改良甘油三酯葡萄糖指数与社区中老年人群慢性肾脏病的相关性研究

Association of Triglyceride Glucose Index and Its Combined Obesity Indices in Chronic Kidney Disease in Community Population

目的 探讨甘油三酯葡萄糖指数(TyG)及其结合肥胖指标的改良TyG指数与社区人群慢性肾脏病(CKD)的相关性。方法 以2021年6月1日至2021年12月30日于北京市通州区永顺卫生服务中心体检的45岁以上常住居民6 274例作为研究对象,对受试者进行病史采集、体格检查以及实验室检查,获得体重指数(BMI)、腰围(WC)和腰高比(WHtR),并分别与TyG相乘计算出TyG-BMI、TyG-WC和TyG-WHtR。采用多因素logistic回归模型、限制性立方样条拟合logistic回归模型和ROC曲线评价各指标与CKD的关联。结果 与非CKD人群相比,CKD患者TyG、TyG-BMI、TyGWC和TyG-WHtR较高(P<0.05)。其中TyG-WHtR对CKD的预测价值最大(曲线下面积为0.648,95%CI:0.612~0.683),其次是TyG-WC。多因素logistic回归模型分析显示TyG、TyG-BMI、TyG-WC和TyG-WHtR均与CKD的发生呈正相关(P<0.05)。限制性立方样条拟合logistic回归分析显示各指标均与CKD呈线性关联(P>0.05)。亚组分析显示,各指标的较高水平四分位分类变量(Q3和Q4)与CKD存在显著关联(P<0.05),且4个研究指标均为男性、女性及中、老年人群CKD发生的独立危险因素(P<0.05)。结论 较高水平的TyG、TyG-BMI、TyG-WC和TyG-WHtR与社区人群CKD的发生呈正相关,其中TyG-WHtR更具优越性。

Objective To explore the relationship between triglyceride glucose index(TyG)and its combined obesity indices(TyG-related parameters)and chronic kidney disease(CKD)in community population.Methods A total of 6274 individuals aged 45 years and above for health physical examination in Yongshun Health Service Center from 1st June 2021 to 30 th December 2021were enrolled.Demographic characteristics,physical and laboratory examination data were collected.Body mass index(BMI),waist circumference(WC)and waist-to-height ratio(WHtR)were determined,and TyG-BMI、TyG-WC and TyG-WHtR were calculated respectively.Multivariate logistic regression model,restricted cubic spline fitting logistic regression model and ROC curve analysis were used to analyze the association between above parameters and CKD.Results Compared with non-CKD group,TyG,TyG-BMI、TyG-WC and TyG-WHtR were significantly higher in CKD patients(all P<0.05).Compared with other indices,TyG-WHtR had the highest AUC value for CKD related events(AUC:0.648,95%CI 0.612-0.683),followed by TyG-WC.Multivariate logistic regression model analysis showed that higher levels of 4 parameters were positively associated with CKD(all P<0.05).The results of restricted cubic spline fitting logistic regression analysis showed linear associations between parameters and CKD(P>0.05).Subgroup analysis showed that the risks of CKD in the third and fourth quartiles groups of 4 parameters were higher than those in the first quartiles group significantly(P<0.05).Besides,these parameters were independent risk factors for CKD in males and females,as well as in<65 years group and≥65 years group(P<0.05).Conclusion Higher levels of TyG,TyG-BMI、TyG-WC and TyG-WHtR are positively correlated with CKD in community population,and modified TyG indices(TyG-WHtR)had better diagnostic accuracy.