Zhang Yan, Song Kexin, Yao Zhuhua
Tianjin Union Medical Center, Tianjin Medical University, Tianjin, 300122, China.
Graduate School of Hebei Medical University, Shijiazhuang, 050017, China.
Diabetol Metab Syndr. 2024 Nov 1;16(1):259. doi: 10.1186/s13098-024-01487-6.
Both anti-aging protein α-Klotho and the triglyceride-glucose (TyG) index hold predictive value for the incidence, progression, and outcomes of cardiovascular disease, diabetes and many other diseases. However, their relationship remains unclear.
We conducted a cross-sectional analysis using data from the National Health and Nutrition Examination Survey (NHANES) 2007-2016. Weighted multivariate linear regression models and subgroup analysis were constructed to assess the association between TyG index and α-Klotho levels. Nonlinear correlations were explored using restricted cubic splines (RCS), generalized additive models (GAM) and smooth curve fitting. Segmented regression model was conducted to explore potential threshold effects and identify the inflection point.
A total of 2568 participants satisfied the predetermined criteria were enrolled in the final analysis. After fully adjusting for covariates, TyG index was shown to be markedly negatively correlated with α-Klotho [β=-74.07, 95%CI (-100.29,-47.85), p < 0.001]. Gender was significantly correlated with this negative connection according to subgroup analysis and interaction testing (p for interaction < 0.05).Additionally, we discovered a linear association between TyG index and α-Klotho in all participants (p for nonlinear = 0.761), while non-linear association in female (p for nonlinear = 0.016).The analysis of threshold effect in the female participants found that the inflection point of TyG index was 8.01, exceed which the level of α-Klotho decreased significantly with increasing TyG index[β=-151.72, 95%CI (-201.93, -101.50), p < 0.001].
Our findings demonstrate a negative association between TyG index and α-Klotho levels, with the effect being more pronounced in females. TyG index may serve as an early indicator of individuals with low α-Klotho levels, especially among females. These findings highlight the need for gender-specific considerations in clinical interventions to improve public health. Further research is needed to clarify the causal direction of this association.
抗衰老蛋白α-klotho和甘油三酯-葡萄糖（TyG）指数对心血管疾病、糖尿病和许多其他疾病的发病率、进展及预后均具有预测价值。然而，它们之间的关系仍不明确。
我们使用2007 - 2016年美国国家健康与营养检查调查（NHANES）的数据进行了横断面分析。构建加权多元线性回归模型和亚组分析以评估TyG指数与α-klotho水平之间的关联。使用受限立方样条（RCS）、广义相加模型（GAM）和平滑曲线拟合探索非线性相关性。进行分段回归模型以探索潜在的阈值效应并确定拐点。
共有2568名符合预定标准的参与者纳入最终分析。在对协变量进行充分调整后，TyG指数与α-klotho呈显著负相关[β = -74.07，95%CI（-100.29，-47.85），p < 0.001]。根据亚组分析和交互作用检验，性别与这种负相关显著相关（交互作用p < 0.05）。此外，我们发现所有参与者中TyG指数与α-klotho呈线性关联（非线性p = 0.761），而女性中呈非线性关联（非线性p = 0.016）。对女性参与者的阈值效应分析发现，TyG指数的拐点为8.01，超过该值后，随着TyG指数升高，α-klotho水平显著下降[β = -151.72，95%CI（-201.93，-101.50），p < 0.001]。
我们的研究结果表明TyG指数与α-klotho水平呈负相关，且在女性中效应更明显。TyG指数可能是α-klotho水平较低个体的早期指标，尤其是在女性中。这些发现凸显了在临床干预中考虑性别差异以改善公众健康的必要性。需要进一步研究以阐明这种关联的因果方向。
