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

Table 1 Baseline characteristics of the overall study population according to sleep-problem status

Characteristic	Overall, n = 12642	Sleep problems		P value
		No, n = 11670 (92.3%)	Yes, n = 972 (7.7%)
Age (years)	46.30 (45.70-46.90)	45.85 (45.22-46.49)	51.41 (50.45-52.38)	< 0.0001
Gender				0.1135
Male	48.79 (47.85-49.73)	48.48 (47.57-49.39)	52.32 (47.54-57.05)
Female	51.21 (50.27-52.15)	51.52 (50.61-52.43)	47.68 (42.95-52.46)
Race/ethnicity				< 0.0001
Non-Hispanic White	68.62 (65.62-71.47)	68.06 (65.03-70.95)	74.96 (71.30-78.29)
Non-Hispanic Black	10.59 (9.21-12.15)	10.56 (9.17-12.15)	10.84 (9.07-12.92)
Mexican American	8.69 (7.32-10.28)	9.03 (7.63-10.65)	4.77 (3.43-6.62)
Other Hispanic	5.33 (4.28-6.62)	5.40 (4.33-6.72)	4.52 (3.27-6.22)
Other race	6.78 (5.90-7.77)	6.94 (6.03-7.98)	4.90 (3.65-6.54)
Education level				0.5355
Under Highschool	5.93 (5.31-6.61)	5.96 (5.35-6.63)	5.60 (4.44-7.03)
Highschool	35.55 (33.49-37.67)	35.71 (33.52-37.95)	33.80 (30.19-37.61)
Above Highschool	58.46 (56.20-60.69)	58.27 (55.91-60.60)	60.61 (56.54-64.54)
Poverty income ratio	2.96 (2.88-3.05)	2.97 (2.88-3.05)	2.90 (2.72-3.08)	0.4002
Smoking status				< 0.0001
Never	52.90 (51.21-54.59)	53.76 (52.14-55.37)	43.09 (38.20-48.11)
Former	23.93 (22.66-25.26)	23.46 (22.16-24.83)	29.28 (25.79-33.03)
Current	20.55 (19.14-22.03)	20.02 (18.60-21.51)	26.65 (23.38-30.20)
Alcohol use				< 0.0001
Never	10.41 (9.36-11.56)	10.41 (9.43-11.48)	10.34 (7.65-13.84)
Former	14.21 (13.16-15.32)	13.58 (12.54-14.68)	21.40 (18.22-24.98)
Mild	32.51 (30.93-34.13)	32.64 (31.04-34.29)	31.00 (26.77-35.57)
Moderate	15.28 (14.31-16.30)	15.20 (14.20-16.25)	16.20 (12.98-20.04)
Heavy	19.52 (18.48-20.60)	19.84 (18.72-21.00)	15.92 (13.07-19.25)
Diastolic blood pressure (mmHg)	69.17 (68.71-69.62)	69.09 (68.62-69.55)	70.09 (69.16-71.03)	0.0387
Systolic blood pressure (mmHg)	120.09 (119.56-120.62)	119.87 (119.34-120.41)	122.52 (121.43-123.60)	< 0.0001
ALT (U/L)	25.51 (25.11-25.91)	25.36 (24.93-25.80)	27.20 (25.64-28.77)	0.0340
AST (U/L)	25.62 (25.25-25.99)	25.50 (25.11-25.88)	26.98 (25.38-28.58)	0.0849
Blood urea nitrogen (mg/dL)	12.87 (12.73-13.00)	12.78 (12.64-12.91)	13.92 (13.50-14.34)	< 0.0001
Creatinine (mg/dL)	0.88 (0.88-0.89)	0.88 (0.87-0.89)	0.94 (0.91-0.96)	< 0.0001
Bilirubin, total (mg/dL)	0.77 (0.76-0.78)	0.77 (0.76-0.78)	0.73 (0.70-0.75)	0.0025
Cholesterol, total (mg/dL)	194.37 (193.25-195.49)	194.57 (193.40-195.74)	192.06 (188.41-195.72)	0.2050
Direct HDL-cholesterol (mg/dL)	54.12 (53.65-54.58)	54.42 (53.94-54.91)	50.65 (49.47-51.83)	< 0.0001
LDH (U/L)	127.54 (126.82-128.26)	127.16 (126.38-127.94)	131.85 (129.49-134.20)	0.0006
Triglycerides (mg/dL)	128.87 (125.50-132.24)	126.69 (123.52-129.86)	153.82 (136.60-171.05)	0.0028
Diabetes mellitus				< 0.0001
No	68.43 (66.94-69.89)	69.61 (68.09-71.09)	55.09 (51.28-58.84)
Diabetes mellitus	14.99 (13.99-16.04)	13.80 (12.83-14.83)	28.45 (24.85-32.34)
Impaired fasting glycaemia	7.88 (7.20-8.61)	7.79 (7.12-8.53)	8.80 (6.81-11.31)
Impaired glucose tolerance	8.71 (8.06-9.40)	8.80 (8.11-9.54)	7.66 (5.82-10.01)
Hyperlipidemia				< 0.0001
No	28.85 (27.57-30.17)	29.74 (28.40-31.12)	18.67 (15.96-21.72)
Yes	71.15 (69.83-72.43)	70.26 (68.88-71.60)	81.33 (78.28-84.04)
Atherosclerotic cardiovascular disease				< 0.0001
No	91.87 (91.02-92.64)	92.79 (92.02-93.49)	81.61 (78.46-84.40)
Yes	8.13 (7.36-8.98)	7.21 (6.51-7.98)	18.39 (15.60-21.54)
Congestive heart failure				< 0.0001
No	97.46 (97.01-97.83)	97.90 (97.52-98.22)	92.52 (90.00-94.45)
Yes	2.54 (2.17-2.99)	2.10 (1.78-2.48)	7.48 (5.55-10.00)
Myocardial infarction				< 0.0001
No	96.36 (95.81-96.84)	96.84 (96.34-97.28)	90.97 (87.90-93.32)
Yes	3.64 (3.16-4.19)	3.16 (2.72-3.66)	9.03 (6.68-12.10)
Angina pectoris				< 0.0001
No	97.75 (97.39-98.07)	98.08 (97.72-98.37)	94.17 (92.42-95.54)
Yes	2.25 (1.93-2.61)	1.92 (1.63-2.28)	5.83 (4.46-7.58)
Sleep duration (hours)	6.89 (6.85-6.93)	6.93 (6.89-6.97)	6.44 (6.32-6.57)	< 0.0001
TyG-ABSI	7.01 (6.98-7.03)	6.98 (6.96-7.01)	7.27 (7.20-7.33)	< 0.0001

