南京市老年人群甘油三酯-葡萄糖乘积指数与慢性肾脏病的相关性研究

Correlation between triglyceride-glucose index and chronic kidney disease in the elderly population in Nanjing

目的调查老年人群甘油三酯-葡萄糖乘积(TyG)指数与估算的肾小球滤过率(eGFR)下降风险的关系,探讨其作为简易的胰岛素抵抗(IR)指标预测慢性肾脏病(CKD)风险的价值。方法本研究纳入了2019年参与健康体检的5946名老年人(平均年龄为70.54岁,63.2%为男性)。通过横断面研究,采用多因素Logistic回归分析和分层分析探讨TyG指数与CKD的相关性,并绘制预测CKD的ROC。结果5946名老年受试者中,CKD的发生率为4.6%。多因素Logistic回归模型显示,TyG指数是CKD发生的危险因素,进一步调整性别、年龄、高血压、BMI后,TyG指数与CKD的发病风险仍存在显著相关性。此外,TyG指数和CKD之间的关联在不同年龄、性别、肥胖或高血压分层中是一致的。经ROC曲线分析,TyG指数和临床危险因素(年龄、性别、肥胖或高血压)对CKD的发生具有一定的预测价值,其AUC分别为0.579、0.774;进一步研究发现,TyG指数结合临床危险因素的预测效果显著优于单独的预测效果,其AUC为0.791。结论在南京市老年人群中,TyG指数作为简易指标对于预测CKD风险有一定的价值。

Objective To investigate the relationship between triglyceride-glucose index(TyG index)and the risk of evalucated glomerular filtration rate(eGFR)in the elderly population,and to explore its value as a simple indicator of insulin resistance(IR)in predicting the risk of chronic kidney disease(CKD).Methods A total of 5946 elderly patients(mean age:70.54 years old,male account for 63.2%)who participated in physical examination from January to December 2019 were enrolled in this study.Through cross-sectional study,multi-factor Logistic regression and stratified analysis were used to explore the correlation between TyG index and CKD,and the receiver operating characteristic(ROC)curve predicting CKD was drawn.Results In 5946 subjects aged≥60 years,the incidence rate of CKD was 4.6%.Multi-factor Logistic regression model showed that TyG index was a risk factor for CKD.After adjusting sex,age,hypertension and body mass index(BMI),there was still a significant correlation between elevated TyG index and the risk of CKD.ROC curve analysis showed that TyG index and the clinical factors including age,sex,obesity and hypertension had a certain value in evaluating the occurrence of CKD,and the area under the curve(AUC)was 0.579 and 0.774,respectively.Further study showed that the predictive effect of TyG index combined with clinical factors was significantly better,and the AUC was 0.791.Conclusions As a simple index,TyG index has certain value in predicting the risk of CKD in the elderly population in Nanjing.