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Yu P, Pu J, Yuan Q, Huang L, Tao L, Peng Z. The prognostic value of triglyceride-glucose index to adverse renal outcomes in patients with type 2 diabetes mellitus: results from the cohort study of ACCORD. Diabetol Metab Syndr 2024; 16:201. [PMID: 39160567 PMCID: PMC11331609 DOI: 10.1186/s13098-024-01439-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2024] [Accepted: 08/05/2024] [Indexed: 08/21/2024] Open
Abstract
BACKGROUND The triglyceride-glucose (TyG) index is a new and good biomarker of insulin resistance (IR). The prognostic utility of the TyG index for patients with type 2 diabetes mellitus (T2DM) remains uncertain. Our study seeks to elucidate the connection between the TyG index and adverse renal outcomes within a T2DM population, while also examining if these relationships are influenced by subgroup variations. METHODS We analyzed data from the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial, involving 10,196 T2DM participants, to assess the link between triglyceride-glucose levels and adverse renal outcomes. This evaluation included Restricted Cubic Spline (RCS) analysis, Kaplan-Meier survival analysis, and Multivariate Cox proportional regression. Additionally, we examined the interaction between subgroups concerning adverse renal outcomes. RESULTS During a 7-year follow-up, 5824 patients (57.1%) experienced worsening renal function, 2309 patients (23.2%) developed albuminuria, and 280 patients (2.7%) advanced to renal failure. After adjusting for a range of confounding variables, triglyceride-glucose levels were significantly linked to both worsening renal function (p < 0.001) and the onset of albuminuria (p = 0.020). Nonetheless, no significant association was observed between triglyceride-glucose levels and renal failure (p = 0.247). Furthermore, there was no significant subgroups interaction to the associations between TyG levels and adverse renal outcomes. CONCLUSION Our study underscores the significant relationship between the triglyceride-glucose index and the risk of adverse renal outcomes in patients with T2DM. The TyG index, as a readily calculable measure, offers clinicians a valuable tool for anticipating the risk of adverse renal outcomes in this patient population.
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Affiliation(s)
- Pan Yu
- Department of Nephrology, Xiangya Hospital, Central South University, No. 87 Xiangya Road, Kaifu District, Changsha, Hunan Province, China
| | - Jiaxi Pu
- Department of Nephrology, Xiangya Hospital, Central South University, No. 87 Xiangya Road, Kaifu District, Changsha, Hunan Province, China
- Hunan Key Lab of Organ Fibrosis, Changsha, China
- National International Collaborative Research Center for Medical Metabolomics, Central South University, Xiangya Hospital, Changsha, China
| | - Qiongjing Yuan
- Department of Nephrology, Xiangya Hospital, Central South University, No. 87 Xiangya Road, Kaifu District, Changsha, Hunan Province, China
- Hunan Key Lab of Organ Fibrosis, Changsha, China
- National International Collaborative Research Center for Medical Metabolomics, Central South University, Xiangya Hospital, Changsha, China
| | - Ling Huang
- Department of Nephrology, Xiangya Hospital, Central South University, No. 87 Xiangya Road, Kaifu District, Changsha, Hunan Province, China
- Hunan Key Lab of Organ Fibrosis, Changsha, China
- National International Collaborative Research Center for Medical Metabolomics, Central South University, Xiangya Hospital, Changsha, China
| | - Lijian Tao
- Department of Nephrology, Xiangya Hospital, Central South University, No. 87 Xiangya Road, Kaifu District, Changsha, Hunan Province, China
- Hunan Key Lab of Organ Fibrosis, Changsha, China
- National International Collaborative Research Center for Medical Metabolomics, Central South University, Xiangya Hospital, Changsha, China
| | - Zhangzhe Peng
- Department of Nephrology, Xiangya Hospital, Central South University, No. 87 Xiangya Road, Kaifu District, Changsha, Hunan Province, China.
- Hunan Key Lab of Organ Fibrosis, Changsha, China.
- National International Collaborative Research Center for Medical Metabolomics, Central South University, Xiangya Hospital, Changsha, China.
