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甘油三酯-葡萄糖指数与肾结石风险的关联:一项基于中国人群的病例对照研究。

Association between triglyceride-glucose index and risk of kidney stone: a Chinese population-based case-control study.

机构信息

Department of Urology, Ruijin Hospital, Shanghai, China.

Department of Urology, Shanghai Pudong New Area People's Hospital, Shanghai, China.

出版信息

BMJ Open. 2024 Nov 21;14(11):e086641. doi: 10.1136/bmjopen-2024-086641.

Abstract

OBJECTIVE

To investigate the association between the triglyceride-glucose (TyG) index, a surrogate marker of insulin resistance and the risk of kidney stones (KSs) in a Chinese population.

DESIGN

Case-control study.

SETTING

Three Physical Examination Centers in Shanghai, China, between January 2020 and December 2022.

PARTICIPANTS

A total of 117 757 Chinese adults underwent health check-ups during the study period.

PRIMARY AND SECONDARY OUTCOME MEASURES

The association between the TyG index and the risk of KS was assessed using multivariable logistic regression analysis. The dose-response relationship between the TyG index and KS risk was evaluated with a restricted cubic spline (RCS) analysis. Stratified analyses were conducted to explore whether factors such as age, sex, obesity, hypertension and diabetes modify the association between the TyG index and KS risk.

RESULTS

Out Of the 117 757 participants, 11 645 (9.9%) were diagnosed with KS using ultrasound. Individuals with KS had significantly higher TyG values than controls (p<0.001). The multivariable-adjusted ORs for KS increased across TyG quartiles, with the highest quartile showing an OR of 1.28 (95% CI 1.20 to 1.36) compared with the lowest quartile. Each SD increase in the TyG index was associated with a 10% higher risk of KS (OR: 1.10, 95% CI 1.08 to 1.13). RCS analysis revealed a significant positive and linear association between TyG index and KS (p overall<0.001, p non-linear=0.136). The positive association persisted across the subgroup and sensitivity analyses.

CONCLUSIONS

The TyG index was positively associated with the risk of prevalent KS, suggesting that insulin resistance may be a risk factor for KS in the Chinese population.

摘要

目的

在中国人群中,研究甘油三酯-葡萄糖(TyG)指数这一胰岛素抵抗替代标志物与肾结石(KS)风险之间的关系。

设计

病例对照研究。

地点

中国上海的三个体检中心,2020 年 1 月至 2022 年 12 月期间。

参与者

共有 117757 名中国成年人在研究期间接受了健康检查。

主要和次要结果

使用多变量逻辑回归分析评估 TyG 指数与 KS 风险之间的关联。使用限制性立方样条(RCS)分析评估 TyG 指数与 KS 风险之间的剂量反应关系。进行分层分析以探讨年龄、性别、肥胖、高血压和糖尿病等因素是否改变 TyG 指数与 KS 风险之间的关联。

结果

在 117757 名参与者中,有 11645 人(9.9%)通过超声诊断为 KS。KS 患者的 TyG 值明显高于对照组(p<0.001)。多变量校正后的 OR 值随着 TyG 四分位值的升高而增加,最高四分位值与最低四分位值相比,OR 值为 1.28(95% CI 1.20 至 1.36)。TyG 指数每增加一个标准差,KS 的风险增加 10%(OR:1.10,95%CI 1.08 至 1.13)。RCS 分析显示 TyG 指数与 KS 之间存在显著的正线性关联(p 整体<0.001,p 非线性=0.136)。这种正相关在亚组和敏感性分析中仍然存在。

结论

TyG 指数与 KS 的发病风险呈正相关,提示胰岛素抵抗可能是中国人 KS 的一个危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3a6b/11590796/ddf4dc16abd4/bmjopen-14-11-g001.jpg

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