三酰甘油-葡萄糖指数与血清肌酐正常老年高血压肾病的关系

Relationship of triglyceride-glucose index and hypertensive nephropathy in elderly patients with normal serum creatinine

目的探讨三酰甘油-葡萄糖(TyG)指数与血清肌酐正常老年高血压肾病的关系。方法392例血清肌酐正常的老年高血压患者,根据尿白蛋白/尿肌酐比值(UACR)分为高血压肾病组(229例,UACR>30mg/g)和单纯高血压组(163例,UACR≤30mg/g)。比较两组患者的临床资料,采用多因素logistic回归分析血清肌酐正常的老年高血压肾病的危险因素,ROC曲线评估TyG指数对血清肌酐正常的老年高血压肾病的预测价值。结果与单纯高血压组比较,高血压肾病组年龄较大,高血压病程较长,吸烟比例、SBP、尿酸、FBG、TG、TyG指数、左心房内径和左心室舒张末期内径较高,左心室射血分数较低(P<0.05)。高龄、高血压病程较长、高尿酸和TyG指数较高是血清肌酐正常老年高血压肾病的独立危险因素(P<0.05)。TyG指数预测血清肌酐正常老年高血压肾病的AUC为0.763[95%CI(0.715~0.812)],取最佳诊断界值为8.74时,其预测的灵敏度为77.7%,特异度为66.3%。结论TyG指数是血清肌酐正常老年高血压肾病的影响因素,对后者发生有一定的预测价值。

Objective To explore the relationship of triglyceride-glucose(TyG)index and hypertensive nephropathy in elderly patients with normal serum creatinine.Methods According to the ratio of urinary albumin to creatinine(UACR),392elderly hypertensive patients with normal serum creatinine were divided into group A(without hypertensive nephropathy,UACR≤30 mg/g,163 cases)and B(with hypertensive nephropathy,UACR>30mg/g,229cases).The clinical data of the patients were compared between the two groups.Multivariate logistic regression was used to analyze the risk factors for hypertensive nephropathy in elderly patients with normal serum creatinine.ROC curve was used to evaluate the value of TyG index in predicting hypertensive nephropathy.Results Compared with group A,the age was older,the course of hypertension was longer,the smoking proportion,SBP,uric acid,FBG,TG,TyG index,LAD and LVDD were higher,and LVEF was lower in group B(P<0.05).Older age,longer course of hypertension,higher uric acid and higher TyG index were the independent risk factors for hypertensive nephropathy in elderly patients with normal serum creatinine(P<0.05).The AUC of TyG index in predicting hypertensive nephropathy in elderly patients with normal serum creatinine was 0.763[95%CI(0.715-0.812)].When the optimal cut-off value was 8.74,the sensitivity and the specificity were 77.7%and 66.3%,respectively.Conclusion In elderly hypertensive patients with normal serum creatinine,TyG index is a risk factor for hypertensive nephropathy and has a certain predictive value for its occurrence.