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Chen T, Liu Y, Wu S, Long S, Feng L, Lu W, Chen W, Hong G, Zhou L, Wang F, Luo Y, Zou H, Liu W. Comparison of TyG and Newly TyG Related Indicators for Chronic Kidney Diseases Estimation in a Chinese Population. Diabetes Metab Syndr Obes 2024; 17:3063-3075. [PMID: 39184550 PMCID: PMC11342947 DOI: 10.2147/dmso.s469260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Accepted: 08/07/2024] [Indexed: 08/27/2024] Open
Abstract
Background Obesity and insulin resistance (IR) are positively associated with chronic kidney disease (CKD). Previous studies have identified triglyceride-glucose index (TyG) as a valuable surrogate of insulin resistance. Recently, new indicators combining TyG and simple anthropometric indices have emerged, The objective of this study was to assess the diagnostic accuracy of TyG and newly TyG related indicators in detecting CKD and explore which indices were superior in associating with CKD in Chinese population. Methods Correlation test, logistic regression analysis, and receiver operating characteristic (ROC) analyses were used to evaluate the optimal cut-off and value of TyG, TyG-body mass index (TyG-BMI), TyG-waist circumference (TyG-WC), TyG-waist to height ratio (TyG-WHtR) for predicting CKD. Results TyG-WHtR, TyG-WC, and TyG-BMI correlated with several risk factors for CKD. After adjusting for confounders, TyG-WHtR and TyG-WC remained significantly associated with CKD, while TyG-BMI did not. The highest quartiles of TyG-WHtR and TyG-WC had 1.95- and 1.91-fold increased risk of CKD than the lowest quartiles (P<0.05). TyG-WHtR had the largest AUC (0.687) for CKD detection, followed by TyG-WC (0.669), TyG (0.652), and TyG-BMI (0.648). A united model that involved TyG-WHtR and other risk variables had higher predictive performance (AUC=0.791) than a single TyG related indicator. However, TyG had the highest OR (2.713, 95% CI, 1.446-5.090) for reduced eGFR in the fully adjusted model. A united model that involved TyG and WHtR separately had stronger predictive ability (AUC: 0.794) than the model that involved TyG-WHtR individually (AUC:0.791). Conclusion This study found that TyG-WHtR had a better diagnostic value in the diagnosis of CKD, compared to other TyG related indicators, but none of the TyG related indicators showed a stronger association with CKD than TyG. Further research and more refined algorithms are needed to verify these new indicators.
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Affiliation(s)
- Tong Chen
- Department of Nephrology, Chongqing Key Laboratory of Prevention and Treatment of Kidney Disease, Chongqing Clinical Research Center of Kidney and Urology Diseases, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, 400037, People’s Republic of China
- South China Hospital of Shenzhen University, Shenzhen, 518116, People’s Republic of China
- Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging, National Regional Key Technology Engineering Laboratory for Medical Ultrasound School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen, 518060, People’s Republic of China
- Department of Nephrology, The Third Affiliated Hospital, Southern Medical University, Guangzhou, People’s Republic of China
| | - Yu Liu
- South China Hospital of Shenzhen University, Shenzhen, 518116, People’s Republic of China
- Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging, National Regional Key Technology Engineering Laboratory for Medical Ultrasound School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen, 518060, People’s Republic of China
| | - Shiquan Wu
- South China Hospital of Shenzhen University, Shenzhen, 518116, People’s Republic of China
| | - Siyu Long
- South China Hospital of Shenzhen University, Shenzhen, 518116, People’s Republic of China
| | - Ling Feng
- Department of Nephrology, The Third Affiliated Hospital, Southern Medical University, Guangzhou, People’s Republic of China
- Department of Nephrology, Shenzhen Hospital, Southern Medical University, Shenzhen, People’s Republic of China
| | - Wenqian Lu
- School of Medicine, The Chinese University of Hong Kong, Shenzhen, People’s Republic of China
| | - Wenya Chen
- South China Hospital of Shenzhen University, Shenzhen, 518116, People’s Republic of China
| | - Guoai Hong
- South China Hospital of Shenzhen University, Shenzhen, 518116, People’s Republic of China
| | - Li Zhou
- South China Hospital of Shenzhen University, Shenzhen, 518116, People’s Republic of China
| | - Fang Wang
- South China Hospital of Shenzhen University, Shenzhen, 518116, People’s Republic of China
| | - Yuechan Luo
- South China Hospital of Shenzhen University, Shenzhen, 518116, People’s Republic of China
| | - Hequn Zou
- South China Hospital of Shenzhen University, Shenzhen, 518116, People’s Republic of China
- Department of Nephrology, The Third Affiliated Hospital, Southern Medical University, Guangzhou, People’s Republic of China
- School of Medicine, The Chinese University of Hong Kong, Shenzhen, People’s Republic of China
| | - Weihua Liu
- Department Nephrology of Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fujian, 350001, People’s Republic of China
