Zhu Fan, Gan Wenyuan, Mao Huihui, Nie Sheng, Zeng Xingruo, Chen Wenli
Department of Nephrology, Tongji Medical College, The Central Hospital of Wuhan, Huazhong University of Science and Technology, Wuhan, Hubei, 430014, China.
Division of Nephrology, State Key Laboratory of Organ Failure Research, National Clinical Research Center for Kidney Disease, Nanfang Hospital, Medical University, 1838 North Guangzhou Avenue, Southern, Guangzhou, 510515, China.
Sci Rep. 2025 Aug 5;15(1):28538. doi: 10.1038/s41598-025-14057-1.
The association between the triglyceride-glucose (TyG) index and the risk of major adverse cardiovascular events (MACE) in patients with chronic kidney disease (CKD) stages 3-4 has not been extensively studied. This study aims to investigate the relationship between baseline TyG index and MACE risk in a CKD stage 3-4 population. This study utilized data from the 2000-2022 China Renal Data System. Multivariate regression analysis models were constructed to explore the association between baseline TyG index and MACE. We employed restricted cubic splines to examine potential nonlinear correlations between these variables. Subgroup analyses were performed for different clinical endpoints. A total of 48,935 participants with CKD stages 3-4 were enrolled, with a mean TyG index of 8.88 [8.45, 9.38]. Participants were divided into quartiles based on TyG index values (quartile thresholds: 8.33, 8.78, 9.24). The overall prevalence of MACE was 15.90%. Multivariate Cox regression indicated a significant association between TyG quartiles and MACE occurrence, with hazard ratios (HR) of 1.08 (95% CI: 1.01-1.15, p = 0.016) for Quartile 1 and 1.12 (95% CI: 1.05-1.20, p = 0.001) for Quartile 4. Restricted cubic spline analysis revealed a nonlinear relationship between TyG index and MACE risk (P for nonlinearity < 0.001) among individuals with CKD stages 3-4. In patients with CKD stages 3-4, the TyG index shows a nonlinear association with the risk of MACE and all-cause mortality. These findings suggest that both elevated and reduced TyG index levels may increase the likelihood of MACE and all-cause mortality.
慢性肾脏病（CKD）3-4期患者的甘油三酯-葡萄糖（TyG）指数与主要不良心血管事件（MACE）风险之间的关联尚未得到广泛研究。本研究旨在调查CKD 3-4期人群中基线TyG指数与MACE风险之间的关系。本研究利用了2000-2022年中国肾脏数据系统的数据。构建多变量回归分析模型以探索基线TyG指数与MACE之间的关联。我们采用受限立方样条来检验这些变量之间潜在的非线性相关性。针对不同的临床终点进行亚组分析。共纳入48935例CKD 3-4期参与者，平均TyG指数为8.88[8.45，9.38]。参与者根据TyG指数值分为四分位数（四分位数阈值：8.33、8.78、9.24）。MACE的总体患病率为15.90%。多变量Cox回归表明TyG四分位数与MACE发生之间存在显著关联，第一四分位数的风险比（HR）为1.08（95%CI：1.01-1.15，p = 0.016），第四四分位数的HR为1.12（95%CI：1.05-1.20，p = 0.001）。受限立方样条分析显示CKD 3-4期个体中TyG指数与MACE风险之间存在非线性关系（非线性p<0.001）。在CKD 3-4期患者中，TyG指数与MACE风险和全因死亡率呈非线性关联。这些发现表明，TyG指数水平的升高和降低都可能增加MACE和全因死亡率的可能性。
