Triglyceride-glucose index is an independent predictor of coronary artery calcification progression in patients with chronic kidney disease.

IF 2.9 3区医学 Q1 UROLOGY & NEPHROLOGY Kidney Research and Clinical Practice Pub Date : 2024-05-01 Epub Date: 2024-03-18 DOI:10.23876/j.krcp.23.264

Ye Eun Ko, Hyung Woo Kim, Jung Tak Park, Seung Hyeok Han, Shin-Wook Kang, Suah Sung, Kyu-Beck Lee, Joongyub Lee, Kook-Hwan Oh, Tae-Hyun Yoo

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Abstract

Background: Coronary artery calcification (CAC) is highly prevalent in patients with chronic kidney disease (CKD) and is associated with major adverse cardiovascular events and metabolic disturbances. The triglyceride-glucose index (TyGI), a novel surrogate marker of metabolic syndrome and insulin resistance, is associated with CAC in the general population and in patients with diabetes. This study investigated the association between the TyGI and CAC progression in patients with CKD, which is unknown.

Methods: A total of 1,154 patients with CKD (grades 1-5; age, 52.8 ± 11.9 years; male, 688 [59.6%]) were enrolled from the KNOWCKD (KoreaN Cohort Study for Outcomes in Patients With Chronic Kidney Disease). The TyGI was calculated as follows: ln (fasting triglycerides × fasting glucose/2). Patients were classified into tertiles (low, intermediate, high) based on the TyGI. The primary outcome was annualized percentage change in CAC score [(percent change in CAC score + 1)12/follow-up months - 1] of ≥15%, defined as CAC progression.

Results: During the 4-year follow-up, the percentage of patients with CAC progression increased across TyGI groups (28.6%, 37.5%, and 46.2% in low, intermediate, and high groups, respectively; p < 0.001). A high TyGI was associated with an increased risk of CAC progression (odds ratio [OR], 2.11; 95% confidence interval [CI], 1.14-3.88; p = 0.02) compared to the low group. Moreover, a 1-point increase in the TyGI was related to increased risk of CAC progression (OR, 1.55; 95% CI, 1.06-1.76; p = 0.02) after adjustment.

Conclusion: A high TyGI may be a useful predictor of CAC progression in CKD.

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甘油三酯-葡萄糖指数是慢性肾病患者冠状动脉钙化进展的独立预测指标。

背景：冠状动脉钙化（CAC）在慢性肾脏病（CKD）患者中非常普遍，并与重大不良心血管事件和代谢紊乱有关。甘油三酯-葡萄糖指数（TyGI）是代谢综合征和胰岛素抵抗的新型替代指标，在普通人群和糖尿病患者中与 CAC 相关。本研究调查了CKD患者的TyGI与CAC进展之间的关系：KNOW-CKD（韩国慢性肾病患者结局队列研究）共招募了 1,154 名 CKD 患者（1-5 级；年龄，52.8 ± 11.9 岁；男性，688 [59.6%]）。TyGI的计算方法如下：ln（空腹甘油三酯×空腹血糖/2）。根据 TyGI 将患者分为三等分（低、中、高）。主要结果是CAC评分的年化百分比变化[（CAC评分百分比变化+1）12/随访月-1]≥15%，定义为CAC进展：在为期4年的随访中，不同TyGI组别中CAC进展患者的比例均有所上升（低、中、高组别分别为28.6%、37.5%和46.2%；P < 0.001）。与低TyGI组相比，高TyGI与CAC进展风险增加相关（几率比[OR]，2.11；95%置信区间[CI]，1.14-3.88；P = 0.02）。此外，经调整后，TyGI每升高1分，CAC恶化的风险就会增加（OR，1.55；95% CI，1.06-1.76；P = 0.02）：结论：高TyGI可能是CKD患者CAC进展的有效预测指标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Kidney Research and Clinical Practice UROLOGY & NEPHROLOGY-

CiteScore

4.60

自引率

10.00%

发文量

审稿时长

10 weeks

期刊介绍： Kidney Research and Clinical Practice (formerly The Korean Journal of Nephrology; ISSN 1975-9460, launched in 1982), the official journal of the Korean Society of Nephrology, is an international, peer-reviewed journal published in English. Its ISO abbreviation is Kidney Res Clin Pract. To provide an efficient venue for dissemination of knowledge and discussion of topics related to basic renal science and clinical practice, the journal offers open access (free submission and free access) and considers articles on all aspects of clinical nephrology and hypertension as well as related molecular genetics, anatomy, pathology, physiology, pharmacology, and immunology. In particular, the journal focuses on translational renal research that helps bridging laboratory discovery with the diagnosis and treatment of human kidney disease. Topics covered include basic science with possible clinical applicability and papers on the pathophysiological basis of disease processes of the kidney. Original researches from areas of intervention nephrology or dialysis access are also welcomed. Major article types considered for publication include original research and reviews on current topics of interest. Accepted manuscripts are granted free online open-access immediately after publication, which permits its users to read, download, copy, distribute, print, search, or link to the full texts of its articles to facilitate access to a broad readership. Circulation number of print copies is 1,600.