甘油三酯-葡萄糖指数与成人隐匿性自身免疫性糖尿病患者慢性肾脏病的相关性。
Association between a high triglyceride-glucose index and chronic kidney disease in adult patients with latent autoimmune diabetes.
机构信息
Department of Endocrinology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, No. 26 of Shengli Street, Jiangan District, Wuhan, 430061, China.
出版信息
BMC Endocr Disord. 2023 Sep 28;23(1):209. doi: 10.1186/s12902-023-01465-5.
BACKGROUND
Insulin resistance (IR) is one of the risk factors for chronic kidney disease (CKD) and diabetes. The triglyceride-glucose (TyG) index is considered a reliable alternative marker of IR. We investigated the correlation between the TyG index and the severity of CKD in patients with latent autoimmune diabetes in adults (LADA).
METHODS
This cross-sectional study included 288 patients with LADA in the department of endocrinology at our hospital between January 2018 and January 2022. The TyG index was calculated as Ln [TG (mg/dl) × fasting blood glucose (FBG) (mg/dl) / 2]. All individuals were divided into either a LADA + CKD group or a LADA + non-CKD group according to the presence or absence of CKD. A correlation analysis, logistic regression analysis and receiver operating characteristics curve analysis were performed.
RESULTS
A total of 130 (45.1%) participants were identified as having CKD. Compared with the non-CKD group, the CKD group had a longer disease duration and a higher proportion of smokers; patients were more likely to have hypertension and higher serum creatinine, triglyceride, cholesterol, low-density lipoprotein cholesterol, FBG, uric acid estimated glomerular filtration rates (eGFR) and TyG levels as well as lower high-density lipoprotein cholesterol levels (all P < 0.05). The positive relationship between the TyG index and the urinary albumin/creatinine ratio was significant (r = 0.249, P = 0.010). There was also a significant correlation between the TyG index and the eGFR (r = - 0.211, P = 0.034) after adjusting for confounding factors. The area-under-the-curve value of the TyG index was 0.708 (95% confidence interval: 0.61-0.81, P < 0.001).
CONCLUSIONS
The TyG index is significantly associated with the severity of CKD in patients with LADA. This conclusion supports the clinical application of the TyG index for the assessment of kidney disease in patients with LADA.
背景
胰岛素抵抗（IR）是慢性肾脏病（CKD）和糖尿病的危险因素之一。三酰甘油-葡萄糖（TyG）指数被认为是 IR 的可靠替代标志物。我们研究了 TyG 指数与成人隐匿性自身免疫性糖尿病（LADA）患者 CKD 严重程度之间的相关性。
方法
本横断面研究纳入了 2018 年 1 月至 2022 年 1 月我院内分泌科的 288 例 LADA 患者。TyG 指数计算方法为 Ln[三酰甘油（mg/dl）×空腹血糖（FBG）（mg/dl）/2]。所有患者根据是否存在 CKD 分为 LADA+CKD 组和 LADA+非 CKD 组。进行相关性分析、Logistic 回归分析和受试者工作特征曲线分析。
结果
共 130 例（45.1%）患者被诊断为 CKD。与非 CKD 组相比，CKD 组的病程更长，吸烟比例更高；高血压、血清肌酐、三酰甘油、胆固醇、低密度脂蛋白胆固醇、FBG、尿酸估算肾小球滤过率（eGFR）和 TyG 水平更高，而高密度脂蛋白胆固醇水平更低（均 P<0.05）。TyG 指数与尿白蛋白/肌酐比值呈正相关（r=0.249，P=0.010）。在校正混杂因素后，TyG 指数与 eGFR 也呈显著负相关（r=-0.211，P=0.034）。TyG 指数的曲线下面积为 0.708（95%置信区间：0.61-0.81，P<0.001）。
结论
TyG 指数与 LADA 患者 CKD 的严重程度显著相关。这一结论支持 TyG 指数在评估 LADA 患者肾脏疾病中的临床应用。
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