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Li X, Wang L, Zhou H, Xu H. Association between triglyceride-glucose index and chronic kidney disease: results from NHANES 1999-2020. Int Urol Nephrol 2024:10.1007/s11255-024-04103-8. [PMID: 38856937 DOI: 10.1007/s11255-024-04103-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 05/29/2024] [Indexed: 06/11/2024]
Abstract
AIMS Examining the connection between the triglyceride-glucose (TyG) index and chronic kidney disease (CKD) was the aim of this investigation. METHODS Data from the National Health and Nutrition Examination Survey (NHANES) covering the years 1999-2020 were analyzed in this study. The TyG index was calculated as Ln (triglycerides (mg/dl) * fasting glucose (mg/dl)/2). The two criteria used to diagnose CKD were low estimated glomerular filtration rate (eGFR) (eGFR < 60 mL/min/1.73m2) or albuminuria (urine albumin-to-creatinine ratio (ACR) ≥ 30 mg/g). To look into the independent associations between TyG index levels with CKD, albuminuria, and low-eGFR, weighted multivariable logistic regression and generalized additive models were employed. To assess and contrast the diagnostic ability, receiver operating characteristic (ROC) curves were employed. RESULTS Out of 18,078 total participants recruited, 48.54% were male. 8.48 + 0.68 was the mean value of the TyG index. CKD, albuminuria, and low-eGFR were common, with respective prevalences of 17.06%, 11.26%, and 8.03%, respectively. The TyG index and CKD were observed to positively correlate (OR = 4.03; 95% CI 1.81, 8.96). In US adults between the ages of 41 and 60, a J-shaped connection was found between the two. Furthermore, a higher TyG index is associated with a higher prevalence of albuminuria (OR = 6.11; 95% CI 2.64, 14.14). Subgroup analyses and interaction tests revealed that different stratifications did not significantly affect the relationship between TyG index and CKD, albuminuria, and low-eGFR. Comparing the TyG index to other indicators [lipid accumulation product (LAP), Visceral adiposity index (VAI), and the triglyceride glucose-body mass index (TyG-BMI)], it may be more accurate and discriminative in predicting CKD and albuminuria. CONCLUSION When predicting CKD and albuminuria, the TyG index may be a more useful marker when compared to other markers (LAP, VAI, and TyG-BMI index). In addition, in American adults aged 41-60, the TyG index shows a J-shaped relationship with CKD. As a result, when assessing the kidney health of US adults, we must pay close attention to the significance of the TyG index.
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Affiliation(s)
- Xiaowan Li
- Department of Critical Care Medicine, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, China
| | - Lanyu Wang
- Department of Urology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, China
| | - Hongyi Zhou
- Department of Urology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, China
| | - Hongyang Xu
- Department of Critical Care Medicine, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, China.
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Yoshida D, Ikeda S, Shinohara K, Kazurayama M, Tanaka S, Yamaizumi M, Nagayoshi H, Toyama K, Kinugawa S. Triglyceride-Glucose Index Associated with Future Renal Function Decline in the General Population. J Gen Intern Med 2024:10.1007/s11606-024-08809-4. [PMID: 38782808 DOI: 10.1007/s11606-024-08809-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Accepted: 05/09/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND The triglyceride-glucose index (TyG index), calculated as the logarithmic product of fasting triglyceride and glucose concentrations, is recognized as a simple marker of insulin resistance. However, the association between the TyG index and future decline of renal function remains unclear in the general population. OBJECTIVE To investigate whether the TyG index was associated with future decline of renal function in the general population who had not progressed to chronic kidney disease stage G2. DESIGN Retrospective longitudinal observational cohort study. PARTICIPANTS Individuals who received a population-based health checkup at JA Ehime Kouseiren Checkup Center from 2010 to 2019 (n = 134,007). Individuals without data of baseline fasting triglyceride or glucose levels, or baseline and follow-up data of estimated glomerular filtration rate (eGFR), or those with baseline eGFR < 60 mL/min/1.73 m2 were excluded. MAIN MEASURES Future renal function decline, defined as a ≥ 25% decrease in eGFR from baseline. KEY RESULTS Of 10,758 participants, 8,076 were classified into the low TyG index group (TyG index < 8.76, 1st to 3rd quartiles) and 2,682 into the high TyG index group (TyG index ≥ 8.76, 4th quartile). The mean follow-up period was 37.8 ± 23.6 months. The incidence rates of renal function decline were 0.31 and 0.69 per 100 person-years in the low and high TyG index groups, respectively. In multivariate Cox proportional hazard models, high TyG index was significantly associated with future renal function decline (hazard ratio 2.25, 95% CI 1.40-3.60). This association was consistent across subgroups stratified by age, sex, body mass index, baseline eGFR, and diagnosed hypertension, diabetes, or dyslipidemia. CONCLUSION In the general population, high TyG index was associated with future renal function decline. The TyG index may be useful in identifying individuals at high risk for future renal function decline in the setting of health checkups.
