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Triglyceride glucose-body mass index and cardiovascular mortality in patients undergoing peritoneal dialysis: a
Cuixia Zhan1,2, Yuan Peng1,2,3, Hongjian Ye1,2
1Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, 58th, Zhongshan Road II, Guangzhou, 510080, China.
Insights
A higher triglyceride glucose-body mass index (TyG-BMI) is linked to increased cardiovascular disease (CVD) and overall mortality risk in patients undergoing peritoneal dialysis (PD). This finding highlights TyG-BMI as a potential predictor for mortality in this vulnerable population.
Area of Science:
- Nephrology
- Cardiology
- Metabolic Syndrome
Background:
- Triglyceride glucose-body mass index (TyG-BMI) is an emerging marker for metabolic dysfunction.
- Previous research links TyG-BMI to cardiovascular disease (CVD) and ischemic stroke.
- The association between TyG-BMI and CVD mortality in peritoneal dialysis (PD) patients remains understudied.
Purpose of the Study:
- To investigate the relationship between baseline TyG-BMI and CVD mortality in southern Chinese PD patients.
- To assess TyG-BMI as a predictor of all-cause mortality in this cohort.
Main Methods:
- A single-center retrospective cohort study included 2,335 incident PD patients (2006-2018).
- TyG-BMI was calculated using fasting plasma glucose, triglyceride, and BMI.
- Multivariate-adjusted Cox proportional hazard regression models were used to evaluate mortality risks.
Main Results:
- The cohort (median age 46.1 years, 59.2% male, 24.2% diabetic) had a median TyG-BMI of 183.7.
- During a median follow-up of 46.6 months, 615 deaths occurred, with 297 from CVD.
- Higher TyG-BMI was independently associated with increased CVD mortality (HR 1.51) and all-cause mortality (HR 1.36).
- A 1 SD increase in TyG-BMI correlated with a 28% higher CVD mortality risk and 19% higher all-cause mortality risk.
Conclusions:
- Elevated baseline TyG-BMI is an independent predictor of CVD and all-cause mortality in PD patients.
- TyG-BMI may serve as a valuable risk stratification tool for PD patients.
- Further research should explore interventions to modify TyG-BMI in this population.
Background:
Recent studies have shown that triglyceride glucose-body mass index (TyG-BMI) is associated with the risk of ischemic stroke and coronary artery disease. However, little attention has been given to the association between TyG-BMI and cardiovascular disease (CVD) mortality in patients undergoing peritoneal dialysis (PD). Therefore, this study aimed to explore the relationship between TyG-BMI and CVD mortality in southern Chinese patients undergoing PD.
Methods:
Incident patients receiving PD from January 1, 2006, to December 31, 2018, with baseline serum triglyceride, glucose, and body mass index (BMI) information, were recruited for this single-center retrospective cohort study. TyG-BMI was calculated based on fasting plasma glucose, triglyceride, and BMI values. The association between TyG-BMI, CVD and all-cause mortality was evaluated using a multivariate-adjusted Cox proportional hazard regression model.
Results:
Of 2,335 patients, the mean age was 46.1 ± 14.8 years; 1,382 (59.2%) were male, and 564 (24.2%) had diabetes. The median TyG-BMI was 183.7 (165.5-209.2). Multivariate linear regression showed that advanced age, male sex, history of CVD, higher levels of albumin and low-density lipoprotein cholesterol, and higher urine output were correlated with a higher TyG-BMI (P < 0.05). During a median follow-up period of 46.6 (22.4-78.0) months, 615 patients died, of whom 297 (48.2%) died as a result of CVD. After adjusting for demographics and comorbidities, TyG-BMI was significantly associated with an increased risk of CVD mortality (hazard ratio [HR] 1.51, 95% confidence interval [CI] 1.05-2.17) and all-cause mortality (HR 1.36, 95% CI 1.05-1.75). After full adjustment, the 28% risk of CVD mortality (HR 1.28, 95% CI 1.13-1.45) and 19% risk of all-cause mortality were elevated (HR 1.19, 95% CI 1.09-1.31) when TyG-BMI increased by 1 stand deviation (SD) (34.2).
Conclusions:
A higher baseline TyG-BMI was independently associated with an increased risk of CVD and all-cause mortality in patients receiving PD.
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