Data are presented as survey-weighted means (95%CIs) for continuous variables and survey-weighted proportions (95%CIs) for categorical variables. ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; HDL: High-density lipoprotein; LDH: Lactate dehydrogenase; TyG-ABSI: Triglyceride-glucose index combined with a body shape index.

Table 2 Baseline characteristics of participants with sleep problems stratified by tertiles of the triglyceride-glucose index combined with a body shape index

Characteristic	TyG-ABSI			P value
	T1 (≤ 6.66)	T2 (< 7.34)	T3 (≥ 7.34)
Participant	217	334	421
Age (years)	42.45 (39.87-45.03)	51.05 (49.13-52.98)	56.32 (54.83-57.80)	< 0.0001
Gender				< 0.0001
Male	31.76 (24.00-40.67)	50.49 (44.49-56.49)	64.37 (57.28-70.87)
Female	68.24 (59.33-76.00)	49.51 (43.51-55.51)	35.63 (29.13-42.72)
Race/ethnicity				< 0.0001
Non-Hispanic White	67.78 (61.29-73.66)	71.86 (66.02-77.04)	81.14 (76.12-85.30)
Non-Hispanic Black	20.76 (16.08-26.39)	11.93 (9.14-15.42)	4.87 (3.30-7.12)
Mexican American	5.04 (2.85-8.76)	4.72 (2.78-7.91)	4.67 (2.96-7.32)
Other Hispanic	3.49 (1.98-6.06)	5.47 (3.59-8.25)	4.30 (2.71-6.78)
Other race	2.92 (1.27-6.59)	6.03 (3.71-9.65)	5.02 (3.01-8.26)
Education level				0.1148
Under Highschool	1.66 (0.67-4.05)	6.65 (3.93-11.03)	6.78 (4.92-9.27)
Highschool	30.67 (23.23-39.28)	33.05 (26.69-40.10)	36.00 (29.80-42.71)
Above Highschool	67.66 (59.09-75.19)	60.30 (52.28-67.81)	57.21 (50.29-63.87)
Poverty income ratio	2.95 (2.71-3.18)	2.97 (2.69-3.25)	2.82 (2.57-3.08)	0.6353
Smoke				< 0.0001
Never	55.46 (46.85-63.76)	45.93 (37.86-54.22)	34.44 (27.84-41.69)
Former	20.01 (13.87-27.97)	24.09 (18.92-30.14)	38.22 (32.24-44.58)
Now	21.87 (16.56-28.31)	28.91 (23.41-35.12)	27.30 (22.15-33.14)
Alcohol use				0.0017
Never	11.77 (7.24-18.58)	8.87 (5.15-14.87)	10.79 (7.78-14.78)
Former	10.59 (6.51-16.77)	22.62 (17.49-28.73)	26.00 (20.30-32.65)
Mild	26.14 (19.63-33.89)	31.14 (23.17-40.41)	33.38 (27.05-40.38)
Moderate	26.38 (18.33-36.40)	15.40 (10.62-21.79)	11.61 (7.88-16.77)
Heavy	18.06 (12.16-25.96)	18.28 (13.49-24.29)	12.92 (9.08-18.06)
Diastolic blood pressure (mmHg)	68.90 (67.17-70.64)	70.05 (68.49-71.62)	70.73 (69.02-72.45)	0.3273
Systolic blood pressure (mmHg)	117.80 (115.78-119.82)	120.46 (118.16-122.76)	126.59 (124.74-128.43)	< 0.0001
