Associations between triglyceride-glucose index and risk of end-stage kidney disease and all-cause  mortality in patients with diabetic kidney disease

Yulin Hu

Associations between triglyceride-glucose index and risk of end-stage kidney disease and all-cause mortality in patients with diabetic kidney disease

14^th World Nephrology Conference
June 27-28, 2024 | Paris, France

Yulin Hu

Chongqing Medical University Affiliated Yongchuan Hospital, China

ScientificTracks Abstracts: J Clin Exp Nephrol

Abstract

The triglyceride-glucose index (TyG) has been suggested as a novel surrogate biomarker for insulin resistance and predicts adverse clinical outcomes in various chronic conditions. However, the association between TyG and risks of end-stage kidney diseases (ESKD), a common microvascular complication of diabetes, remains largely unknown. METHODS Data from a total of 279 patients with type 2 diabetic kidney disease with an estimated glomerular f iltration rate (eGFR) > 15ml/min/1.73m2 seeking medical attention between June 1, 2015 to October 31, 2022 were retrospectively collected and analyzed. ESKD were defined as an eGFR < 15ml/min/1.73m2 or dialysis or kidney transplantation. All-cause mortality was defined as death from any causes. The multivariate Cox proportional hazard regression model was applied to explore the predictive capacity for ESKD and all-cause mortality. RESULTS The receiver-operating characteristic curve suggested that the optimal cohort-specific cut-off points for TyG is 9.04. During a median of 54 (interquartile range 41-70) months follow-up, a total of 142 patients reached ESKD and and 39 patients died. The cumulative incidence of ESKD and all-cause mortality was significantly higher in patients with a TyG > 9.04 than those with a TyG ≤ 9.04 (P=0.007). After adjusting for clinical and laboratory test parameters, high TyG > 9.04 is still associated with a greater risk of ESKD (HR=4.02, 95% CI 2.04-6.53, P < 0.001) and all-cause mortality (HR=3.22, 95% CI 1.94-4.99, P < 0.001). Restricted cubic spline analyses indicated an S-shaped relationship between the TyG index and risk of ESKD or all-cause mortality (P for nonlinearity < 0.001). Subgroup analysis showed that patients with stage 1 and stage 2 chronic kidney disease showed more pronounced associations between TyG and risk of ESKD. CONCLUSION An elevated TyG is associated with an increased risk of ESKD and all-cause mortality in type 2 diabetic kidney disease, especially in those with relatively early chronic kidney stages. ny syndrome and to discuss our proposed clinical approach.