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Affiliation(s)
- Daisuke Yoshida
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shota Ikeda
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
- Cardiovascular Center, Steel Memorial Yawata Hospital, Fukuoka, Japan
| | - Keisuke Shinohara
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan.
| | | | | | | | | | - Kensuke Toyama
- JA Ehime Kouseiren Checkup Center, Ehime, Japan
- Department of Pharmacology, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Shintaro Kinugawa
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
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Wei S, Wu T, You Y, Liu F, Hou Q, Mo C, Zhou L, Yang J. Correlation between the triglyceride-glucose index and chronic kidney disease among adults with metabolic-associated fatty liver disease: fourteen-year follow-up. Front Endocrinol (Lausanne) 2024; 15:1400448. [PMID: 38846493 PMCID: PMC11153799 DOI: 10.3389/fendo.2024.1400448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 05/08/2024] [Indexed: 06/09/2024] Open
Abstract
Background and aims According to previous studies, triglyceride-glucose (TyG) is related to chronic kidney disease (CKD), but no studies have explored the correlation between TyG and CKD among adults with metabolic dysfunction-associated fatty liver disease (MAFLD). We aimed to explore the associations of the TyG index with CKD among adults with MAFLD. Methods In this retrospective observational cohort study, data from 11,860 participants who underwent a minimum of three health assessments between 2008 and 2015 were retrospectively collected. Participants were followed up until the final medical visit or health examination. CKD refers to an eGFR < 60 mL/min per 1·73 m2 or the occurrence of two or more incidents of proteinuria. Results Within a median 10·02-year follow-up period, 2005 (16·9%) participants reported developing CKD. Multivariate Cox regression models indicated a noticeable correlation between the TyG index and CKD incidence (HR per unit increase, 1.19; 95% CI: 1.09-1.29) and between the TyG index and CKD incidence (HR per SD increase, 1.12; 95% CI: 1.06-1.18). The CKD incidence increased by 1.8 times in participants in the highest TyG index quartile relative to patients in the lowest quartile of the TyG index quartile (HR 1·18, 95% CI: 1.01-1.38, P = 0.007). According to subgroup analysis, an elevated TyG index is likely to become more harmful to participants younger than 60 years (P for interaction = 0.035). Conclusion An elevated TyG index may increase CKD incidence among MAFLD adults, particularly among younger people. Early intervention may help reduce the incidence of CKD.
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Affiliation(s)
- Suosu Wei
- Department of Scientific Cooperation of Guangxi Academy of Medical Sciences, People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Tengyan Wu
- Department of Health Service Management, School of Information and Management, Guangxi Medical University, Nanning, China
| | - Yanwu You
- Department of Nephrology, People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Fei Liu
- Scientific Research and Experimental Center, The People’s Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical Sciences, Nanning, China
| | - Qiyan Hou
- Graduate School of Guangxi University of Chinese Medicine, Nanning, China
| | - Chongde Mo
- Department of Colorectal and Anal Surgery, Guangxi Academy of Medical Sciences, People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Lei Zhou
- Guangxi Academy of Medical Sciences, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Jianrong Yang
- Department of Hepatobiliary, Pancreas and Spleen Surgery, Guangxi Academy of Medical Sciences, People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
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Li L, Xu Z, Jiang L, Zhuang L, Huang J, Liu D, Wu Q. Triglyceride-Glucose Index and Its Correlates: Associations with Serum Creatinine and Estimated Glomerular Filtration Rate in a Cross-Sectional Study from CHARLS 2011-2015. Metab Syndr Relat Disord 2024; 22:179-189. [PMID: 38133543 DOI: 10.1089/met.2023.0188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023] Open
Abstract
Background: Chronic kidney disease (CKD) has emerged as a significant global public health challenge, and the estimated glomerular filtration rate (eGFR) is widely used due to its convenience, low cost, and broad clinical applicability. Concurrently, insulin resistance (IR) serves as a crucial marker of metabolic disturbance, and alternative indicators have garnered increasing attention in CKD research in recent years. Objective: This study aims to investigate the relationship between IR-related indices (TyG index, TyG-BMI index, and TyG-WC index) and serum creatinine levels, as well as the eGFR, with the intention of uncovering their potential roles in the assessment of renal function. Methods: We analyzed nationally representative cross-sectional data from a cohort of individuals aged 45 and above in China, comprising 11,608 participants. Participants were categorized into different groups based on quartiles of the TyG index, and multiple factors, including gender, age, lifestyle, and co-morbidities, were adjusted for using linear regression models. Results: By linear regression, TyG, TyG-BMI, and TyG-WC indices were significantly positively correlated with serum creatinine and significantly negatively correlated with eGFR. Results showed similar trends when TyG, TyG-BMI, and TyG-WC indices were used as categorical variables. In the fully adjusted model, the highest quartile of serum creatinine was higher than the first quartile for TyG, TyG-BMI, and TyG-WC indices, with β values of 2.673, 3.67, and 1.937 mg/dL, respectively; the highest quartile of eGFR was lower than the first quartile, with β values of -2.4, -2.955, and -1.823 mL/min/1.73 m2. P values were statistically significant. Conclusions: This study indicates a consistent correlation between the TyG index and its related indices with serum creatinine levels and eGFR among the middle aged and elderly population in China. These findings suggest the potential utility of these indices in early screening and management of the risk of chronic kidney disease.
