Jv Menglei, Zhang Jun, Han Yuzhang, Yang Anni, Zhu Ye
Department of Nephrology, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, China.
Department of Otolaryngology Head and Neck Surgery, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, China.
Eur J Med Res. 2024 Dec 26;29(1):627. doi: 10.1186/s40001-024-02234-3.
IgA nephropathy (IgAN) is one of the most prevalent forms of glomerulonephritis worldwide, particularly affecting 40-50% of the East Asian population. Cardiovascular mortality represents a leading cause of death in patients with IgAN. Left ventricular hypertrophy (LVH) serves as a predictor of heart failure and cardiovascular mortality. Previous studies have indicated that Triglyceride glucose-body mass index (TyG-BMI), a surrogate marker for insulin resistance surrogates, correlated with the development of LVH. However, there is a lack of information available regarding the association between TyG-BMI and LVH in patients with IgAN. This study aims to explore the relationship between TyG-BMI and LVH in this population.
This retrospective study was conducted in the Fifth Affiliated Hospital of Sun Yat-sen University recruiting inpatients with renal biopsy-confirmed IgAN who were over the age of 18 years. Left ventricular dimensions were assessed through echocardiography. Linear regression and multivariate logistic regression analyses were performed using R language software and SPSS to investigate the association between TyG-BMI levels and LVH risk. Statistical significance was set at p < 0.05.
A total of 327 patients with IgAN were enrolled in this study. Left ventricular mass index (LVMI) was positively correlated with TyG-BMI index (corr. coefficient: 0.453, p < 0.001) and inversely correlated with eGFR (corr. coefficient: -0.392, p < 0.001). After adjusting for age, gender, smoking, alcohol use, hemoglobin, low-density lipoprotein cholesterol, Scr, and urine output, advanced age and higher levels of hemoglobin and Scr were independently associated with increased TyG-BMI (p < 0.05). The odds ratios of the highest quartile of TyG-BMI compared with the lowest quartile were 8.39 (95%CI 1.66-42.39; p = 0.010).
Our findings indicated that the TyG-BMI level was positively correlated with LVMI. A high TyG-BMI level was independently associated with an increased risk of LVH in patients with IgAN. TyG-BMII demonstrated predictive ability for LVH in IgAN patients.
IgA 肾病（IgAN）是全球最常见的肾小球肾炎形式之一，尤其在东亚人群中发病率为 40%-50%。心血管疾病死亡率是 IgAN 患者的主要死因。左心室肥厚（LVH）是心力衰竭和心血管疾病死亡率的预测指标。既往研究表明，甘油三酯葡萄糖-体重指数（TyG-BMI）作为胰岛素抵抗的替代标志物，与 LVH 的发生相关。然而，关于 IgAN 患者中 TyG-BMI 与 LVH 之间的关联，目前尚缺乏相关信息。本研究旨在探讨该人群中 TyG-BMI 与 LVH 的关系。
本回顾性研究在中山大学附属第五医院进行，纳入年龄超过 18 岁、经肾活检确诊为 IgAN 的住院患者。通过超声心动图评估左心室尺寸。使用 R 语言软件和 SPSS 进行线性回归和多因素逻辑回归分析，以研究 TyG-BMI 水平与 LVH 风险之间的关联。设定统计学显著性为 p < 0.05。
本研究共纳入 327 例 IgAN 患者。左心室质量指数（LVMI）与 TyG-BMI 指数呈正相关（相关系数：0.453，p < 0.001），与估算肾小球滤过率（eGFR）呈负相关（相关系数：-0.392，p < 0.001）。在调整年龄、性别、吸烟、饮酒、血红蛋白、低密度脂蛋白胆固醇、血清肌酐（Scr）和尿量后，高龄以及较高水平的血红蛋白和 Scr 与 TyG-BMI 升高独立相关（p < 0.05）。TyG-BMI 最高四分位数与最低四分位数相比的比值比为 8.39（95%置信区间 1.66-42.39；p = 0.010）。
我们的研究结果表明，TyG-BMI 水平与 LVMI 呈正相关。高 TyG-BMI 水平与 IgAN 患者发生 LVH 的风险增加独立相关。TyG-BMI 对 IgAN 患者的 LVH 具有预测能力。
