Lee Yu Ho, Kang Seok Hui, Kim Dae Kyu, Kim Jin Sug, Jeong Kyung Hwan, Kim Yang Gyun, Lee Dong-Young, Ahn Shin Young, Chung Sungjin, Sun In O, Lee Min-Jeong, Hwang Hyeon Seok
Division of Nephrology, Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea.
Department of Nephrology, Department of Internal Medicine, Yeungnam University Medical Center, Daegu, Republic of Korea.
Clin Kidney J. 2025 Jan 20;18(3):sfaf016. doi: 10.1093/ckj/sfaf016. eCollection 2025 Mar.
Triglyceride-glucose (TyG) index has recently been established as an indicator of insulin resistance and has predictive value for cardiovascular (CV) disease. However, the clinical significance of the TyG index in patients undergoing hemodialysis remains unknown.
We prospectively enrolled 759 patients undergoing maintenance hemodialysis. The participants were divided into tertiles based on their baseline TyG index. Echocardiographic parameters, vascular calcification scores, and several plasma biomarkers were obtained and compared using the TyG index.
The TyG index was positively correlated with levels of circulating vascular pathologic markers, endostatin ( = 0.134, = .025) and vascular adhesion protein-1 ( = 0.130, = .012), but not with vascular calcification score. The TyG index was not correlated with any echocardiographic parameters. Patients in tertile 3 showed the highest cumulative event rates of CV and cardiac events (< .001 and = .001, respectively). In the multivariable Cox regression analysis, patients in the TyG index tertile 3 had a significantly increased risk of CV and cardiac events compared to those in the TyG index tertile 1 [adjusted hazard ratio (HR): 1.89, 95% confidence interval (CI): 1.08-3.30, and adjusted HR: 2.01, 95% CI: 1.05-3.82, respectively]. A 1 standard deviation increase in the TyG index was also associated with significantly higher risks of CV and cardiac events.
The TyG index was associated with vascular pathology markers and an increased risk of adverse CV outcomes in patients undergoing hemodialysis. Our study suggests that the TyG index has the potential to assist clinicians in identifying a high CV risk in hemodialysis patients.
甘油三酯-葡萄糖（TyG）指数最近已被确立为胰岛素抵抗的指标，并且对心血管（CV）疾病具有预测价值。然而，TyG指数在接受血液透析的患者中的临床意义仍不明确。
我们前瞻性纳入了759例接受维持性血液透析的患者。根据患者的基线TyG指数将其分为三分位数。获取超声心动图参数、血管钙化评分和几种血浆生物标志物，并使用TyG指数进行比较。
TyG指数与循环血管病理标志物、内皮抑素（r = 0.134，P = 0.025）和血管黏附蛋白-1（r = 0.130，P = 0.012）的水平呈正相关，但与血管钙化评分无关。TyG指数与任何超声心动图参数均无相关性。三分位数3的患者显示出最高的心血管和心脏事件累积发生率（分别为P < 0.001和P = 0.001）。在多变量Cox回归分析中，与TyG指数三分位数1的患者相比，TyG指数三分位数3的患者发生心血管和心脏事件的风险显著增加[调整后的风险比（HR）：1.89，95%置信区间（CI）：1.08 - 3.30，以及调整后的HR：2.01，95% CI：1.05 - 3.82]。TyG指数增加1个标准差也与心血管和心脏事件的风险显著升高相关。
TyG指数与接受血液透析患者的血管病理标志物以及不良心血管结局风险增加相关。我们的研究表明，TyG指数有可能帮助临床医生识别血液透析患者的高心血管风险。