ALT (U/L)	22.39 (20.31-24.47)	25.33 (23.46-27.20)	31.22 (28.25-34.19)	0.0001
AST (U/L)	23.96 (21.77-26.14)	26.46 (23.22-29.70)	28.97 (26.70-31.24)	0.0134
Blood urea nitrogen (mg/dL)	13.16 (12.32-13.99)	13.11 (12.53-13.70)	14.96 (14.34-15.58)	< 0.0001
Creatinine (mg/dL)	0.88 (0.85-0.91)	0.91 (0.88-0.95)	0.99 (0.94-1.03)	0.0002
Bilirubin, total (mg/dL)	0.73 (0.67-0.79)	0.72 (0.68-0.76)	0.73 (0.68-0.77)	0.9687
Cholesterol, total (mg/dL)	181.50 (174.02-188.98)	194.00 (188.25-199.75)	195.96 (189.73-202.20)	0.0222
Direct HDL-cholesterol (mg/dL)	59.62 (56.80-62.45)	53.43 (51.24-55.63)	43.80 (42.29-45.32)	< 0.0001
LDH (U/L)	129.37 (124.38-134.37)	132.71 (128.40-137.03)	132.43 (128.78-136.08)	0.5165
Triglycerides (mg/dL)	73.57 (66.58-80.55)	114.43 (107.92-120.94)	226.72 (190.74-262.69)	< 0.0001
Diabetes mellitus				< 0.0001
No	83.02 (77.27-87.55)	63.15 (57.00-68.90)	34.35 (28.13-41.17)
Diabetes mellitus	9.42 (6.15-14.16)	13.91 (9.85-19.29)	49.77 (43.02-56.53)
Impaired fasting glycaemia	2.03 (0.80-5.06)	12.03 (7.97-17.76)	9.71 (6.78-13.73)
Impaired glucose tolerance	5.53 (2.91-10.27)	10.91 (7.19-16.22)	6.16 (3.72-10.04)
Hyperlipidemia				< 0.0001
No	42.98 (35.28-51.03)	18.26 (13.59-24.08)	6.47 (3.95-10.44)
Yes	57.02 (48.97-64.72)	81.74 (75.92-86.41)	93.53 (89.56-96.05)
Atherosclerotic cardiovascular disease				0.0001
No	91.71 (86.19-95.14)	85.37 (79.93-89.52)	73.59 (66.71-79.48)
Yes	8.29 (4.86-13.81)	14.63 (10.48-20.07)	26.41 (20.52-33.29)
Congestive heart failure				0.0361
No	97.68 (91.30-99.41)	92.50 (88.18-95.32)	89.97 (85.65-93.09)
Yes	2.32 (0.59-8.70)	7.50 (4.68-11.82)	10.03 (6.91-14.35)
Myocardial infarction				0.0001
No	96.82 (93.77-98.40)	92.55 (88.00-95.47)	86.79 (81.91-90.51)
Yes	3.18 (1.60-6.23)	7.45 (4.53-12.00)	13.21 (9.49-18.09)
Angina pectoris				0.0004
No	98.25 (95.92-99.26)	95.83 (92.84-97.60)	90.84 (86.86-93.71)
Yes	1.75 (0.74-4.08)	4.17 (2.40-7.16)	9.16 (6.29-13.14)
Sleep duration (hours)	6.20 (5.90-6.49)	6.40 (6.20-6.59)	6.61 (6.40-6.82)	0.0904

Data are presented as survey-weighted means (95%CIs) for continuous variables and survey-weighted proportions (95%CIs) for categorical variables. ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; HDL: High-density lipoprotein; LDH: Lactate dehydrogenase; TyG-ABSI: Triglyceride-glucose index combined with a body shape index.

