TyG Index and Obesity‐Related Measures in Relation to All‐Cause Mortality Among HSV‐Positive Adults

Background: Previous studies have extensively explored the association between the triglyceride-glucose (TyG) index and mortality; however, evidence specific to the herpes simplex virus (HSV)-positive population remains limited. Therefore, this study aims to investigate the association between the TyG index and mortality among HSV-positive adults, providing new insights into this field. Methods: This study included 8465 HSV-positive adults from the National Health and Nutrition Examination Survey (NHANES) 1999-2018, with mortality follow-up through 2019. The TyG index and four derived indices, TyG-BMI, TyG-WC, TyG-WHtR, and TyG-ABSI, were calculated using fasting triglycerides, glucose, and anthropometric data. Associations with all-cause mortality were assessed using Cox proportional hazards models. Two-piecewise Cox regression models were applied to explore potential threshold effects. Results: Over a median follow-up of 143 months, 297 all-cause deaths (3.5%) occurred. Higher levels of the TyG index and its derivatives were significantly associated with increased all-cause mortality. TyG-WHtR showed the strongest association (HR: 2.08, 95% CI: 1.41-3.06), followed by TyG-WC (HR: 1.95, 95% CI: 1.34-2.82), TyG-BMI (HR: 1.22, 95% CI: 1.11-1.33), and the TyG index itself (HR: 1.35, 95% CI: 1.20-1.52). TyG-ABSI also demonstrated a positive linear association (HR: 1.33, 95% CI: 1.18-1.50). Conclusions: Elevated levels of the TyG index and its obesity-related derivatives, particularly TyG-WHtR, were associated with increased all-cause mortality in HSV-positive adults.