美国慢性肾脏病成年人中甘油三酯-葡萄糖指数与心血管疾病的关联：一项基于人群的研究。
Association between triglyceride-glucose index and cardiovascular disease in US adults with chronic kidney disease: a population-based study.
作者信息
Liu Lijia, Sun Hui, Yi Lan, Wang Gang, Zou Yanqin
机构信息
Department of Nephrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China.
Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China.
出版信息
BMC Cardiovasc Disord. 2024 Dec 20;24(1):723. doi: 10.1186/s12872-024-04407-8.
OBJECTIVES
Triglyceride-glucose (TyG) index, which is a valuable measure of insulin resistance, has been found to have predictive value for cardiovascular disease (CVD). However, its relationship with CVD among individuals with chronic kidney disease (CKD) has not been thoroughly investigated. This study focused on examining the relationship of the TyG index and CVD among CKD patients in United States.
METHODS
3507 eligible participants from the National Health and Nutrition Examination Survey (2003-2018) were surveyed in this study. Methods such as multivariable logistic regression analysis and smooth curve fitting were employed to estimate how the TyG index is linked to CVD in CKD populations. Subgroup and interaction analyses were conducted in order to figure out potential moderating effects of various factors.
RESULTS
In this cross-sectional study which based on a population with CKD, 29.5% of patients also had CVD. An independent and positive link of TyG and CVD was revealed (OR 1.213, 95% CI 1.059, 1.389). This association was nonlinear, with a threshold effect observed at a TyG index of 8.98. The results of subgroup analysis suggested that the relationships of TyG and CVD differed according to CKD stage: (OR 1.048, 95% CI 0.857, 1.282) in CKD stages 1-2; (OR 1.267, 95% CI 1.030-1.560) in stage 3; and (OR 2.131, 95% CI 1.224-3.709) in stages 4-5. Interaction analyses further suggested the potential moderating effects of CKD stage. Additionally, among specific CVD types, only coronary heart disease (CHD) had a significant and positive relationship with TyG (OR 1.617, 95% CI 1.123, 2.327).
CONCLUSIONS
TyG index was identified to be independently and positively related to the likelihood of CVD, specifically in populations with an eGFR < 60 mL/min/1.73 m². The association had a threshold effect. The results highlight the potential of the TyG index as a tool for screening and risk assessment of CVD in populations suffering from CKD, warranting further investigation.
目的
甘油三酯-葡萄糖（TyG）指数是衡量胰岛素抵抗的一项重要指标，已被发现对心血管疾病（CVD）具有预测价值。然而，其在慢性肾脏病（CKD）患者中与CVD的关系尚未得到充分研究。本研究聚焦于美国CKD患者中TyG指数与CVD的关系。
方法
本研究对来自国家健康与营养检查调查（2003 - 2018年）的3507名符合条件的参与者进行了调查。采用多变量逻辑回归分析和平滑曲线拟合等方法来评估TyG指数在CKD人群中如何与CVD相关联。进行亚组分析和交互分析以找出各种因素的潜在调节作用。
结果
在这项基于CKD人群的横断面研究中，29.5%的患者同时患有CVD。TyG与CVD之间存在独立且正相关的联系（OR 1.213，95% CI 1.059，1.389）。这种关联是非线性的，在TyG指数为8.98时观察到阈值效应。亚组分析结果表明，TyG与CVD的关系因CKD分期而异：CKD 1 - 2期为（OR 1.048，95% CI 0.857，1.282）；3期为（OR 1.267，95% CI 1.030 - 1.560）；4 - 5期为（OR 2.131，95% CI 1.224 - 3.709）。交互分析进一步表明了CKD分期的潜在调节作用。此外，在特定的CVD类型中，只有冠心病（CHD）与TyG存在显著正相关（OR 1.617，95% CI 1.123，2.327）。
结论
TyG指数被确定与CVD的发生可能性独立且正相关，特别是在估算肾小球滤过率（eGFR）<60 mL/min/1.73 m²的人群中。这种关联具有阈值效应。研究结果凸显了TyG指数作为CKD患者CVD筛查和风险评估工具的潜力，值得进一步研究。
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