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甘油三酯-葡萄糖指数与其综合肥胖指数与心肾疾病之间的关联:2013 - 2018年美国国家健康与营养检查调查周期分析

Association between triglyceride-glucose index and its composite obesity indexes and cardio-renal disease: analysis of the NHANES 2013-2018 cycle.

作者信息

Wu Yu, Liu Chengsen, Cao Jiandong

机构信息

Department of Oncology, Huainan Xinhua Medical Group Xinhua Hospital, Huainan, Anhui, China.

Department of Radiotherapy, The People's Hospital of Liaoning Province, Shenyang, Liaoning, China.

出版信息

Front Endocrinol (Lausanne). 2025 Jan 31;16:1505808. doi: 10.3389/fendo.2025.1505808. eCollection 2025.

Abstract

BACKGROUND

The association between triglyceride-glucose (TYG) and its composite obesity indexes and cardio-renal disease in the American population remains insufficiently researched.

METHODS

This study examined a cohort of 11,491 American adults aged 20 years and older from the 2003-2018 National Health and Nutrition Examination Survey (NHANES). To explore the associations between TYG, TyG-Waist-to-Height Ratio (TyG-WHtR), TyG-Body Mass Index (TyG-BMI), TyG-Waist Circumference (TyG-WC), and chronic kidney disease (CKD), cardiovascular disease (CVD), and cardiorenal syndrome (CRS), we utilized weighted multivariate logistic regression, restricted cubic spline (RCS), Receiver operating characteristic (ROC), and subgroup analyses.

RESULTS

Adjusted for confounding factors, there are positive associations between the likelihood of CKD, CVD, and CRS, as well as TYG and its composite obesity indexes. The TYG index was correlated most strongly with CKD (OR 1.42, 95% CI 1.11, 1.82; P = 0.007), while TyG-WHtR had the strongest correlations with CVD (OR 1.63, 95% CI 1.19, 2.22; P = 0.003) and CRS (OR 1.44, 95% CI 1.00, 2.08; P = 0.055). A nonlinear connection was found by RCS analysis between TYG and its composite obesity indexes with CKD (P for overall < 0.001, P for nonlinear < 0.05), while the association with CVD and CRS was predominantly linear (P for overall < 0.001, P for nonlinear > 0.05). Based on ROC curves, TyG-WHtR and TyG-WC emerged as more reliable diagnostic tools than TYG for cardiac and renal diseases. According to subgroup analyses, TyG and its composite obesity measurements were more strongly associated with CKD in younger individuals (≤ 50), males, and those with diabetes mellitus (P for interaction 0.05).

CONCLUSIONS

The TyG-WHtR and TyG-WC are associated with an increased risk of cardiac and renal disease, indicating enhanced diagnostic accuracy. These metrics provide an effective tool for identifying early cardiorenal disease and improving risk stratification.

摘要

背景

在美国人群中,甘油三酯 - 葡萄糖(TYG)及其综合肥胖指数与心肾疾病之间的关联研究尚不充分。

方法

本研究调查了2003 - 2018年美国国家健康与营养检查调查(NHANES)中11491名20岁及以上的美国成年人队列。为了探究TYG、甘油三酯 - 腰高比(TyG-WHtR)、甘油三酯 - 体重指数(TyG-BMI)、甘油三酯 - 腰围(TyG-WC)与慢性肾脏病(CKD)、心血管疾病(CVD)和心肾综合征(CRS)之间的关联,我们采用了加权多变量逻辑回归、受限立方样条(RCS)、受试者工作特征(ROC)和亚组分析。

结果

在对混杂因素进行调整后,CKD、CVD和CRS的患病可能性与TYG及其综合肥胖指数之间存在正相关。TYG指数与CKD的相关性最强(OR 1.42,95% CI 1.11,1.82;P = 0.007),而TyG-WHtR与CVD(OR 1.63,95% CI 1.19,2.22;P = 0.003)和CRS(OR 1.44,95% CI 1.00,2.08;P = 0.055)的相关性最强。RCS分析发现TYG及其综合肥胖指数与CKD之间存在非线性关联(总体P < 0.001,非线性P < 0.05),而与CVD和CRS的关联主要是线性的(总体P < 0.001,非线性P > 0.05)。基于ROC曲线,对于心脏和肾脏疾病,TyG-WHtR和TyG-WC比TYG是更可靠的诊断工具。根据亚组分析,TyG及其综合肥胖测量指标在较年轻个体(≤50岁)、男性和糖尿病患者中与CKD的关联更强(交互作用P = 0.05)。

结论

TyG-WHtR和TyG-WC与心脏和肾脏疾病风险增加相关,表明诊断准确性提高。这些指标为识别早期心肾疾病和改善风险分层提供了有效工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/15bf/11825323/9c522805ed68/fendo-16-1505808-g001.jpg

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