Department of Cardiology, Medical School of Southeast University, Nanjing, China.
Department of Cardiology, Zhongda Hospital affiliated with Southeast University, Nanjing, China.
Front Endocrinol (Lausanne). 2021 Jan 22;11:522883. doi: 10.3389/fendo.2020.522883. eCollection 2020.
Triglyceride-glucose (TyG) is an emerging vital indicator of insulin resistance and is associated with increased risk of T2DM and cardiovascular events. We aimed to explore the TyG index and contrast-induced acute kidney injury (CI-AKI) in patients with type 2 diabetes who underwent coronary angiology.
This study enrolled 928 patients with suspected coronary artery disease who underwent coronary angiology or percutaneous coronary intervention in Zhongda hospital. Patient data were divided into quartiles according to the TyG index: group 1: TyG ≤ 8.62; group 2: 8.62<TyG ≤ 9.04; group 3: 9.04<TyG ≤ 9.45; and group 4: TyG>9.45. CI-AKI was diagnosed according to the KIDIGO criteria. Demographic data, hematological parameters, coronary angiology data, and medications were all recorded. We calculated the TyG index using the following formula: ln [fasting TG (mg/dL)×FPG (mg/dL)/2].
Patients who developed CI-AKI exhibited significantly higher TyG index levels compared to patients who did not develop CI-AKI. The incidence of CI-AKI sharply increased with increasing TyG. Univariate and multivariate analysis identified TyG as an independent risk factor for CI-AKI. The AUC of the ROC curve was as high as 0.728 when the value of TyG was 8.88. The corresponding sensitivity was as high as 94.9%. Adding the variable TyG to the model for predicting CI-AKI risk further increased the predictive value of the model from 80.4% to 82%.
High TyG is closely associated with increased incidence of CI-AKI, demonstrating that TyG is an independent risk factor for CI-AKI. TyG has potentially predictive value for CI-AKI and may play a crucial role in risk stratification in clinical practice.
甘油三酯-葡萄糖(TyG)是一种新出现的胰岛素抵抗的重要指标,与 2 型糖尿病(T2DM)和心血管事件风险增加相关。我们旨在探讨 TyG 指数与接受冠状动脉血管造影的 2 型糖尿病患者对比剂诱导的急性肾损伤(CI-AKI)之间的关系。
本研究纳入了在中大医院接受冠状动脉血管造影或经皮冠状动脉介入治疗的 928 例疑似冠心病患者。根据 TyG 指数将患者数据分为四组:第 1 组:TyG≤8.62;第 2 组:8.62< TyG≤9.04;第 3 组:9.04< TyG≤9.45;第 4 组:TyG>9.45。根据 KIDIGO 标准诊断 CI-AKI。记录人口统计学数据、血液学参数、冠状动脉血管造影数据和药物治疗情况。我们使用以下公式计算 TyG 指数:ln[空腹 TG(mg/dL)×FPG(mg/dL)/2]。
发生 CI-AKI 的患者的 TyG 指数明显高于未发生 CI-AKI 的患者。随着 TyG 的增加,CI-AKI 的发生率急剧增加。单因素和多因素分析均表明 TyG 是 CI-AKI 的独立危险因素。TyG 值为 8.88 时,ROC 曲线的 AUC 高达 0.728。相应的敏感性高达 94.9%。将 TyG 变量添加到预测 CI-AKI 风险的模型中,进一步提高了模型的预测价值,从 80.4%提高到 82%。
高 TyG 与 CI-AKI 发生率增加密切相关,表明 TyG 是 CI-AKI 的独立危险因素。TyG 对 CI-AKI 具有潜在的预测价值,可能在临床实践中对风险分层具有重要作用。