Objective:

To assess the associations of the triglyceride-glucose (TyG) index and its body fat distribution composites with prevalent coronary heart disease (CHD) and incident major adverse cardiovascular events (MACE) in adults with obstructive sleep apnea-hypopnea syndrome (OSAHS), highlighting the significance of these associations in cardiovascular risk stratification.

Key Findings:

• All TyG-related indices were independently associated with prevalent CHD after full adjustment, indicating their potential utility in clinical settings.
• TyG-WWI showed the strongest association with prevalent CHD (odds ratio 3.21), suggesting it may be a critical factor in risk assessment.
• Adding TyG-WWI to conventional risk factors improved CHD discrimination significantly, underscoring its importance in enhancing predictive models.
• During a median follow-up of 17 months, TyG-WWI was also strongly associated with incident MACE (hazard ratio 1.545), indicating its relevance for long-term cardiovascular risk.

Interpretation:

TyG and its adiposity-based composites are associated with prevalent CHD and follow-up MACE in adults with OSAHS, with TyG-WWI showing the most consistent predictive value, suggesting its potential role in clinical risk stratification.

Limitations:

• Limited number of MACE events during follow-up may restrict the generalizability of the findings.
• The exploratory nature of the statistical decomposition requires cautious interpretation and prospective validation to confirm these associations.

Conclusion:

TyG-WWI may serve as a candidate marker for cardiovascular risk stratification in OSAHS patients, warranting further research to validate its clinical applicability.