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Affiliation(s)
- Lei Li
- Department of Laboratory Medicine, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - Zichen Xu
- Department of Laboratory Medicine, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - Luqing Jiang
- Department of Laboratory Medicine, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - Lingdan Zhuang
- Department of Laboratory Medicine, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - Jianjun Huang
- Department of Laboratory Medicine, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - Daoqin Liu
- Department of Kidney Medicine, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - Qiwen Wu
- Department of Laboratory Medicine, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
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Weyman-Vela Y, Guerrero-Romero F, Simental-Mendía LE. The triglycerides and glucose index is more strongly associated with metabolically healthy obesity phenotype than the lipid and obesity indices. J Endocrinol Invest 2024; 47:865-871. [PMID: 37768526 DOI: 10.1007/s40618-023-02201-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023]
Abstract
PURPOSE The triglycerides and glucose (TyG) index is a reliable biomarker for estimating insulin resistance; however, evidence regarding the use of the TyG index in individuals with metabolically healthy obesity (MHO) is scarce. Thus, we examined the association between the TyG index and the MHO phenotype. METHODS Apparently healthy men and women aged 18 years or more with obesity (body mass index [BMI] ≥ 30 kg/m2) were allocated into the following groups: MHO and metabolically unhealthy obesity (MUO). The MHO phenotype was defined by obesity and the absence of the following metabolic disorders: elevated triglyceride concentrations, elevated glucose levels, elevated blood pressure, and low HDL-C. The MUO was defined by individuals with obesity and at least one of the aforementioned cardiovascular risk factors. RESULTS A total 827 individuals, 605 (73.1%) women and 222 (26.9%) men were enrolled and allocated into the MHO (n = 104) and MUO (n = 723) groups. The adjusted regression analysis by age, sex, BMI, and waist circumference showed that fasting glucose (OR = 0.90; 95% CI: 0.88-0.93), and triglycerides (OR = 0.97; 95% CI: 0.96-0.98), as well as the triglycerides/HDL-C (OR = 0.18; 95% CI: 0.13-0.26), lipid accumulation product (OR = 0.95; 95% CI: 0.93-0.96), visceral adipose index (OR = 0.38; 95% CI: 0.31-0.46), and TyG index (OR = 0.001; 95% CI: 0.000-0.004) are inversely associated with the MHO, while the HDL-C (OR = 1.10; 95% CI: 1.07-1.12) had a direct association. CONCLUSIONS Our results show that the TyG index is more strongly associated with the MHO phenotype than the lipid and obesity indices.
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Affiliation(s)
- Y Weyman-Vela
- Unidad de Investigación Biomédica, Instituto Mexicano del Seguro Social, Delegación Durango, Durango, México
| | - F Guerrero-Romero
- Unidad de Investigación Biomédica, Instituto Mexicano del Seguro Social, Delegación Durango, Durango, México
| | - L E Simental-Mendía
- Unidad de Investigación Biomédica, Instituto Mexicano del Seguro Social, Delegación Durango, Durango, México.
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Lv L, Xiong J, Huang Y, He T, Zhao J. Association between the Triglyceride Glucose Index and All-Cause Mortality in Critically Ill Patients with Acute Kidney Injury. KIDNEY DISEASES (BASEL, SWITZERLAND) 2024; 10:69-78. [PMID: 38322625 PMCID: PMC10843181 DOI: 10.1159/000535891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 12/15/2023] [Indexed: 02/08/2024]
Abstract
Introduction The triglyceride glucose (TyG) index is a reliable alternative biomarker of insulin resistance, but the association between the TyG index and acute kidney injury (AKI) in critically ill patients remains unclear. Methods The data for the study were extracted from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. Cox regression and restricted cubic spline (RCS) analysis were performed to analyze the association between the TyG index and all-cause mortality. Besides, Cox regression was carried out in subgroups of age, gender, BMI, diabetes history, and dialysis status. Results A total of 7,508 critically ill participants with AKI from the MIMIC-IV database were included in this study, with 3,688 (49.12%) participants failed to survive. In Cox regression, after confounder adjustment, patients with a higher TyG index had a higher risk of all-cause mortality (HR = 1.845, 95% CI = 1.49-2.285, p < 0.001). In RCS, after confounder adjustment, the risk of death was positively correlated with the increased value of the TyG index when TyG index surpassed 10.014. This relationship was validated in age, gender, BMI, diabetes subgroups but not in the dialysis subgroup. Interestingly, RCS analysis demonstrated that, in patients undertaking dialysis, there is a "U"-shaped curve for the value of TyG index and risk of all-cause mortality. When TyG index is less than 10.460, the risk of all-cause mortality would decrease with the increased value of TyG index, while when TyG index is higher than 11.180, the risk of all-cause mortality would increase firmly with the increased value of TyG index. Conclusion Overall, a higher TyG index is associated with a higher risk of all-cause mortality in critically ill AKI. Interestingly, the relationship in the dialysis subgroup follows a "U"-shaped curve, indicating the importance of proper clinical blood glucose and lipid management in this particular population.
