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用三酰甘油-葡萄糖指数估算肾小球滤过率:来自一般中国人群的见解。

Estimate of reduced glomerular filtration rate by triglyceride-glucose index: insights from a general Chinese population.

机构信息

a Department of Cardiology , The First Affiliated Hospital of China Medical University , Shenyang , Liaoning , People's Republic of China.

b Department of Cardiovascular Ultrasound , The First Affiliated Hospital of China Medical University , Shenyang , Liaoning , People's Republic of China.

出版信息

Postgrad Med. 2019 May;131(4):287-294. doi: 10.1080/00325481.2019.1595983. Epub 2019 Mar 28.

Abstract

: Recent studies have identified triglyceride-glucose index (TyG) as a surrogate of insulin resistance. Since insulin resistance correlates with renal damage, our study aims to investigate the impact of TyG on the risk of reduced eGFR and explore its value to improve the risk stratification and prevention of reduced eGFR. : This cross-sectional study included 6466 participants (mean age:59.57 years, 60.2% females) from rural areas of northeast China between September 2017 to May 2018. TyG was calculated as ln[fasting triglyceride (mg/dL)×fasting plasma glucose (mg/dL)/2]. Reduced eGFR was defined as eGFR<60ml/min per 1.73m. : The prevalence of reduced eGFR was 2.94%. After full adjustment, each SD increase of TyG caused 42.6% additional risk for reduced eGFR. When dividing TyG into quartiles, the top quartile had a 1.934 times risk than the bottom quartile. Furthermore, the risk of reduced eGFR increased linearly with the increment of TyG. Subgroup analysis also revealed the association was robust to several risk factors of renal damage. Finally, category-free net reclassification index (0.204, 95% CI: 0.060-0.349, p = 0.005) and integrated discrimination index (0.010, 95% CI: 0.005-0.016, p < 0.001) demonstrated the value of TyG to refine the risk stratification of reduced eGFR. : Our work reveals the robust association between TyG and reduced eGFR. Moreover, the present study implicates the potential role of TyG as a risk indicator to optimize the prevention of reduced eGFR. Lastly, the findings also suggest the importance of simultaneous glycemic and lipid control to avoid the development and progression of reduced eGFR.

摘要

: 最近的研究已经确定甘油三酯-葡萄糖指数(TyG)是胰岛素抵抗的替代指标。由于胰岛素抵抗与肾损伤相关,我们的研究旨在探讨 TyG 对 eGFR 降低风险的影响,并探讨其在改善风险分层和预防 eGFR 降低方面的价值。: 这项横断面研究纳入了 2017 年 9 月至 2018 年 5 月期间来自中国东北地区农村地区的 6466 名参与者(平均年龄:59.57 岁,60.2%为女性)。TyG 通过计算 ln[空腹甘油三酯(mg/dL)×空腹血糖(mg/dL)/2]得出。eGFR<60ml/min/1.73m 定义为 eGFR 降低。: eGFR 降低的患病率为 2.94%。经过充分调整后,TyG 每增加 1 个标准差,eGFR 降低的风险增加 42.6%。当将 TyG 分为四等分时,最高四分位组的风险是最低四分位组的 1.934 倍。此外,eGFR 降低的风险与 TyG 的增加呈线性相关。亚组分析还表明,这种关联对肾损伤的几个危险因素具有稳健性。最后,类别自由净重新分类指数(0.204,95%CI:0.060-0.349,p=0.005)和综合判别指数(0.010,95%CI:0.005-0.016,p<0.001)表明 TyG 对细化 eGFR 降低风险分层具有价值。: 我们的研究揭示了 TyG 与 eGFR 降低之间的稳健关联。此外,本研究表明 TyG 作为风险指标具有潜在作用,可以优化 eGFR 降低的预防。最后,研究结果还表明同时控制血糖和血脂对于避免 eGFR 降低的发生和进展非常重要。

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