Table 3 Survey-weighted logistic regression analyses of the association between the triglyceride-glucose index combined with a body shape index and sleep problems

Variables	Model 1		Model 2		Model 3
	OR (95%CI)	P value	OR (95%CI)	P value	OR (95%CI)	P value
Sleep problem	1.335 (1.269-1.404)	< 0.001	1.308 (1.225-1.395)	< 0.001	1.173 (1.063-1.295)	0.0019

OR: Odds ratio.

Table 4 Association between the triglyceride-glucose index combined with a body shape index and sleep duration according to sleep-problem status and demographic characteristics

Group	Participant with sleep disorder			Participant without sleep disorder
	Model 1	Model 2	Model 3	Model 1	Model 2	Model 3
Total	Ref	0.13 (-0.02 to 0.29) 0.0864	0.31 (0.05-0.57) 0.0201	Ref	-0.03 (-0.07 to 0.01) 0.1213	0.00 (-0.06 to 0.07) 0.9024
Sex
Male	Ref	0.06 (-0.15 to 0.27) 0.5742	0.12 (-0.27 to 0.50) 0.5523	Ref	-0.10 (-0.16 to -0.04) 0.0004	-0.05 (-0.15 to 0.05) 0.3490
Female	Ref	0.20 (-0.03 to 0.43) 0.0864	0.50 (0.10-0.90) 0.0140	Ref	0.03 (-0.02 to 0.08) 0.3060	0.05 (-0.03 to 0.13) 0.2544
Age
≥ 18	Ref	0.18 (-0.15 to 0.52) 0.2870	0.21 (-0.51 to 0.93) 0.5634	Ref	-0.02 (-0.08 to 0.04) 0.5068	-0.08 (-0.19 to 0.03) 0.1765
40-59	Ref	0.04 (-0.20 to 0.27) 0.7675	0.47 (0.03-0.91) 0.0391	Ref	-0.07 (-0.13 to -0.01) 0.0249	0.00 (-0.10 to 0.10) 0.9967
≥ 60	Ref	0.22 (-0.03 to 0.47) 0.0841	-0.01 (-0.43 to 0.41) 0.9745	Ref	0.00 (-0.07 to 0.07) 0.9678	0.06 (-0.06 to 0.17) 0.3133
Ethnicity
Non-Hispanic White	Ref	0.04 (-0.16 to 0.23) 0.7078	0.03 (-0.31 to 0.37) 0.8441	Ref	-0.07 (-0.12 to -0.01) 0.0130	-0.03 (-0.12 to 0.06) 0.5677
Non-Hispanic Black	Ref	0.14 (-0.22 to 0.50) 0.4427	0.20 (-0.49 to 0.89) 0.5678	Ref	-0.09 (-0.18 to -0.00) 0.0402	-0.04 (-0.20 to 0.13) 0.6672
Mexican American	Ref	0.59 (0.08-1.09) 0.0258	1.35 (0.26-2.44) 0.0196	Ref	0.15 (0.06-0.23) 0.0009	0.08 (-0.08 to 0.24) 0.3360
Other Hispanic	Ref	0.05 (-0.61 to 0.70) 0.8924	1.60 (-0.16 to 3.36) 0.0848	Ref	0.11 (-0.02 to 0.24) 0.0868	0.15 (-0.07 to 0.37) 0.1726
Other race	Ref	0.44 (-0.19 to 1.08) 0.1790	0.78 (-0.43 to 1.98) 0.2339	Ref	-0.09 (-0.20 to 0.03) 0.1436	0.11 (-0.11 to 0.33) 0.3373

Results are presented as β (95%CI) and P values from survey-weighted linear regression. β represents the change in sleep duration (hours) per 1-unit increase in the original, unstandardized triglyceride-glucose – a body shape index. Model 1 was unadjusted; model 2 was adjusted for age, sex, and race; model 3 was further adjusted for socioeconomic, lifestyle, blood pressure, laboratory, and cardiovascular covariates. In subgroup analyses, the corresponding stratification variable was not included in the model. Ref: Reference.