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甘油三酯葡萄糖指数:慢性肾脏病患者心力衰竭的重要预后标志物。

Triglyceride glucose index: a significant prognostic marker of heart failure in patients with chronic kidney disease.

机构信息

Nephrology Department, The First Affiliated Hospital of Dalian Medical University, Dalian, China.

Cardiology Department, The First Affiliated Hospital of Dalian Medical University, Dalian, China.

出版信息

Ren Fail. 2024 Dec;46(2):2432547. doi: 10.1080/0886022X.2024.2432547. Epub 2024 Nov 27.

Abstract

BACKGROUND

Triglycerides and glucose (TyG) index, a relatively convenient method for assessing insulin resistance, has been confirmed as an independent predictor both for chronic kidney disease (CKD) and cardiovascular disease (CVD) in previous studies. However, a few studies focus on the prognostic value of TyG index for CVD in patients diagnosed with CKD, especially in advanced CKD patients. In this study, we aim to investigate the prognostic value of TyG index for heart failure (HF) in patients with non-dialysis CKD stage 3-5.

METHODS AND RESULTS

This retrospective study was conducted at The First Affiliated Hospital of Dalian Medical University. Patients with non-dialysis CKD stage 3-5 between 1 January 2016 and 1 January 2023 were included in our study. The endpoints included cardiovascular death and HF-related rehospitalization. Finally, a total of 284 subjects were enrolled in our cohort. Multivariate Cox regression analysis revealed that TyG index was one of the independent risk factors both for HF-related rehospitalization and cardiovascular death in non-dialysis CKD stage 3-5 patients. Furthermore, Cox regression model showed a favorable predictive efficiency of TyG index for adverse clinical events. Multivariate logistic regression analysis revealed that TyG index was one of the positive independent predictors of HF.

CONCLUSIONS

Non-dialysis CKD stage 3-5 patients with higher TyG index level experience worsening cardiovascular outcomes, and TyG index is associated with the occurrence of HF. Highlighting that TyG index may be a significant marker for assessing cardiovascular prognosis in CKD patients.

摘要

背景

甘油三酯和葡萄糖(TyG)指数是一种评估胰岛素抵抗的相对便捷方法,先前的研究已经证实其是慢性肾脏病(CKD)和心血管疾病(CVD)的独立预测因子。然而,少数研究关注 TyG 指数对 CKD 患者 CVD 的预后价值,特别是在晚期 CKD 患者中。在本研究中,我们旨在探讨 TyG 指数对非透析 CKD 3-5 期患者心力衰竭(HF)的预后价值。

方法和结果

本回顾性研究在大连医科大学第一附属医院进行。我们纳入了 2016 年 1 月 1 日至 2023 年 1 月 1 日期间非透析 CKD 3-5 期的患者作为研究对象。终点事件包括心血管死亡和 HF 相关再住院。最终,共有 284 名患者纳入本队列。多变量 Cox 回归分析显示,TyG 指数是非透析 CKD 3-5 期患者 HF 相关再住院和心血管死亡的独立危险因素之一。此外,Cox 回归模型显示 TyG 指数对不良临床事件具有良好的预测效率。多变量逻辑回归分析显示,TyG 指数是 HF 的阳性独立预测因子之一。

结论

TyG 指数较高的非透析 CKD 3-5 期患者心血管结局恶化,TyG 指数与 HF 的发生相关。提示 TyG 指数可能是评估 CKD 患者心血管预后的重要标志物。

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