Li Chen, Lv Xingping, Shen Yezhou, Zhou Wei, Shen Tuo, Fan Guoliang, Zhu Feng
Department of Critical Care Medicine, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China.
Front Cardiovasc Med. 2025 May 9;12:1572096. doi: 10.3389/fcvm.2025.1572096. eCollection 2025.
The triglyceride-glucose (TyG) index, indicative of insulin resistance, is recognized for predicting cardiovascular disease and metabolic disorders, notably kidney disease. In coronary artery bypass grafting (CABG) surgery, its association with postoperative renal injury is significant, suggesting its potential as a predictor for acute kidney injury (AKI) in these patients.
This single-center, retrospective study included 296 patients. Patients were divided into AKI and non-AKI groups postoperatively according to the KDIGO grading criteria. Multiple linear regression was employed to identify factors influencing the TyG index. Logistic regression was utilized to examine the TyG index's association with AKI in CABG patients. The TyG index's predictive power for postoperative AKI was assessed using receiver operating characteristic (ROC) curve analysis. Assessment of the Predictive Performance of the Prediction Model via Calibration plot and Clinical Decision Curve Analysis.
In comparison between the AKI group and the non- AKI group post-CABG surgery, there was statistically significant differences in TyG index [7.53 [7.25, 7.95] vs. 6.99 [6.64, 7.39], < 0.05]. Logistic regression analysis indicated that for each unit increase in the TyG index, the odds of developing acute kidney injury post-CABG surgery increased by 30.573 times [odds ratio (OR) = 30.573, 95% confidence interval (CI) 3.930-237.807, < 0.001]. The area under the curve (AUC) for the TyG index in predicting postoperative AKI in CABG patients was 0.802 ( < 0.001; 95% CI: 0.753-0.851). The calibration plot of the model closely approximated the ideal diagonal line, and the clinical decision curve analysis demonstrated favorable clinical applicability.
Elevated levels of the TyG index are closely associated with the occurrence of AKI in patients following CABG surgery, and the TyG index is a potential indicator for the development of AKI post-CABG.
甘油三酯-葡萄糖（TyG）指数可反映胰岛素抵抗，在预测心血管疾病和代谢紊乱（尤其是肾脏疾病）方面已得到认可。在冠状动脉旁路移植术（CABG）手术中，其与术后肾损伤的关联显著，提示其在预测这些患者急性肾损伤（AKI）方面的潜力。
本单中心回顾性研究纳入了296例患者。术后根据KDIGO分级标准将患者分为AKI组和非AKI组。采用多元线性回归确定影响TyG指数的因素。利用逻辑回归分析CABG患者中TyG指数与AKI的关联。通过受试者工作特征（ROC）曲线分析评估TyG指数对术后AKI的预测能力。通过校准图和临床决策曲线分析评估预测模型的预测性能。
CABG术后AKI组与非AKI组相比，TyG指数存在统计学显著差异[7.53[7.25，7.95]对6.99[6.64，7.39]，<0.05]。逻辑回归分析表明，TyG指数每增加一个单位，CABG术后发生急性肾损伤的几率增加30.573倍[比值比（OR）=30.573，95%置信区间（CI）3.930 - 237.807，<0.001]。TyG指数预测CABG患者术后AKI的曲线下面积（AUC）为0.802（<0.001；95%CI：0.753 - 0.851）。模型的校准图与理想对角线密切近似，临床决策曲线分析显示出良好的临床适用性。
TyG指数升高与CABG术后患者AKI的发生密切相关，TyG指数是CABG术后AKI发生的潜在指标。
