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一项基于人群的关于白细胞、中性粒细胞和血小板在甘油三酯-葡萄糖指数与尿白蛋白排泄关系中的中介作用的研究。

A Population-Based Study of the Mediating Role of WBC, NEUT and PLT in the Relationship Between Triglyceride-Glucose Index and Urinary Albumin Excretion.

作者信息

Sun Xu, Zhu Jun, Qian Zhuyin, Chen Xiaowei, Zhang Jie, Ji Cheng, Zhao Li

机构信息

China Pharmaceutical University, Nanjing, 211198, People's Republic of China.

Department of Pharmacy, Nanjing Luhe People's Hospital, Nanjing, 211500, People's Republic of China.

出版信息

J Inflamm Res. 2024 Dec 7;17:10613-10626. doi: 10.2147/JIR.S491694. eCollection 2024.

Abstract

AIM

To assess the potential association between the TyG index and the risk of abnormal UACR. Additionally, we aimed to determine the role and degree of influence of inflammatory biomarkers between the TyG index and abnormal UACR.

MATERIALS AND METHODS

A cross-sectional study recruited 1021 participants from a health management center between 2021 and 2022. Logistic or linear regression models, as well as mediation analysis, were employed to investigate the associations between the TyG index, inflammatory biomarkers (total and differential white blood cell counts, platelet, mean platelet volume(MPV), C-reactive protein(CRP)), and the risk of abnormal UACR.

RESULTS

The study included 1021 participants, of whom 55.0% were men. The median age (interquartile range [IQR]) was 61.0 (53, 70) years. In multivariable-adjusted logistic regression models, both with and without the inclusion of smoking, alcohol drinking, BMI, Lipid-lowering drugs using, TC, SUA, ALT, and AST as potential covariates, the TyG index was associated with the risk of UACR, both with the odds ratios (ORs) per 1-standard deviation (SD) increase were 1.32 (95% CI, 1.08-1.62) and 1.27 (95% CI, 1.05-1.52), respectively. This study also demonstrated a significant indirect effect of the TyG index on the risk of abnormal UACR through total white blood cell counts, neutrophil counts and platelet (P values < 0.05); The proportions mediated was 11.2%, 3.5% and 29.6% for each respective variable.

CONCLUSION

Insulin resistance and inflammation are associated with an increased risk of kidney insufficiency. And indicators of inflammation weakly mediate insulin resistance and risk of kidney insufficiency.

摘要

目的

评估TyG指数与尿白蛋白肌酐比值(UACR)异常风险之间的潜在关联。此外,我们旨在确定炎症生物标志物在TyG指数与UACR异常之间的作用及影响程度。

材料与方法

一项横断面研究于2021年至2022年期间从一个健康管理中心招募了1021名参与者。采用逻辑回归或线性回归模型以及中介分析,来研究TyG指数、炎症生物标志物(白细胞总数及分类计数、血小板、平均血小板体积(MPV)、C反应蛋白(CRP))与UACR异常风险之间的关联。

结果

该研究纳入了1021名参与者,其中55.0%为男性。年龄中位数(四分位间距[IQR])为61.0(53,70)岁。在多变量调整的逻辑回归模型中,无论是否纳入吸烟、饮酒、体重指数(BMI)、使用降脂药物、总胆固醇(TC)、血尿酸(SUA)、谷丙转氨酶(ALT)和谷草转氨酶(AST)作为潜在协变量,TyG指数均与UACR风险相关,每增加1个标准差(SD)的比值比(OR)分别为1.32(95%置信区间[CI],1.08 - 1.62)和1.27(95%CI,1.05 - 1.52)。本研究还表明,TyG指数通过白细胞总数、中性粒细胞计数和血小板对UACR异常风险有显著的间接影响(P值< 0.05);各变量的中介比例分别为11.2%、3.5%和29.6%。

结论

胰岛素抵抗和炎症与肾功能不全风险增加相关。炎症指标对胰岛素抵抗和肾功能不全风险的中介作用较弱。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d2ff/11633290/ee480c448fae/JIR-17-10613-g0001.jpg

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