Liang Jing-Hua, Wang Leng-Meng, Song Shu-Fen, Yu Cong, Chen Xing-Lin, Yu Jin-Rong, Chen Ya-Ling, Xia Hu-Lu
Department of Paediatrics, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Sungang West Road No. 3002, Shenzhen, 518035, Guangdong Province, China.
Department of Obstetrics, Gynecology and Paediatrics, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Sungang West Road No. 3002, Shenzhen, 518035, Guangdong Province, China.
Sci Rep. 2025 Apr 1;15(1):11149. doi: 10.1038/s41598-024-83093-0.
Previous studies have shown that an elevated triglyceride-glucose (TyG) index is associated with all-cause mortality in patients. However, the potential mediating effect of blood urea nitrogen (BUN) within these associations has not been reported. The focus of this study was to investigate the potential mediating effect of BUN within these associations. This was a retrospective cohort study of patients in the eICU Collaborative Research Database (eICU-CRD) from 208 different ICUs in the United States between 2014 and 2015 that explored. The primary endpoint of the study was all-cause mortality within 28 days of ICU admission. In addition, the following formula was used to calculate the TyG index: Ln [fasting TG (mg/dL) × FBG (mg/dL)/2]. Cox regression model and subgroup analysis were performed to assess the associations of TyG index with 28-day mortality. The mediating effect of BUN was assessed to investigate the potential mechanism of the associations between TyG index and mortality using the mediation package in R 4.2.0. Of the 14,414 patients with a mean age of 64.1 years, 809 (5.61%) died within 28 days of ICU admission. The proportion of women was 57.9% and the mean TyG index was 8.97 ± 0.82. In the multivariable-adjusted model, the high tertile showed an even stronger association with 28-day ICU mortality than the low tertile, with a hazard ratio (HR) of 1.27 (95% CI: 1.05, 1.53; P = 0.014). Mediation analysis showed that BUN mediated 12.4% of the association between the TyG index and mortality. Our study showed that an elevated TyG index was associated with an increased risk of mortality in critically ill patients. The association appeared to be partially mediated by BUN.
先前的研究表明，甘油三酯-葡萄糖（TyG）指数升高与患者的全因死亡率相关。然而，这些关联中血尿素氮（BUN）的潜在中介作用尚未见报道。本研究的重点是调查BUN在这些关联中的潜在中介作用。这是一项对2014年至2015年间美国208个不同重症监护病房（ICU）的eICU协作研究数据库（eICU-CRD）中的患者进行的回顾性队列研究。该研究的主要终点是ICU入院28天内的全因死亡率。此外，使用以下公式计算TyG指数：Ln[空腹甘油三酯（mg/dL）×空腹血糖（mg/dL）/2]。进行Cox回归模型和亚组分析以评估TyG指数与28天死亡率的关联。使用R 4.2.0中的中介分析包评估BUN的中介作用，以研究TyG指数与死亡率之间关联的潜在机制。在14414名平均年龄为64.1岁的患者中，809名（5.61%）在ICU入院28天内死亡。女性比例为57.9%，平均TyG指数为8.97±0.82。在多变量调整模型中，高三分位数与28天ICU死亡率的关联比低三分位数更强，风险比（HR）为1.27（95%CI：1.05，1.53；P = 0.014）。中介分析表明，BUN介导了TyG指数与死亡率之间12.4%的关联。我们的研究表明，TyG指数升高与危重症患者的死亡风险增加相关。这种关联似乎部分由BUN介导。
