Zhang Pirun, Zhang Wenli, Han Yan, Yang Tong, Zhong Jiayi, Yun Han, Fang Lai
The Second Institute of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China.
Qingdao Mental Health Center, Qingdao, Shandong Province, China.
Ren Fail. 2025 Dec;47(1):2449199. doi: 10.1080/0886022X.2024.2449199. Epub 2025 Jan 6.
The TyG index serves as a valuable tool for evaluating insulin resistance. An elevated TyG has shown a strong association with the occurrence of acute kidney injury (AKI). Nevertheless, existing literature does not address the relationship between the TyG index and acute kidney injury in patients with sepsis. Sepsis patients were identified from the MIMIC-IV database and categorized into four groups according to quadrilles of their TyG index values. The primary outcome of this study was the incidence of AKI. The relationship between the TyG index and the risk of AKI in septic patients was evaluated using Cox proportional hazards and restricted cubic spline models. Subgroup analyses were conducted to investigate the prognostic value of the TyG index in different subgroups. A total of 2,616 patients with sepsis (57% of whom were male) were included in this study. The incidence of AKI was found to be 78%. Cox proportional hazards analysis revealed a significant correlation between the TyG index and the occurrence of AKI in septic patients. Furthermore, a restricted cubic spline model revealed an approximately linear relationship between a higher TyG index and an elevated risk of AKI in septic patients. The trend of the hazard ratio (HR) remained consistent across various subgroups. These findings emphasize the reliability of the TyG index as an independent predictor for the occurrence of AKI and unfavorable renal outcomes in sepsis patients. Nevertheless, establishing a causal relationship between the two requires demonstration through larger prospective studies.
TyG指数是评估胰岛素抵抗的一项重要工具。TyG指数升高已显示出与急性肾损伤（AKI）的发生密切相关。然而，现有文献并未涉及脓毒症患者中TyG指数与急性肾损伤之间的关系。从MIMIC-IV数据库中识别出脓毒症患者，并根据其TyG指数值的四分位数将其分为四组。本研究的主要结局是AKI的发生率。使用Cox比例风险模型和限制性立方样条模型评估TyG指数与脓毒症患者发生AKI风险之间的关系。进行亚组分析以研究TyG指数在不同亚组中的预后价值。本研究共纳入2616例脓毒症患者（其中57%为男性）。发现AKI的发生率为78%。Cox比例风险分析显示TyG指数与脓毒症患者发生AKI之间存在显著相关性。此外，限制性立方样条模型显示脓毒症患者中较高的TyG指数与AKI风险升高之间存在近似线性关系。风险比（HR）的趋势在各个亚组中保持一致。这些发现强调了TyG指数作为脓毒症患者发生AKI及不良肾脏结局的独立预测指标的可靠性。然而，要确定两者之间的因果关系需要通过更大规模的前瞻性研究来证实。