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Affiliation(s)
- Liangjing Lv
- Department of Nephrology, the Key Laboratory for the Prevention and Treatment of Chronic Kidney Disease of Chongqing, Chongqing Clinical Research Center of Kidney and Urology Diseases, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Jiachuan Xiong
- Department of Nephrology, the Key Laboratory for the Prevention and Treatment of Chronic Kidney Disease of Chongqing, Chongqing Clinical Research Center of Kidney and Urology Diseases, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Yinghui Huang
- Department of Nephrology, the Key Laboratory for the Prevention and Treatment of Chronic Kidney Disease of Chongqing, Chongqing Clinical Research Center of Kidney and Urology Diseases, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Ting He
- Department of Nephrology, the Key Laboratory for the Prevention and Treatment of Chronic Kidney Disease of Chongqing, Chongqing Clinical Research Center of Kidney and Urology Diseases, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Jinghong Zhao
- Department of Nephrology, the Key Laboratory for the Prevention and Treatment of Chronic Kidney Disease of Chongqing, Chongqing Clinical Research Center of Kidney and Urology Diseases, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, China
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Jin Z, Xiao L, Xu X, Miao C, Liu Y. Association between triglyceride-glucose index and acute kidney injury in patients with acute myocardial infarction based on medical information mart for intensive care database: A cross-sectional study. J Med Biochem 2024; 43:153-161. [PMID: 38496026 PMCID: PMC10943466 DOI: 10.5937/jomb0-45219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 08/18/2023] [Indexed: 03/19/2024] Open
Abstract
Background The relationship between triglyceride glucose (TyG) index and the incidence of acute kidney injury (AKI) in patients with acute myocardial infarction (AMI) is unclear. This study aims to explore the relationship between the two. Methods Participants were enrolled from Medical Information Mart for Intensive Care IV (MIMICIV) and grouping of subjects based on the quartile interval of the TyG index. With the presence of AKI as the main outcome, a logistic regression model was constructed. The correlation of the TyG index with the results obtained was examined by using a restricted cubic spline (RCS) model.
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Affiliation(s)
- Zihan Jin
- Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Lu Xiao
- University of Traditional Chinese Medicine, First Teaching Hospital of Tianjin, Tianjin, China
| | - Xinyi Xu
- University of Traditional Chinese Medicine, First Teaching Hospital of Tianjin, Tianjin, China
| | - Changhong Miao
- University of Traditional Chinese Medicine, First Teaching Hospital of Tianjin, Tianjin, China
| | - Yi Liu
- University of Traditional Chinese Medicine, First Teaching Hospital of Tianjin, Tianjin, China
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Chen N, Ma LL, Zhang Y, Chu X, Dong J, Yan YX. Association of long-term triglyceride-glucose index patterns with the incidence of chronic kidney disease among non-diabetic population: evidence from a functional community cohort. Cardiovasc Diabetol 2024; 23:7. [PMID: 38172903 PMCID: PMC10765660 DOI: 10.1186/s12933-023-02098-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 12/17/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND The triglyceride-glucose (TyG) index is a reliable surrogate marker of insulin resistance and previous studies have confirmed the association of TyG index with incident chronic kidney disease (CKD). However, the impact of longitudinal patterns of TyG index on CKD risk among non-diabetic population is still unknown. Therefore, this study aimed to investigate the association of longitudinal patterns of TyG index with incident CKD among non-diabetic population. METHODS A total of 5484 non-diabetic participants who underwent one health examination per year from 2015 to 2017 were included in this prospective study. TyG index variability and cumulative TyG index were calculated to assess the longitudinal patterns of TyG index. Cox proportional hazard models were performed to estimate the association of TyG index variability or cumulative TyG index with incident CKD. RESULTS During a median of 3.82 years follow-up, 879 participants developed CKD. Compared with participants in the lowest quartile, the hazard ratio (HR) and 95% confidence interval (CI) of incident CKD were 1.772 (95% CI: 1.453, 2.162) for the highest TyG index variability quartile and 2.091 (95% CI: 1.646, 2.655) for the highest cumulative TyG index quartile in the fully adjusted models. The best discrimination and reclassification improvement were observed after adding baseline TyG, TyG index variability and cumulative TyG index to the clinical risk model for CKD. CONCLUSIONS Both TyG index variability and cumulative TyG index can independently predict incident CKD among non-diabetic population. Monitoring longitudinal patterns of TyG index may assist with prediction and prevention of incident CKD.
