Triglyceride-glucose index combined with a body shape index in relation to sleep problems and sleep duration

doi:10.5498/wjp.123981

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World Journal of Psychiatry

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2220-3206

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Observational Study

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Psychiatry. Nov 19, 2026; 16(11): 123981
Published online Nov 19, 2026. doi: 10.5498/wjp.123981

Triglyceride-glucose index combined with a body shape index in relation to sleep problems and sleep duration

Yong-Cai Zhang, Zhen-Zhen Yu, Wen-Tao Zheng, Chen Wang

Yong-Cai Zhang, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen 361000, Fujian Province, China

Zhen-Zhen Yu, Department of Neurology, The Second Affiliated Hospital of Xiamen Medical College, Xiamen 361000, Fujian Province, China

Wen-Tao Zheng, Department of Neurosurgery, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen 361000, Fujian Province, China

Chen Wang, Xiamen Xianyue Hospital, Xianyue Hospital Affiliated with Xiamen Medical College, Fujian Psychiatric Center, Fujian Clinical Research Center for Mental Disorders, Xiamen 361000, Fujian Province, China

Co-first authors: Yong-Cai Zhang and Zhen-Zhen Yu.

Co-corresponding authors: Wen-Tao Zheng and Chen Wang.

Author contributions: Zhang YC and Yu ZZ performed data analysis as co-first authors; Zhang YC and Wang C designed and implemented the study; Zheng WT and Wang C have played important and indispensable roles in the experimental design as co-corresponding authors; Zhang YC, Yu ZZ, Zheng WT and Wang C collected and analyzed the data and drafted the manuscript; all authors read and approved the final manuscript.

AI contribution statement: ChatGPT (OpenAI, GPT-5.5) was used to assist with English translation, language editing, sentence restructuring, and formatting during manuscript preparation. It was not used to generate research data, perform statistical analyses, or independently determine the interpretation of results, conclusions, or references. All AI-assisted content was critically reviewed, verified, and revised by the authors, who take full responsibility for the accuracy, originality, and integrity of the manuscript.

Supported by the Natural Science Foundation of Fujian Province, No. 2026J0011829; the Xiamen Health High-Quality Development Science and Technology Program Medical Innovation Project, No. 2024GZL-CX38; and the Guangdong Mental Health Association, No. 2025GDMHA002.

Institutional review board statement: National Health and Nutrition Examination Survey protocols were approved by the National Center for Health Statistics Research Ethics Review Board, and all participants provided written informed consent. The present study utilized publicly available, de-identified data and was therefore exempt from additional institutional review.

Informed consent statement: National Health and Nutrition Examination Survey protocols were approved by the National Center for Health Statistics Research Ethics Review Board, and all participants provided written informed consent. The present study utilized publicly available, de-identified data and was therefore exempt from additional written informed consent.

Conflict-of-interest statement: All authors declare no conflict of interest in publishing the manuscript.

STROBE statement: The authors have read the STROBE Statement – checklist of items, and the manuscript was prepared and revised according to the STROBE Statement – checklist of items.

Data sharing statement: The datasets analyzed in this study are publicly available through the National Health and Nutrition Examination Survey website. The statistical code is available from the corresponding author upon reasonable request.

Corresponding author: Chen Wang, MD, PhD, Assistant Professor, Xiamen Xianyue Hospital, Xianyue Hospital Affiliated with Xiamen Medical College, Fujian Psychiatric Center, Fujian Clinical Research Center for Mental Disorders, No. 387-399 Xianyue Road, Siming District, Xiamen 361000, Fujian Province, China. wangchen1986xm@163.com

Received: June 5, 2026
Revised: July 30, 2026
Accepted: September 21, 2026
Published online: November 19, 2026
Processing time: 147 Days and 0.1 Hours

Abstract

BACKGROUND

Sleep problems commonly coexist with insulin resistance and abdominal adiposity. The triglyceride-glucose index combined with a body shape index (TyG-ABSI) incorporates metabolic and body-shape information. However, few studies have specifically examined its associations with sleep problems and sleep duration, and how depressive symptoms relate statistically to the TyG-ABSI-sleep duration association remains unclear.

AIM

To investigate associations of TyG-ABSI with sleep problems and sleep duration and evaluate depressive symptoms using statistical analysis.

METHODS

This cross-sectional study included 12642 adults from the 2005-2014 National Health and Nutrition Examination Survey. TyG-ABSI was analyzed continuously and by tertiles. Sleep problems were defined by affirmative responses to either of two self-reported questionnaire items; sleep duration was analyzed continuously. Survey-weighted multivariable logistic and linear regressions assessed the associations. Each sleep item was examined separately in sensitivity analyses. Bootstrap statistical decomposition estimated total, direct, and indirect effects using binary depressive status and continuous Patient Health Questionnaire-9 scores.

RESULTS

Survey-weighted analyses showed that a 1-unit increase in TyG-ABSI was associated with higher odds of self-reported sleep problems (odds ratio = 1.17; 95%CI: 1.06-1.30; P = 0.002). Among those reporting sleep problems, TyG-ABSI was positively associated with sleep duration (β = 0.31 hours per unit; 95%CI: 0.05-0.57; P = 0.020), whereas the association was not statistically significant among those without sleep problems (β = 0.00). Restricted cubic splines suggested a nonlinear association with sleep duration (P for nonlinearity < 0.05). Decomposition using continuous depressive scores yielded a negative indirect estimate (β = -0.044; 95%CI: -0.082 to -0.016; P < 0.001) and a positive direct estimate, consistent with statistical suppression.

CONCLUSION

Higher TyG-ABSI is associated with self-reported sleep problems and with longer sleep duration among participants reporting sleep problems. Depressive symptoms show statistical suppression, warranting prospective validation.

Keywords: Triglyceride-glucose index combined with a body shape index; Sleep problems; Sleep duration; Depressive symptoms; Insulin resistance; Cross-sectional studies; National Health and Nutrition Examination Survey

Core Tip: This population-based study used survey-weighted data from United States adults to assess the association of the triglyceride-glucose index combined with a body shape index with self-reported sleep problems and sleep duration. Higher triglyceride-glucose index combined with a body shape index was associated with greater odds of sleep problems, while analyses suggested a possible nonlinear association with sleep duration among participants with sleep problems. Depressive symptoms exhibited a statistical suppression effect rather than conventional mediation. These findings extend evidence on metabolic-sleep associations by integrating metabolic and body-shape information and warrant prospective validation.