Association between triglyceride-glucose index and cardiovascular disease in US adults with chronic kidney disease: a
Lijia Liu1,2, Hui Sun1,2, Lan Yi1
1Department of Nephrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China.
Insights
The Triglyceride-glucose (TyG) index is linked to a higher risk of cardiovascular disease (CVD) in chronic kidney disease (CKD) patients. This association, particularly evident in later CKD stages, suggests TyG index utility for CVD risk assessment.
Area of Science:
- Cardiology
- Nephrology
- Metabolic Syndrome
Background:
- The Triglyceride-glucose (TyG) index is a recognized marker for insulin resistance and has shown predictive value for cardiovascular disease (CVD).
- The relationship between the TyG index and CVD in patients with chronic kidney disease (CKD) remains underexplored.
- Understanding this association is crucial for managing CVD risk in the CKD population.
Purpose of the Study:
- To investigate the association between the TyG index and the prevalence of CVD among individuals with CKD in the United States.
- To explore potential nonlinear relationships and threshold effects of the TyG index on CVD in CKD patients.
- To examine how factors like CKD stage modify the relationship between the TyG index and CVD.
Main Methods:
- Utilized data from 3507 participants in the National Health and Nutrition Examination Survey (2003-2018) with CKD.
- Employed multivariable logistic regression and smooth curve fitting to analyze the TyG index-CVD association.
- Conducted subgroup and interaction analyses to assess the moderating role of CKD stage and other factors.
Main Results:
- A significant, independent, and positive association was found between the TyG index and CVD in the CKD population (OR 1.213).
- A nonlinear relationship with a threshold effect was observed at a TyG index of 8.98.
- The association was stronger in later stages of CKD (OR 2.131 for stages 4-5) and significant for coronary heart disease (CHD).
Conclusions:
- The TyG index is positively associated with CVD risk in CKD patients, especially those with eGFR < 60 mL/min/1.73 m².
- A threshold effect exists, highlighting specific TyG index values of concern.
- The TyG index shows potential as a screening and risk assessment tool for CVD in the CKD population.
Objectives:
Triglyceride-glucose (TyG) index, which is a valuable measure of insulin resistance, has been found to have predictive value for cardiovascular disease (CVD). However, its relationship with CVD among individuals with chronic kidney disease (CKD) has not been thoroughly investigated. This study focused on examining the relationship of the TyG index and CVD among CKD patients in United States.
Methods:
3507 eligible participants from the National Health and Nutrition Examination Survey (2003-2018) were surveyed in this study. Methods such as multivariable logistic regression analysis and smooth curve fitting were employed to estimate how the TyG index is linked to CVD in CKD populations. Subgroup and interaction analyses were conducted in order to figure out potential moderating effects of various factors.
Results:
In this cross-sectional study which based on a population with CKD, 29.5% of patients also had CVD. An independent and positive link of TyG and CVD was revealed (OR 1.213, 95% CI 1.059, 1.389). This association was nonlinear, with a threshold effect observed at a TyG index of 8.98. The results of subgroup analysis suggested that the relationships of TyG and CVD differed according to CKD stage: (OR 1.048, 95% CI 0.857, 1.282) in CKD stages 1-2; (OR 1.267, 95% CI 1.030-1.560) in stage 3; and (OR 2.131, 95% CI 1.224-3.709) in stages 4-5. Interaction analyses further suggested the potential moderating effects of CKD stage. Additionally, among specific CVD types, only coronary heart disease (CHD) had a significant and positive relationship with TyG (OR 1.617, 95% CI 1.123, 2.327).
Conclusions:
TyG index was identified to be independently and positively related to the likelihood of CVD, specifically in populations with an eGFR < 60 mL/min/1.73 m². The association had a threshold effect. The results highlight the potential of the TyG index as a tool for screening and risk assessment of CVD in populations suffering from CKD, warranting further investigation.
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