Relationship between triglyceride-glucose index and diabetic kidney disease
Objective To explore the relationship between triglyceride-glucose(TyG)index and diabetic kidney disease(DKD).Methods A total of 895 patients with type 2 diabetes(T2D)who treated at Jinhua Central Hospital from September 2021 to October 2022 were included in the study,including 297 cases with DKD(DKD group)and 598 cases without DKD(control group).The general data from two groups of patients were collected,and laboratory indicators such as the TyG index were tested.The patients were divided into four groups based on the quartiles of the TyG index:Q1,Q2,Q3 and Q4.Logistic regression analysis was used to identify risk factors for DKD,and TyG index quartile group comparisons were conducted.Restricted cubic spline(RCS)analysis was used to examine the relationship between DKD risk and TyG index,and the optimal cut-off point for the non-linear relationship between DKD and TyG index was determined using the R package CatPredi algorithm,followed by threshold effect analysis.Results Compared to the control group,the DKD group had higher age,higher proportion of hypertension,angiotensin-converting enzyme inhibitors/angiotensin Ⅱ receptor blocker therapy and insulin therapy,longer duration of diabetes,higher systolic blood pressure and body mass index,higher triglycerides,TyG index,uric acid,and serum creatinine levels(all P<0.05).Quartile analysis of TyG index showed that compared to patients in the Q1 of TyG index,those in Q4 had a significantly higher risk of DKD(OR=2.13,95%CI:1.29~3.51,P=0.003).RCS analysis revealed a non-linear relationship between DKD and TyG index,with Pron_linear=0.019.The CatPredi algorithm determined the optimal cut-off value of TyG index for this relationship to be 9.35.When TyG index>9.35,for each 1 unit increase in TyG index,the risk of DKD increased by 1.15 folds(OR=2.15,95%CI:1.21~3.82,P=0.009).Conclusion There is a non-linear relationship between TyG index and DKD.When TyG index is low,the DKD risk remains stable at a low level;while it shows a significant upward trend,when TyG index exceeds 9.35,suggesting that early monitoring and control of high TyG index may help to reduce the risk of DKD.
Type 2 diabetesDiabetic kidney diseaseTriglyceride-glucose indexNon-linear relationship