Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, China.
Beijing Friendship Hospital, Capital Medical University, Beijing, 100053, China.
Lipids Health Dis. 2023 Nov 11;22(1):193. doi: 10.1186/s12944-023-01958-1.
The association between triglyceride-glucose (TyG) index and poor prognosis remains controversial. Whether renal function status affects the ability of the TyG index to predict poor prognosis has not yet been elucidated and merits further studies.
This retrospective cohort study included 22,031 participants from communities in the U.S. By juxtaposing the TyG categories with the estimated glomerular filtration rate (eGFR, either < 60 mL/min/1.73m or ≥ 60 mL/min/1.73m), participants were categorized into four distinct groups: (1) TyG_L/eGFR_H; (2) TyG_H/eGFR_H; (3) TyG_L/eGFR_L; and (4) TyG_H/eGFR_L. The endpoint was the all-cause mortality rate. Standard Kaplan-Meier plots were constructed and multifactor Cox regression analyses were carried out and restricted cubic spline regression analysis was utilized to assess the association between death and the TyG index for different renal function statuses.
No statistical differences were found in the TyG groups in participants with normal renal function after adjustment for all covariates (P = 0.070). However, in the high TyG index group with renal insufficiency, the risk of all-cause mortality rates was reduced by 18%. (HR, 0.82; CI, 0.69-0.98). The TyG index (high vs. low) and renal function (eGFR < 60 vs. eGFR ≥ 60) had statistically significant interactions with death (P < 0.001). When all covariates were adjusted, the risk of mortality for the TyG_L combined with eGFR_L group was 56% higher than that for the TyG_L combined with eGFR_H group (HR, 1.56; CI, 1.33-1.82). In the renal insufficiency population, a nonlinear relationship was observed between mortality and the TyG index, albeit with a differing pattern (P for nonlinearity < 0.001).
While it has been known that TyG index was a prognosis marker of CVD, this research highlights that higher TyG index was associated with higher all-cause mortality rates for all participants. Furthermore, renal function status significantly moderates the effect of the TyG index on all-cause mortality in community-dwelling adults.
甘油三酯-葡萄糖（TyG）指数与预后不良之间的关联仍存在争议。肾功能状况是否影响 TyG 指数预测不良预后尚未阐明，值得进一步研究。
本回顾性队列研究纳入了来自美国社区的 22031 名参与者。通过将 TyG 类别与估算肾小球滤过率（eGFR，<60ml/min/1.73m 或≥60ml/min/1.73m）进行对比，将参与者分为四个不同的组别：（1）TyG_L/eGFR_H；（2）TyG_H/eGFR_H；（3）TyG_L/eGFR_L；和（4）TyG_H/eGFR_L。终点是全因死亡率。绘制标准 Kaplan-Meier 图，并进行多因素 Cox 回归分析，同时利用限制立方样条回归分析评估不同肾功能状态下死亡与 TyG 指数之间的关联。
在调整所有协变量后，肾功能正常的参与者在 TyG 组之间没有统计学差异（P=0.070）。然而，在肾功能不全的高 TyG 指数组中，全因死亡率的风险降低了 18%（HR，0.82；95%CI，0.69-0.98）。TyG 指数（高 vs. 低）和肾功能（eGFR<60 vs. eGFR≥60）与死亡具有统计学显著的交互作用（P<0.001）。当调整所有协变量后，TyG_L 合并 eGFR_L 组的死亡风险比 TyG_L 合并 eGFR_H 组高 56%（HR，1.56；95%CI，1.33-1.82）。在肾功能不全人群中，虽然存在非线性关系（P<0.001），但死亡率与 TyG 指数之间的关系模式不同。
虽然已知 TyG 指数是 CVD 预后标志物，但本研究强调，对于所有参与者，较高的 TyG 指数与更高的全因死亡率相关。此外，肾功能状况显著调节 TyG 指数对社区居住成年人全因死亡率的影响。
