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创伤性脑损伤后甘油三酯葡萄糖指数与急性肾损伤之间的关联。

Association between the triglyceride glucose index and acute kidney injury following traumatic brain injury.

作者信息

Pan Rujun, Li Shaojie, Wu Baofang, Wang Jiayin, Lin Shanglu, Chen Longjie, Wei De, Gao Hongzhi

机构信息

Department of Neurosurgery, The Second Affiliated Clinical Medical College of Fujian, Medical University, Quanzhou, 362000, China.

Department of Neurosurgery, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, 350001, China.

出版信息

Sci Rep. 2025 Jan 2;15(1):456. doi: 10.1038/s41598-024-84690-9.

Abstract

Acute kidney injury (AKI) is associated with adverse hospitalization. Previous studies have reported that an elevated triglyceride glucose (TyG) index is significantly associated with the development of AKI in patients with cardiovascular disease, as well as in those undergoing surgery; however, the potential of the TyG index to predict AKI following neurotrauma remains unclear. Patients diagnosed with traumatic brain injury (TBI) in Chinese tertiary hospitals between January 2014 and December 2023 were included in this retrospective study. The outcome was the incidence of AKI. TyG was identified as an independent risk factor for AKI using logistic regression and propensity score matching (PSM). Finally, the association between TyG index and AKI was further assessed using multivariate logistic regression, restricted cubic spline (RCS) regression, and subgroup analysis. The present study enrolled 1,505 patients with TBI, of whom 66.45% were male, with an average age of 55.47 ± 17.32 years. The incidence of AKI was 9.4%. Multiple logistic regression analyses identified a relationship between the TyG levels and AKI risk. This relationship was retained after PSM. A significant positive correlation between TyG level and AKI was observed in all three models constructed using multivariate logistic regression. RCS regression analyses further indicated a linear increase in AKI risk with an increasing TyG index. In subgroup analyses, this correlation remained stable for the majority of the population but could be influenced by sex. TyG levels were positively correlated with the risk of AKI development in patients following TBI. As a predictive biomarker, the TyG index enables effective risk stratification and customization of management protocols to mitigate AKI in these patients, thus enhancing clinical outcomes.

摘要

急性肾损伤(AKI)与不良住院结局相关。既往研究报道,甘油三酯葡萄糖(TyG)指数升高与心血管疾病患者以及手术患者发生AKI显著相关;然而,TyG指数预测神经创伤后AKI的潜力仍不明确。本回顾性研究纳入了2014年1月至2023年12月在中国三级医院诊断为创伤性脑损伤(TBI)的患者。结局指标为AKI的发生率。采用逻辑回归和倾向评分匹配(PSM)确定TyG为AKI的独立危险因素。最后,使用多因素逻辑回归、限制性立方样条(RCS)回归和亚组分析进一步评估TyG指数与AKI之间的关联。本研究共纳入1505例TBI患者,其中66.45%为男性,平均年龄为55.47±17.32岁。AKI的发生率为9.4%。多项逻辑回归分析确定了TyG水平与AKI风险之间的关系。PSM后这种关系依然存在。在使用多因素逻辑回归构建的所有三个模型中,均观察到TyG水平与AKI之间存在显著正相关。RCS回归分析进一步表明,随着TyG指数升高,AKI风险呈线性增加。在亚组分析中,这种相关性在大多数人群中保持稳定,但可能受性别影响。TBI患者的TyG水平与发生AKI的风险呈正相关。作为一种预测生物标志物,TyG指数能够进行有效的风险分层并定制管理方案,以减轻这些患者的AKI,从而改善临床结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/13d3/11698734/9c8ac506a79e/41598_2024_84690_Fig1_HTML.jpg

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