	< 0.0001	1.101 (1.065, 1.138)	< 0.0001
Q1	406/2524	Reference		Reference		Reference		Reference
Q2	447/2523	1.11 (0.97, 1.27)	0.1183	1.11 (0.97, 1.27)	0.1448	1.08 (0.94, 1.24)	0.2769	1.06 (0.93, 1.22)	0.3817
Q3	484/2523	1.219 (1.068, 1.391)	0.0033	1.241 (1.084, 1.422)	0.0018	1.183 (1.030, 1.359)	0.0171	1.170 (1.018, 1.344)	0.0272
Q4	577/2524	1.520 (1.339, 1.726)	< 0.0001	1.689 (1.475, 1.933)	< 0.0001	1.535 (1.330, 1.770)	< 0.0001	1.480 (1.282, 1.710)	< 0.0001
Per 1 SD		1.173 (1.122, 1.226)	< 0.0001	1.227 (1.169, 1.288)	< 0.0001	1.180 (1.120, 1.244)	< 0.0001	1.166 (1.106, 1.230)	< 0.0001
P for trend			< 0.0001		< 0.0001		< 0.0001		< 0.0001

Data are expressed as hazard ratio and 95%CIs (reported in parentheses) as assessed by multivariable Cox regression analysis. Model 1 Adjusted for sex, race, age, education, history of cardiovascular disease, previous hypertension and previous hyperlipidemia systolic blood pressure, diastolic blood pressure. Model 2 adjusted for model 1 covariables plus duration of diabetes, proteinuria, heart failure, depression, smoking, glycated hemoglobin, total cholesterol, low-density lipoprotein cholesterol and estimated glomerular filtration rate. Model 3 Adjusted for model 2 covariables plus the medications use, calcium channel blockers, beta-blockers, biguanides, thiazolidinediones, insulins, aspirin, statins, cholesterol absorption inhibitors. TyG: Triglyceride glucose; WC: Waist circumference; MACEs: Major adverse cardiovascular events; HR: Hazard ratio.

Table 5 Analysis of the threshold effects of triglyceride glucose-waist height ratio and triglyceride glucose-waist circumference levels on overall mortality

	One linear-regression model	Inflection point (K)	< K, effect 1	> K, effect 2	P value for LRT
TyG-WHtR	1.163 (1.099, 1.231); P < 0.0001	5.062	0.802 (0.626, 1.026); P = 0.0797	1.223 (1.146, 1.306); P < 0.0001	0.004
TyG-WC	1.101 (1.065, 1.138); P < 0.0001	870.1	0.891 (0.781, 1.017); P = 0.0880	1.137 (1.094, 1.182); P < 0.0001	0.002

The effects shown are adjusted for model 3, including sex, race, age, education, history of cardiovascular disease, previous hypertension and previous hyperlipidemia systolic blood pressure, diastolic blood pressure, duration of diabetes, proteinuria, heart failure, depression, smoking, glycated hemoglobin, total cholesterol, low-density lipoprotein cholesterol, estimated glomerular filtration rate, calcium channel blockers, beta-blockers, biguanides, thiazolidinediones, insulins, aspirin, statins and cholesterol absorption inhibitors. TyG: Triglyceride glucose; WHtR: Waist height ratio; WC: Waist circumference; LRT: Likelihood ratio test.

Table 6 Additional predictive value of triglyceride-glucose related indices for major adverse cardiovascular events and total mortality

	AUC (95%CI)	P value	NRI (95%CI)	P value	IDI (95%CI)	P value
MACEs
Basic model	0.6264 (0.6131, 0.6396)		Reference		Reference
Basic model + TyG	0.6318 (0.6186, 0.6450)	0.0039	0.0660 (0.0380, 0.1000)	< 0.0001	0.0030 (0.0010, 0.0060)	< 0.0001
Basic model + TyG-WHtR	0.6344 (0.6213, 0.6475)	0.0012	0.0770 (0.0450, 0.1060)	< 0.0001	0.0040 (0.0020, 0.0070)	< 0.0001
Basic model + TyG-WC	0.6322 (0.6191, 0.6454)	0.0043	0.0610 (0.0280, 0.0850)	< 0.0001	0.0030 (0.0010, 0.0060)	< 0.0001
Total mortality
Basic model	0.6667 (0.6539, 0.6794)		Reference		Reference
Basic model + TyG	0.6683 (0.6556, 0.6811)	0.0324	0.0340 (0.0020, 0.0630)	0.0400	0.0010 (0.0000, 0.0020)	0.1200
Basic model + TyG-WHtR	0.6696 (0.6569, 0.6823)	0.0038	0.0520 (0.0200, 0.0800)	< 0.0001	0.0020 (0.0000, 0.0040)	0.0070
Basic model + TyG-WC	0.6701 (0.6574, 0.6829)	0.0025	0.0410 (0.0110, 0.0690)	< 0.0001	0.0020 (0.0000, 0.0050)	0.0070

Basic model: Sex, age, duration of diabetes, smoking, body mass index, glycated hemoglobin, systolic blood pressure, diastolic blood pressure, low-density lipoprotein cholesterol, previous hypertension and previous hyperlipidemia, insulins use. MACEs: Major adverse cardiovascular events; TyG: Triglyceride glucose; WHtR: Waist height ratio; WC: Waist circumference; AUC: Area under curve; NRI: Net reclassification index; IDI: Integrated discrimination improvement.