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Affiliation(s)
- Ning Chen
- Department of Epidemiology and Biostatistics, Municipal Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Lin-Lin Ma
- Department of Epidemiology and Biostatistics, Municipal Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Yu Zhang
- Department of Epidemiology and Biostatistics, Municipal Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Xi Chu
- Health Management Center, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Jing Dong
- Health Management Center, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Yu-Xiang Yan
- Department of Epidemiology and Biostatistics, Municipal Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China.
- School of Public Health, Capital Medical University, No.10 Xitoutiao, You'anmenWai, Fengtai District, Beijing, 100069, China.
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Jin Z, Zhang K. Association between triglyceride-glucose index and AKI in ICU patients based on MIMICIV database: a cross-sectional study. Ren Fail 2023; 45:2238830. [PMID: 37563796 PMCID: PMC10424620 DOI: 10.1080/0886022x.2023.2238830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 06/30/2023] [Accepted: 07/15/2023] [Indexed: 08/12/2023] Open
Abstract
BACKGROUND Methods for early prediction of the occurrence of acute kidney injury (AKI) were limited. The relationship between triglyceride glucose index (TyG) and the incidence of acute kidney injury in ICU patients is unclear. This study aims to explore the relationship between the two. METHODS Based on their TyG index, participants from the Intensive Care Medical Information Market IV (MIMIC-IV) were divided into quartiles. A logistic regression model was constructed based on the risk of acute kidney injury as the main outcome, in order to detect a potential relationship that may exist between the TyG index and acute kidney injury in ICU patients. Finally, in order to confirm the relationship existing between the TyG index and the results, a restricted cubic spline model was used. RESULTS In total, 54,263 patients were involved in our present study, of whom 48.2% were male. The occurrence of acute kidney injury was 25.1%. An independent relationship was observed between the TyG index and an increased risk of acute kidney injury through multivariate logistic regression analysis (OR, 1.28 [95% CI 1.22-1.35] p < 0.001). Q4 (5.344-9.911) of the TyG index quartiles was independently associated with an increase in the risk of acute kidney injury (OR, 1.43 [95% CI (1.32-1.54)] p < 0.001). Through the restricted cubic spline regression model, the risk of acute kidney injury was also demonstrated to increase linearly with an increase in the TyG index. CONCLUSION The triglyceride glucose index is related to the risk of acute kidney injury in ICU patients. In the future, in order to further validate this finding, larger prospective studies are needed.
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Affiliation(s)
- Zihan Jin
- Tianjin University of Traditional Chinese Medicine, Tianjin, P.R. China
| | - Kai Zhang
- The Second Hospital of Jilin University, Changchun, P.R. China
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Yang Z, Gong H, Kan F, Ji N. Association between the triglyceride glucose (TyG) index and the risk of acute kidney injury in critically ill patients with heart failure: analysis of the MIMIC-IV database. Cardiovasc Diabetol 2023; 22:232. [PMID: 37653418 PMCID: PMC10472684 DOI: 10.1186/s12933-023-01971-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 08/19/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND Insulin resistance (IR) can be effectively assessed using the dependable surrogate biomarker triglyceride-glucose (TyG) index. In various critical care contexts, like contrast-induced acute kidney injury (AKI), an elevated TyG index has demonstrated a robust correlation with the incidence of AKI. Nonetheless, the potential of the TyG index to predict AKI in critically ill patients with heart failure (HF) remains uncertain. METHODS A cohort of participants was non-consecutively selected from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database and divided into quartiles based on their TyG index values. The incidence of AKI was the primary outcome. The secondary endpoint was in-hospital mortality within both the whole study population and the subset of AKI patients. The use of the renal replacement therapy (RRT) which represented the progression of AKI severity was also included as a secondary endpoint representing renal outcome. A restricted cubic splines model and Cox proportional hazards models were utilized to evaluate the association of TyG index with the risk of AKI in patients with HF in a critical condition. Kaplan-Meier survival analysis was employed to estimate primary and secondary endpoint disparities across groups differentiated by their TyG index. RESULTS This study included a total of 1,393 patients, with 59% being male. The incidence of AKI was 82.8%. Cox proportional hazards analyses revealed a significant association between TyG index and the incidence of AKI in critically ill patients with HF. The restricted cubic splines model illustrated the linear relationship between higher TyG index and increased risk of AKI in this specific patient population. Furthermore, the Kaplan-Meier survival analyses unveiled statistically significant differences in the use of RRT across the subset of AKI patients based on the quartiles of the TyG index. CONCLUSIONS The results highlight the TyG index as a robust and independent predictor of the incidence of AKI and poor renal outcome in patients with HF in a critical condition. However, further confirmation of causality necessitates larger prospective studies.
