School of Medicine, Southeast University, Nanjing, China.
Department of Cardiology, Zhongda Hospital, Southeast University, Nanjing, China.
Front Endocrinol (Lausanne). 2022 Feb 22;13:817176. doi: 10.3389/fendo.2022.817176. eCollection 2022.
Triglyceride-glucose (TyG) index is a reliable and specific biomarker for insulin resistance and is associated with renal dysfunction. The present study sought to explore the relationship between TyG index and the incidence of contrast-induced nephropathy (CIN) in non-ST elevation acute coronary syndrome (NSTE-ACS) patients implanted with drug-eluting stents (DESs).
A total of 1108 participants were recruited to the study and assigned to two groups based on occurrence of CIN. TyG index was calculated as ln [fasting triglycerides (mg/dL) × fasting blood glucose (mg/dL)/2]. Baseline characteristics and incidence of CIN were compared between the two groups. Logistic regression analysis was performed to evaluate the relationship between TyG index and CIN.
The results showed that 167 participants (15.1%) developed CIN. Subjects in the CIN group had a significantly higher TyG index compared with subjects in the non-CIN group (8.9 ± 0.7 vs. 9.3 ± 0.7, P<0.001). TyG index was significantly correlated with increased risk of CIN after adjusting for confounding factors irrespective of diabetes mellitus status and exhibited a J-shaped non-linear association. Subgroup analysis showed a significant gender difference in the relationship between TyG index and CIN. Receiver operating characteristic (ROC) curve analysis indicated that the risk assessment performance of TyG index was superior compared with other single metabolic indexes. Addition of TyG index to the baseline model increased the area under the curve from 0.713 (0.672-0.754) to 0.742 (0.702-0.782) and caused a reclassification improvement of 0.120 (0.092-0.149).
The findings from the present study show that a high TyG index is significantly and independently associated with incidence of CIN in NSTE-ACS patients firstly implanted with DESs. Routine preoperative assessment of TyG index can alleviate CIN and TyG index provides a potential target for intervention in prevention of CIN.
甘油三酯-葡萄糖（TyG）指数是胰岛素抵抗的可靠且特异的生物标志物，与肾功能障碍相关。本研究旨在探讨 TyG 指数与非 ST 段抬高型急性冠状动脉综合征（NSTE-ACS）患者植入药物洗脱支架（DES）后对比剂诱导肾病（CIN）发生率之间的关系。
共纳入 1108 名研究对象，并根据 CIN 的发生情况将其分为两组。TyG 指数的计算方法为 ln[空腹甘油三酯（mg/dL）×空腹血糖（mg/dL）/2]。比较两组间的基线特征和 CIN 的发生率。采用 logistic 回归分析评估 TyG 指数与 CIN 的关系。
结果显示，167 名（15.1%）参与者发生了 CIN。CIN 组的 TyG 指数明显高于非 CIN 组（8.9±0.7 比 9.3±0.7，P<0.001）。调整混杂因素后，TyG 指数与 CIN 风险呈显著正相关，且呈 J 形非线性关系。亚组分析显示，TyG 指数与 CIN 之间的关系存在显著的性别差异。受试者工作特征（ROC）曲线分析表明，TyG 指数的风险评估性能优于其他单一代谢指标。将 TyG 指数加入基础模型后，曲线下面积从 0.713（0.672-0.754）增加至 0.742（0.702-0.782），重新分类改善 0.120（0.092-0.149）。
本研究首次表明，高 TyG 指数与 NSTE-ACS 患者首次植入 DES 后 CIN 的发生率显著且独立相关。术前常规评估 TyG 指数可减轻 CIN，TyG 指数为预防 CIN 提供了潜在的干预靶点。
