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Published on: October 2, 2020
Cardiovascular risk prediction in hemodialysis patients using the triglyceride-glucose index: a multicenter
Yu Ho Lee1, Seok Hui Kang2, Dae Kyu Kim3
1Division of Nephrology, Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea.
Insights
The Triglyceride-glucose (TyG) index indicates higher cardiovascular risk in hemodialysis patients. This index may help identify individuals needing closer monitoring for adverse cardiac events.
Area of Science:
- Nephrology
- Cardiology
- Metabolic Syndrome
Background:
- Insulin resistance is a growing concern in hemodialysis patients.
- The Triglyceride-glucose (TyG) index is a novel marker for insulin resistance.
- The clinical utility of the TyG index in hemodialysis patients is currently unknown.
Purpose of the Study:
- To investigate the association between the TyG index and cardiovascular (CV) disease risk in patients undergoing maintenance hemodialysis.
- To explore the relationship between the TyG index and vascular pathology markers.
- To determine if the TyG index can predict adverse CV outcomes in this population.
Main Methods:
- A prospective study enrolled 759 hemodialysis patients.
- Participants were categorized into tertiles based on baseline TyG index.
- Echocardiographic parameters, vascular calcification scores, and plasma biomarkers were assessed.
Main Results:
- The TyG index positively correlated with endostatin and vascular adhesion protein-1.
- No correlation was found between the TyG index and vascular calcification or echocardiographic parameters.
- Patients in the highest TyG index tertile had significantly higher cumulative rates of CV and cardiac events.
Conclusions:
- The TyG index is linked to vascular pathology markers in hemodialysis patients.
- Elevated TyG index is associated with an increased risk of adverse CV outcomes.
- The TyG index may serve as a valuable tool for identifying high-CV risk individuals in hemodialysis settings.
Background:
Triglyceride-glucose (TyG) index has recently been established as an indicator of insulin resistance and has predictive value for cardiovascular (CV) disease. However, the clinical significance of the TyG index in patients undergoing hemodialysis remains unknown.
Methods:
We prospectively enrolled 759 patients undergoing maintenance hemodialysis. The participants were divided into tertiles based on their baseline TyG index. Echocardiographic parameters, vascular calcification scores, and several plasma biomarkers were obtained and compared using the TyG index.
Results:
The TyG index was positively correlated with levels of circulating vascular pathologic markers, endostatin (ρ = 0.134, P = .025) and vascular adhesion protein-1 (ρ = 0.130, P = .012), but not with vascular calcification score. The TyG index was not correlated with any echocardiographic parameters. Patients in tertile 3 showed the highest cumulative event rates of CV and cardiac events (P < .001 and P = .001, respectively). In the multivariable Cox regression analysis, patients in the TyG index tertile 3 had a significantly increased risk of CV and cardiac events compared to those in the TyG index tertile 1 [adjusted hazard ratio (HR): 1.89, 95% confidence interval (CI): 1.08-3.30, and adjusted HR: 2.01, 95% CI: 1.05-3.82, respectively]. A 1 standard deviation increase in the TyG index was also associated with significantly higher risks of CV and cardiac events.
Conclusions:
The TyG index was associated with vascular pathology markers and an increased risk of adverse CV outcomes in patients undergoing hemodialysis. Our study suggests that the TyG index has the potential to assist clinicians in identifying a high CV risk in hemodialysis patients.
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