Association between triglyceride glucose- systemic immune inflammation index and deep venous thrombosis in fresh fracture patient: a real-world retrospective study

Background: Currently, systemic inflammation indices and insulin resistance are both recognised as high-risk factors for venous thromboembolic diseases. However, there is a lack of research on the relationship between the triglyceride-glucose-systemic inflammation index (TyG-SII) and the risk of lower limb deep vein thrombosis (DVT) in populations with traumatic fractures. This study aims to investigate the relationship between TyG-SII and the risk of DVT. Methods: The study participants were inpatients from the Orthopaedic Centre of Foshan Traditional Chinese Medicine Hospital. Participants were divided into three groups using K-means clustering analysis based on changes in TyG-SII. Multivariate binary logistic regression analysis was used to explore the association between different groups (based on different levels of TyG-SII and DVT. Restricted cubic spline (RCS) regression models were used to explore the potential nonlinear association between TyG-SII and DVT events. Receiver operating characteristic (ROC) curves were employed to quantify the predictive ability of TyG-SII for DVT. Subgroup analyses further confirmed the relationship between TyG-SII and DVT in different populations. Results: Among the 5,455 patients, 1,991 (36.50%) developed DVT, and 646 (11.84%) developed only MCVT. After adjusting for various potential confounding factors, patients with moderate (OR = 0.86, 95% CI: 0.66-0.98) and high levels of TyG-SII had a significantly lower risk of DVT compared to those with low levels of TyG-SII (OR = 0.73, 95% CI: 0.58-0.95). Compared with the lowest quartile (Q1) of baseline TyG-SII, the third quartile (Q3) showed the most significant protective effect (OR = 0.46, 95% CI: 0.39-0.55). Additionally, there was a nonlinear U-shaped relationship between baseline TyG-SII and DVT risk, with thresholds of 242.14 and 3710.98, respectively. Conclusions: For patients with traumatic fractures, TyG-SII is independently associated with the risk of lower limb DVT. Maintaining a good TyG-SII index helps prevent the occurrence of DVT after traumatic fractures.