Health Management Center & Health Management Research Institute, Sichuan Provincial People's Hospital, Chengdu, China.
School of Public Health, Southwest Medical University, Luzhou, China.
Front Endocrinol (Lausanne). 2024 May 15;15:1376166. doi: 10.3389/fendo.2024.1376166. eCollection 2024.
The triglyceride-glucose (TyG) index, a simple surrogate marker of insulin resistance, is significantly associated with chronic kidney disease (CKD). However, there is limited research on the longitudinal trajectory of TyG index over time and its relationship with CKD.
To analyse the characteristics of the longitudinal trajectory of the TyG index over time and its association with the development of CKD in a health check-up population.
Participants who underwent at least three annual health check-ups at the Health Management Center of Sichuan Provincial People's Hospital from 2015 to 2022 were included in this retrospective cohort study. The TyG index was calculated as ln [fasting triglycerides (mg/dL) × fasting glucose (mg/dL)/2]. The latent class mixed model (LCMM) was used to identify the TyG index trajectory of the study population. A Cox proportional hazard model was used to estimate the CKD incidence risk in different quartile groups and the association of changes in the TyG index trajectory with the development of CKD.
A total of 4,921 participants were included in this study, and they were divided into four groups according to the quartiles of the baseline TyG index: Q1 (5.43-6.66), Q2 (6.67-7.04), Q3 (7.05-7.43), and Q4 (7.43-9.97). There was no difference in the risk of CKD occurrence among the TyG groups. Three different TyG index trajectories were identified in this study: a high-level group, middle-level stable group and low-level stable group, respectively. The incidence rate of CKD in the high-level TyG index trajectory group was 2.399 times greater than that in the low-level stable trajectory group (HR=2.399, 95% CI 1.167-4.935).
Individuals with long-term exposure to high TyG index levels had a significantly greater risk of CKD. Routine monitoring of the TyG index and its longitudinal trend will aid in the risk stratification of CKD in the general population and will be helpful for CKD prevention and targeted management.
三酰甘油-葡萄糖（TyG）指数是一种简单的胰岛素抵抗替代标志物，与慢性肾脏病（CKD）显著相关。然而，关于 TyG 指数随时间的纵向轨迹及其与 CKD 的关系的研究有限。
分析健康体检人群中 TyG 指数随时间的纵向轨迹特征及其与 CKD 发展的关系。
本回顾性队列研究纳入了 2015 年至 2022 年在四川省人民医院健康管理中心至少进行了 3 次年度健康检查的参与者。TyG 指数计算为 ln[空腹三酰甘油（mg/dL）×空腹血糖（mg/dL）/2]。采用潜在类别混合模型（LCMM）来识别研究人群的 TyG 指数轨迹。采用 Cox 比例风险模型估计不同四分位组的 CKD 发病风险，以及 TyG 指数轨迹变化与 CKD 发展的关系。
本研究共纳入 4921 名参与者，根据基线 TyG 指数的四分位数分为 4 组：Q1（5.43-6.66）、Q2（6.67-7.04）、Q3（7.05-7.43）和 Q4（7.43-9.97）。各组发生 CKD 的风险无差异。本研究中鉴定出 3 种不同的 TyG 指数轨迹：高水平组、中水平稳定组和低水平稳定组。高水平 TyG 指数轨迹组 CKD 的发生率是低水平稳定轨迹组的 2.399 倍（HR=2.399，95%CI 1.167-4.935）。
长期暴露于高水平 TyG 指数的个体发生 CKD 的风险显著增加。常规监测 TyG 指数及其纵向趋势有助于对一般人群的 CKD 进行风险分层，并有助于 CKD 的预防和针对性管理。
