Endocrinology and Metabolism Research Center (EMRC), School of Medicine, Vali-Asr Hospital, P.O.Box 13145784, Tehran, Iran.
Eur J Med Res. 2023 May 10;28(1):166. doi: 10.1186/s40001-023-01134-2.
Diabetes is the leading cause of kidney disease. Up to 40% of the population with diabetes experience diabetic kidney disease (DKD). The correlation of DKD with insulin resistance (IR) indices has been shown in previous studies. In this study, the objective was to evaluate surrogate IR indices, including the Triglyceride-Glucose (TyG) index, Visceral Adiposity Index (VAI), Lipid Accumulation Product (LAP), and Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) to find the most valuable index for the correlation between albuminuria and IR in the type 2 diabetes (T2D) population. Albuminuria is defined as urine albumin excretion of > 30 mg/day.
In this cross-sectional study, 2934 participants were enrolled and evaluated for urinary albumin excretion, and albuminuria was detected in 526 of the entries. The logistic regression models and Receiver Operating Characteristic (ROC) curve analysis were performed to assess the relationship of TyG index, VAI, LAP, and HOMA-IR's with albuminuria in patients with T2D.
The TyG index had the highest association (OR 1.67) with the presence of albuminuria in patients with T2D, followed by HOMA-IR (OR 1.127), VAI (OR 1.028), and LAP (OR 1.004). These four indices remained independent after adjustment for multiple confounders. Based on the ROC curve, TyG revealed the best area under the curve (AUC) for revealing albuminuria with sufficient accuracy (AUC: 0.62) in comparison with other measured indices. The calculated TyG index cut-off point for the presence of albuminuria was 9.39.
Among the indices, TyG index had the most significant correlation with albuminuria in patients with T2D.
糖尿病是导致肾病的主要原因。多达 40%的糖尿病患者患有糖尿病肾病（DKD）。先前的研究表明，DKD 与胰岛素抵抗（IR）指数相关。在这项研究中，目的是评估替代 IR 指数，包括甘油三酯-葡萄糖（TyG）指数、内脏脂肪指数（VAI）、脂积分数（LAP）和胰岛素抵抗的稳态模型评估（HOMA-IR），以找到最有价值的指数，用于评估 2 型糖尿病（T2D）人群中蛋白尿与 IR 之间的相关性。蛋白尿定义为尿白蛋白排泄量>30mg/天。
在这项横断面研究中，共纳入 2934 名参与者并评估其尿白蛋白排泄量，其中 526 名参与者的检测结果显示蛋白尿。采用逻辑回归模型和受试者工作特征（ROC）曲线分析评估 TyG 指数、VAI、LAP 和 HOMA-IR 与 T2D 患者蛋白尿的关系。
TyG 指数与 T2D 患者蛋白尿的发生具有最高的相关性（OR 1.67），其次是 HOMA-IR（OR 1.127）、VAI（OR 1.028）和 LAP（OR 1.004）。在调整了多个混杂因素后，这四个指数仍然是独立的。根据 ROC 曲线，TyG 指数在揭示白蛋白尿方面具有最佳的曲线下面积（AUC），具有足够的准确性（AUC：0.62），优于其他测量指数。计算出的 TyG 指数截断值为 9.39，用于判断是否存在蛋白尿。
在这些指数中，TyG 指数与 T2D 患者的蛋白尿相关性最强。
