Wang Xiaopu, Zheng Keyang, Hu Xinqun, Pei Junyu
Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; The Libin Cardiovascular Institute of Alberta, Cumming School of Medicine, The University of Calgary, Calgary, Alberta, Canada.
Department of General Practice, Beijing Nuclear Industry Hospital, Beijing 100045, China.
Diabetes Res Clin Pract. 2025 Jun;224:112163. doi: 10.1016/j.diabres.2025.112163. Epub 2025 Apr 16.
The triglyceride-glucose (TyG) index has emerged as a surrogate marker for insulin resistance and is associated with the incidence and progression of chronic kidney disease (CKD) in patients with type 2 diabetes.
Data from the ACCORD trial were used. The Cox proportional hazards model was employed to calculate hazard ratios (HRs), while generalized additive mixed models were used to capture the non-linear eGFR slope in each group. The primary outcome was CKD.
9360 participants were included in this study, divided into tertiles based on their TyG index, with 3 119, 3 121, and 3 120 individuals in T1 (low), T2 (medium), and T3 (high), respectively. After a median follow-up of 4 years, 1 229 cases of CKD (13.30 %) occurred. Among women rather than men, CKD risk increased across ascending TyG index groups (adjusted HR for T3, Model 3, 1.46 [95 % CI, 1.13-1.88]) (p for interaction = 0.03). Additionally, longitudinal analysis revealed a rapid eGFR decline in women in the T3 group (-4.79 mL/min/1.73 m) than the T1 group (-3.07 mL/min/1.73 m, p < 0.05), but not in men.
A higher TyG index was associated with elevated CKD risk and accelerated eGFR decline, particularly in women.
甘油三酯-葡萄糖（TyG）指数已成为胰岛素抵抗的替代指标，并与2型糖尿病患者慢性肾脏病（CKD）的发生和进展相关。
使用了ACCORD试验的数据。采用Cox比例风险模型计算风险比（HRs），同时使用广义相加混合模型来捕捉每组中估算肾小球滤过率（eGFR）的非线性斜率。主要结局为CKD。
本研究纳入9360名参与者，根据TyG指数分为三分位数，T1（低）、T2（中）和T3（高）组分别有3119、3121和3120人。中位随访4年后，发生1229例CKD（13.30%）。在女性而非男性中，CKD风险随TyG指数升高组增加（T3组校正HR，模型3，1.46[95%CI，1.13 - 1.88]）（交互作用p = 0.03）。此外，纵向分析显示，T3组女性的eGFR下降速度（-4.79 mL/min/1.73m²）比T1组（-3.07 mL/min/1.73m²，p < 0.05）快，但男性并非如此。
较高的TyG指数与CKD风险升高和eGFR下降加速相关，尤其是在女性中。
