Pos1171 new index using triglyceride-glucose-body mass index for predicting mortality in patients with antineutrophil cytoplasmic antibody-associated vasculitis

Background The mortality rate of patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is relatively higher than that of those with other vasculitides. Various biomarkers are developed to predict outcome of AAV. Recently, a novel index, triglyceride (TG) glucose-body mass index (BMI) (TyG-BMI) was introduced to predict insulin resistance (IR), cardiovascular disease, cerebrovascular accidents in general population. Given that IR and its related diseases such as CVD and CVA are generally major risk factors for all-cause mortality in the general population, it could be assumed that TyG-BMI could be a robust predictor of all-cause mortality in AAV patients. Objectives This study aimed to investigated whether TyG-BMI and a new index using TyG-BMI (NITGB) could predict all-cause mortality in nonobese patients with AAV. Methods The medical records of 78 nonobese AAV patients (BMI < 23.0 kg/m2 for Asian) were retrospectively reviewed. TyG-BMI was calculated by the equation: Ln [triglyceride × fasting glucose/2] × BMI. To develop NITGB, we assigned a weight of a number close to an 0.1 decimal integer to each variable according to the slopes for independent variables with P-value < 0.1 in the multivariable Cox analysis. Results The median age was 54.3 years and five patients died. When nonobese AAV patients were divided into two groups based on TyG-BMI ≥ 187.74, those with TyG-BMI ≥ 187.74 exhibited a significantly higher risk for all-cause mortality than those without (RR 9.450). Since age (HR 1.324), Birmingham vasculitis activity score (BVAS; HR 1.212), and TyG-BMI ≥ 187.74 (HR 12.168) were independently associated with all-cause mortality, NITGB was developed as follow: age + 0.2 × BVAS + 2.5 × TyG-BMI ≥ 187.74. When nonobese AAV patients were divided into two groups based on NITGB ≥ 27.36, those with NITGB ≥ 27.36 showed a significantly higher risk for all-cause mortality than those without (RR 284.000). Conclusion Both nonobese AAV patients with TyG-BMI ≥ 187.74 and those with NITGB ≥ 27.36 exhibited significantly higher cumulative rates of all-cause mortality than those without. NITGB along with TyG-BMI could predict all-cause mortality in nonobese AAV patients. References [1]Wallace ZS, Fu X, Harkness T, Stone JH, Zhang Y, Choi H. All-cause and cause-specific mortality in ANCA-associated vasculitis: overall and according to ANCA type. Rheumatology (Oxford). 2020;59(9):2308-2315. [2]Murray CJ, Atkinson C, Bhalla K, et al. The state of US health, 1990-2010: burden of diseases, injuries, and risk factors. JAMA. 2013 Aug 14;310(6):591-608. [3]Er LK, Wu S, Chou HH, et al. Triglyceride Glucose-Body Mass Index Is a Simple and Clinically Useful Surrogate Marker for Insulin Resistance in Nondiabetic Individuals. PLoS One. 2016;11(3):e0149731. [4]Du Z, Xing L, Lin M, Sun Y. Estimate of prevalent ischemic stroke from triglyceride glucose-body mass index in the general population. BMC Cardiovasc Disord. 2020;20(1):483. Figure 1. Acknowledgements: NIL. Disclosure of Interests None Declared.