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甘油三酯-葡萄糖指数与慢性肾脏病的关系:NHANES 1999-2020 年的研究结果。

Association between triglyceride-glucose index and chronic kidney disease: results from NHANES 1999-2020.

机构信息

Department of Critical Care Medicine, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, China.

Department of Urology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, China.

出版信息

Int Urol Nephrol. 2024 Nov;56(11):3605-3616. doi: 10.1007/s11255-024-04103-8. Epub 2024 Jun 10.

Abstract

AIMS

Examining the connection between the triglyceride-glucose (TyG) index and chronic kidney disease (CKD) was the aim of this investigation.

METHODS

Data from the National Health and Nutrition Examination Survey (NHANES) covering the years 1999-2020 were analyzed in this study. The TyG index was calculated as Ln (triglycerides (mg/dl) * fasting glucose (mg/dl)/2). The two criteria used to diagnose CKD were low estimated glomerular filtration rate (eGFR) (eGFR < 60 mL/min/1.73m) or albuminuria (urine albumin-to-creatinine ratio (ACR) ≥ 30 mg/g). To look into the independent associations between TyG index levels with CKD, albuminuria, and low-eGFR, weighted multivariable logistic regression and generalized additive models were employed. To assess and contrast the diagnostic ability, receiver operating characteristic (ROC) curves were employed.

RESULTS

Out of 18,078 total participants recruited, 48.54% were male. 8.48 + 0.68 was the mean value of the TyG index. CKD, albuminuria, and low-eGFR were common, with respective prevalences of 17.06%, 11.26%, and 8.03%, respectively. The TyG index and CKD were observed to positively correlate (OR = 4.03; 95% CI 1.81, 8.96). In US adults between the ages of 41 and 60, a J-shaped connection was found between the two. Furthermore, a higher TyG index is associated with a higher prevalence of albuminuria (OR = 6.11; 95% CI 2.64, 14.14). Subgroup analyses and interaction tests revealed that different stratifications did not significantly affect the relationship between TyG index and CKD, albuminuria, and low-eGFR. Comparing the TyG index to other indicators [lipid accumulation product (LAP), Visceral adiposity index (VAI), and the triglyceride glucose-body mass index (TyG-BMI)], it may be more accurate and discriminative in predicting CKD and albuminuria.

CONCLUSION

When predicting CKD and albuminuria, the TyG index may be a more useful marker when compared to other markers (LAP, VAI, and TyG-BMI index). In addition, in American adults aged 41-60, the TyG index shows a J-shaped relationship with CKD. As a result, when assessing the kidney health of US adults, we must pay close attention to the significance of the TyG index.

摘要

目的

本研究旨在探讨甘油三酯-葡萄糖(TyG)指数与慢性肾脏病(CKD)之间的关系。

方法

本研究分析了 1999 年至 2020 年美国国家健康和营养检查调查(NHANES)的数据。TyG 指数的计算方法为 Ln(甘油三酯(mg/dl)*空腹血糖(mg/dl)/2)。诊断 CKD 的两个标准是估算肾小球滤过率(eGFR)低(eGFR<60 mL/min/1.73m)或白蛋白尿(尿白蛋白/肌酐比值(ACR)≥30 mg/g)。为了研究 TyG 指数水平与 CKD、白蛋白尿和低 eGFR 之间的独立关联,采用加权多变量逻辑回归和广义加性模型。为了评估和比较诊断能力,采用了接收者操作特征(ROC)曲线。

结果

在纳入的 18078 名参与者中,48.54%为男性。TyG 指数的平均值为 8.48±0.68。CKD、白蛋白尿和低 eGFR 的患病率分别为 17.06%、11.26%和 8.03%。观察到 TyG 指数与 CKD 呈正相关(OR=4.03;95%CI 1.81,8.96)。在美国 41-60 岁的成年人中,两者之间存在 J 形关系。此外,较高的 TyG 指数与较高的白蛋白尿患病率相关(OR=6.11;95%CI 2.64,14.14)。亚组分析和交互检验表明,不同分层对 TyG 指数与 CKD、白蛋白尿和低 eGFR 之间的关系没有显著影响。与其他指标[脂质蓄积产物(LAP)、内脏脂肪指数(VAI)和甘油三酯-葡萄糖-体重指数(TyG-BMI)]相比,TyG 指数在预测 CKD 和白蛋白尿方面可能更准确和具有鉴别力。

结论

在预测 CKD 和白蛋白尿时,与其他指标(LAP、VAI 和 TyG-BMI 指数)相比,TyG 指数可能是一个更有用的标志物。此外,在美国 41-60 岁的成年人中,TyG 指数与 CKD 呈 J 形关系。因此,在评估美国成年人的肾脏健康状况时,我们必须密切关注 TyG 指数的意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/84a6/11464617/02373e4b9eba/11255_2024_4103_Fig1_HTML.jpg

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