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Affiliation(s)
- Zewen Yang
- Department of Cardiology, Yiwu Central Hospital, 699 Jiangdong Road, Yiwu, 322000, Zhejiang, China
| | - Hongxia Gong
- Department of Cardiology, Yiwu Central Hospital, 699 Jiangdong Road, Yiwu, 322000, Zhejiang, China
| | - Fuqiang Kan
- Department of Cardiology, Yiwu Central Hospital, 699 Jiangdong Road, Yiwu, 322000, Zhejiang, China
| | - Ningning Ji
- Department of Cardiology, Yiwu Central Hospital, 699 Jiangdong Road, Yiwu, 322000, Zhejiang, China.
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Cheng L, Zhang F, Xue W, Yu P, Wang X, Wang H, Wang J, Hu T, Gong H, Lin L. Association of dynamic change of triglyceride-glucose index during hospital stay with all-cause mortality in critically ill patients: a retrospective cohort study from MIMIC IV2.0. Cardiovasc Diabetol 2023; 22:142. [PMID: 37330498 PMCID: PMC10276426 DOI: 10.1186/s12933-023-01874-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 06/02/2023] [Indexed: 06/19/2023] Open
Abstract
BACKGROUND Biomarker of insulin resistance, namely triglyceride-glucose index, is potentially useful in identifying critically ill patients at high risk of hospital death. However, the TyG index might have variations over time during ICU stay. Hence, the purpose of the current research was to verify the associations between the dynamic change of the TyG index during the hospital stay and all-cause mortality. METHODS The present retrospective cohort study was conducted using the Medical Information Mart for Intensive Care IV 2.0 (MIMIC-IV) critical care dataset, which included data from 8835 patients with 13,674 TyG measurements. The primary endpoint was 1-year all-cause mortality. Secondary outcomes included in-hospital all-cause mortality, the need for mechanical ventilation during hospitalization, length of stay in the hospital. Cumulative curves were calculated using the Kaplan-Meier method. Propensity score matching was performed to reduce any potential baseline bias. Restricted cubic spline analysis was also employed to assess any potential non-linear associations. Cox proportional hazards analyses were performed to examine the association between the dynamic change of TyG index and mortality. RESULTS The follow-up period identified a total of 3010 all-cause deaths (35.87%), of which 2477 (29.52%) occurred within the first year. The cumulative incidence of all-cause death increased with a higher quartile of the TyGVR, while there were no differences in the TyG index. Restricted cubic spline analysis revealed a nearly linear association between TyGVR and the risk of in-hospital all-cause mortality (P for non-linear = 0.449, P for overall = 0.004) as well as 1-year all-cause mortality (P for non-linear = 0.909, P for overall = 0.019). The area under the curve of all-cause mortality by various conventional severity of illness scores significantly improved with the addition of the TyG index and TyGVR. The results were basically consistent in subgroup analysis. CONCLUSIONS Dynamic change of TyG during hospital stay is associated with in-hospital and 1-year all-cause mortality, and may be superior to the effect of baseline TyG index.
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Affiliation(s)
- Long Cheng
- Department of Cardiology, Jinshan Hospital of Fudan University, Shanghai, China
| | - Feng Zhang
- Department of Cardiology, Jinshan Hospital of Fudan University, Shanghai, China
| | - Wenjing Xue
- Department of Cardiology, Jinshan Hospital of Fudan University, Shanghai, China
| | - Peng Yu
- Department of Urology, Shanghai Punan Hospital of Pudong New District, Punan Branch of Renji Hospital, No. 279 Linyi Road, Shanghai, 200000, China
| | - Xiaoyan Wang
- Institute of Cardiovascular Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Hairong Wang
- Department of Cardiovascular Medicine, Shanghai Pudong New Area Gongli Hospital, Shanghai, 200000, People's Republic of China
| | - Jun Wang
- Department of Neurology, First People's Hospital of Yancheng, Yulong Western Road, Yancheng, 224006, Jiangsu, China
| | - Tianyang Hu
- Precision Medicine Center, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Hui Gong
- Department of Cardiology, Jinshan Hospital of Fudan University, Shanghai, China
| | - Li Lin
- Department of Cardiovascular Medicine,, Shanghai East Hospital, Tongji University School of Medicine, Jimo Road 150, Shanghai, 200120, China.
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