The Journal of Practical Medicine >
Association of high triglyceride glucose index with increased mortality in peritoneal dialysis： A cohort study
Received date: 2023-08-10
Online published: 2024-02-22
Objective The objective of this study is to investigate whether there is a correlation between a high TyG index （serum triglyceride glucose index） and higher mortality rates among patients undergoing peritoneal dialysis （PD）. Methods This study utilized a single-center retrospective cohort as the basis for its methods.. From January 1，2007 to December 31，2015，a total of 519 PD patients kept under observation until December 31，2018. There searchers employed the Kaplan-Meier method and Cox proportional hazards modelsto examine the correlation between TyG index levels and mortality. Results Over a period of 40.5 months， 104 （20.0%） individuals with Parkinson's disease passed away， with 55 （52.9%） of these deaths attributed to cardiovascular disease （CVD）. The serum median TyG index at baseline was 8.44 （6.48， 11.94）. Through Cox regression analysis subject to the adjustments of such parameters as gender， age， body mass index（BMI）， presence of cardiovascular disease， hypertension， diabetes mellitus， hemoglobin， serum albumin， serum Ferritin， total cholesterol， renal residual function（RRF）， An increased risk of all-cause mortality （HR = 2.22，95%CI： 1.43 ~ 3.44，P < 0.001） and CVD mortality （HR = 2.50，95%CI： 1.34 ~ 4.65，P = 0.004） was observed with a higher baseline TyG index （8.44）. A comparable impact was observed in the correlation between the average TyG index over time（TA-TyG index）and both all-cause mortality and CVD mortality. （HR = 1.90， 95％CI： 1.25 ~ 2.90， P = 0.003； HR = 2.05， 95％CI： 1.14 ~ 3.70， P = 0.017，respectively）. Conclusion PD patients with a higher serum TyG index have a greater risk of all-cause mortality and mortality related to cardiovascular disease.
Key words： triglyceride glucose index; peritoneal dialysis; mortality
Shan YANG , Hongying LI , Jingxuan ZHOU , Yaode CHEN , Yaqin LI , Ziqi GU , Hongxin NIU . Association of high triglyceride glucose index with increased mortality in peritoneal dialysis： A cohort study[J]. The Journal of Practical Medicine, 2024 , 40(3) : 371 -377 . DOI: 10.3969/j.issn.1006-5725.2024.03.016
| 1 | TANG S， YU X， CHEN H C， et al. Dialysis Care and Dialysis Funding in Asia［J］. Am J Kidney Dis， 2020， 75（5）：772-781. doi:10.1053/j.ajkd.2019.08.005 |
| 2 | LEES J S， WELSH C E， CELIS-MORALES C A， et al. Glomerular filtration rate by differing measures， albuminuria and prediction of cardiovasculardisease， mortality and end-stage kidney disease［J］. Nature medicine，2019， 25（11）：1753-1760. doi:10.1038/s41591-019-0627-8 |
| 3 | WANG L， XU X， ZHANG M， et al. Prevalence of Chronic Kidney Disease in China： Results From the Sixth China Chronic Disease and Risk Factor Surveillance［J］. JAMA Intern Med，2023， 183（4）：298-310. doi:10.1001/jamainternmed.2022.6817 |
| 4 | BANSHODANI M， KAWANISHI H， MORIISHI M， et al. Association between Dialysis Modality and Cardiovascular Diseases： A Comparison between Peritoneal Dialysis and Hemodialysis［J］. Blood Purif，2020， 49（3）： 302-309. doi:10.1159/000504040 |
| 5 | BRESSLER P， BAILEY S R， MATSUDA M， etal. Insulin resistance and coronary artery disease［J］. Diabetologia， 1996， 39（11）： 1345-1350. doi:10.1007/s001250050581 |
| 6 | HANLEY A J， WILLIAMS K， STERN M P， et al. Homeostasis model assessment of insulin resistance in relation to the incidence of cardiovascular disease： the San Antonio Heart Study［J］. Diabetes Care， 2002， 25（7）： 1177-1184. doi:10.2337/diacare.25.7.1177 |
| 7 | BONORA E， KIECHL S， WILLEIT J， et al. Insulin resistance as estimated by homeostasis model assessment predicts incident symptomatic cardiovascular disease in caucasian subjects from the general population： the Bruneck study［J］. Diabetes Care， 2007， 30（2）： 318-324. doi:10.2337/dc06-0919 |
