The obesity paradox effect of triglyceride-glucose-body mass index (TyG-BMI) on all-cause mortality in patients with malignant tumors: a machine learning-driven cohort study.

Q1 comparison yielded an HR of 1.66 (P=0.017), with a significant trend test (P=0.008).

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Although the linear trend test across the continuous TyG-BMI scale did not reach statistical significance (P=0.167), the quartile analysis revealed a U-shaped risk distribution consistent with the previously described “obesity paradox.” This pattern suggests that while a moderate increase in TyG-BMI may confer a survival benefit—potentially reflecting a metabolic reserve—this protective association attenuates at the highest levels, without evidence of exerting a confirmed detrimental effect.

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