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甘油三酯-葡萄糖指数变化与中国高血压人群的慢性肾脏病进展。

Triglyceride-glucose index change and chronic kidney disease progression in a Chinese hypertensive population.

机构信息

Department of Cardiovascular Medicine, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China.

Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China.

出版信息

Front Endocrinol (Lausanne). 2024 Feb 9;15:1342408. doi: 10.3389/fendo.2024.1342408. eCollection 2024.

Abstract

BACKGROUND

The impact of triglyceride-glucose (TyG) index variations on chronic kidney disease (CKD) progression remains unexplored. To investigate the effects of the TyG index and its dynamic changes on CKD progression.

METHOD

This prospective cohort study included data from 8,418 hypertensive participants. The exposure variable in this study was defined as the difference between the TyG index at the last visit from that at baseline. The study's outcome variable was the progression of CKD, defined as follows: for subjects with an estimated glomerular filtration rate (eGFR) ≥60 mL/min, a ≥30% decrease in eGFR with a final follow-up value <60 mL/min; for those with an eGFR <60 mL/min, a ≥50% decrease in eGFR; or terminal renal failure requiring dialysis.

RESULTS

During a median follow-up period of 48 months, 1077 patients were diagnosed with CKD progression. In the fully adjusted Model 3, patients with a change in the TyG index <0 exhibited a significantly decreased 13% risk of CKD progression (HR: 0.87, 95% CI: 0.76-0.98) compared to those with a change in the TyG index≥0 group. Subgroup analyses showed that changes in the TyG index significantly increased the risk of CKD progression only in patients with diastolic blood pressure (DBP) <90mmHg. In the path analysis, baseline TyG was associated with follow-up eGFR (the standard regression coefficient was 1.26 [95% CI, 0.45-2.06]).

CONCLUSIONS

Our findings suggest that TyG variability may serve as a useful tool for identifying individuals at risk of CKD progression, particularly hypertensive patients with normal DBP levels.

摘要

背景

甘油三酯-葡萄糖(TyG)指数变化对慢性肾脏病(CKD)进展的影响仍不清楚。本研究旨在探讨 TyG 指数及其动态变化对 CKD 进展的影响。

方法

本前瞻性队列研究纳入了 8418 例高血压患者的数据。本研究的暴露变量定义为最后一次就诊时的 TyG 指数与基线时的差异。研究的结局变量为 CKD 的进展,定义如下:对于肾小球滤过率(eGFR)≥60mL/min 的患者,eGFR 下降≥30%,最终随访值<60mL/min;对于 eGFR<60mL/min 的患者,eGFR 下降≥50%;或终末期肾衰竭需要透析。

结果

在中位随访 48 个月期间,1077 例患者被诊断为 CKD 进展。在完全调整的模型 3 中,与 TyG 指数变化≥0 的患者相比,TyG 指数变化<0 的患者发生 CKD 进展的风险显著降低 13%(HR:0.87,95%CI:0.76-0.98)。亚组分析显示,TyG 指数的变化仅在舒张压(DBP)<90mmHg 的患者中显著增加 CKD 进展的风险。在路径分析中,基线 TyG 与随访 eGFR 相关(标准回归系数为 1.26[95%CI:0.45-2.06])。

结论

我们的研究结果表明,TyG 变化可能是识别 CKD 进展风险人群的有用工具,尤其是舒张压正常的高血压患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/41fe/10893760/1e7dba16b2d2/fendo-15-1342408-g001.jpg

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