| 8 | RABBANI N， THORNALLEY P J. Advanced glycation end products in the pathogenesis of chronic kidney disease［J］. Kidney Int， 2018， 93（4）： 803-813. doi:10.1016/j.kint.2017.11.034 |
| 9 | 叶明君，戴勇，汤冬娥，等. 腹膜透析代谢组学研究进展［J］. 实用医学杂志，2022，38（1）：1-6. doi:10.3969/j.issn.1006-5725.2022.01.001 |
| 10 | LO W K. Metabolic syndrome and obesity in peritoneal dialysis［J］. Kidney Res Clin Pract， 2016， 35（1）： 10-14. doi:10.1016/j.krcp.2015.12.007 |
| 11 | DE MORAES T P， PECOITS-FILHO R. Metabolic impact of peritoneal dialysis［J］. Contrib Nephrol， 2009， 163： 117-123. doi:10.1159/000223789 |
| 12 | SIMENTAL-MENDIA L E， RODRIGUEZ-MORAN M， GUERRERO-ROMERO F. The product of fasting glucose and triglycerides as surrogate for identifying insulin resistance in apparently healthy subjects［J］. Metab Syndr Relat Disord， 2008， 6（4）： 299-304. doi:10.1089/met.2008.0034 |
| 13 | DU T， YUAN G， ZHANG M， et al. Clinical usefulness of lipid ratios， visceral adiposity indicators， and the triglycerides and glucose index as risk markers of insulin resistance［J］. Cardiovasc Diabetol， 2014， 13： 146. doi:10.1186/s12933-014-0146-3 |
| 14 | VASQUES A C， NOVAES F S， DE OLIVEIRA M S， et al. TyG index performs better than HOMA in a Brazilian population： a hyperglycemic clamp validated study［J］. Diabetes Res Clin Pract， 2011， 93（3）： e98-e100. doi:10.1016/j.diabres.2011.05.030 |
| 15 | 孟启哲，奚志，王铭，等. 胰岛素抵抗与Tyg指数与脑小血管病患者合并脑微出血的相关性［J］. 实用医学杂志，2022，38（24）：3112-3117， 3124. doi:10.3969/j.issn.1006?5725.2022.24.016 |
| 16 | SANCHEZ-INIGO L， NAVARRO-GONZALEZ D， FERNANDEZ-MONTERO A， et al. The TyG index may predict the development of cardiovascular events［J］. Eur J Clin Invest， 2016， 46（2）： 189-197. doi:10.1111/eci.12583 |
| 17 | WU H， XIONG L， XU Q， et al. Higher serum triglyceride to high-density lipoprotein cholesterol ratio was associated with increased cardiovascular mortality in female patients on peritoneal dialysis［J］. Nutr Metab Cardiovasc Dis， 2015， 25（8）： 749-755. doi:10.1016/j.numecd.2015.05.006 |
| 18 | BAKRIS G L. Lipid disorders in uremia and dialysis［J］. Contrib Nephrol， 2012， 178： 100-105. doi:10.1159/000337821 |
| 19 | PRASAD N， SINHA A， GUPTA A， et al. Effect of metabolic syndrome on clinical outcomes of non-diabetic peritoneal dialysis patients in India［J］. Nephrology （Carlton）， 2013， 18（10）： 657-664. doi:10.1111/nep.12124 |
| 20 | 张悦，华佳，刘晓斌，等. 心脏瓣膜钙化和颈动脉粥样硬化对维持性腹膜透析患者预后的影响［J］. 实用医学杂志，2021，37（18）：2360-2365. doi:10.3969/j.issn.1006-5725.2021.18.011 |
| 21 | DU?EJOVSKá M， VECKA M， RYCHLíK I， et al. Dyslipidemia in patients with chronic kidney disease： etiology and management［J］. Vnitr Lek， 2020， 66（5）： 275-281. doi:10.36290/vnl.2020.082 |
| 22 | YAN Z， YU D， CAI Y， et al. Triglyceride Glucose Index Predicting Cardiovascular Mortality in Chinese Initiating Peritoneal Dialysis： A Cohort Study［J］. Kidney Blood Press Res， 2019， 44（4）： 669-678. doi:10.1159/000500979 |
| 23 | HEDBLAD B， NILSSON P， ENGSTROM G， et al. Insulin resistance in non-diabetic subjects is associated with increased incidence of myocardial infarction and death［J］. Diabet Med， 2002， 19（6）： 470-475. doi:10.1046/j.1464-5491.2002.00719.x |
| 24 | LIU Y， CORESH J， EUSTACE J A， et al. Association between cholesterol level and mortality in dialysis patients： role of inflammation and malnutrition［J］. JAMA， 2004， 291（4）： 451-459. doi:10.1001/jama.291.4.451 |
| 25 | CHIU Y W， MEHROTRA R. Can we reduce the cardiovascular risk in peritoneal dialysis patients？［J］. Indian J Nephrol， 2010， 20（2）： 59-67. doi:10.4103/0971-4065.65296 |
| 26 | SANCHEZ-GARCIA A， RODRIGUEZ-GUTIERREZ R， MANCILLAS-ADAME L， et al. Diagnostic Accuracy of the Triglyceride and Glucose Index for Insulin Resistance：A Systematic Review［J］. Int J Endocrinol， 2020，2020：4678526. doi:10.1155/2020/4678526 |
/
| 〈 |
|
〉 |