The impact of sex-related disparities on the association between triglyceride-glucose index and renal function decline in patients with type 2 diabetes: Insights from the ACCORD trial

IF 6.1 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes research and clinical practice Pub Date : 2025-04-16 DOI:10.1016/j.diabres.2025.112163

Xiaopu Wang , Keyang Zheng , Xinqun Hu , Junyu Pei

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Abstract

Background

The triglyceride-glucose (TyG) index has emerged as a surrogate marker for insulin resistance and is associated with the incidence and progression of chronic kidney disease (CKD) in patients with type 2 diabetes.

Methods

Data from the ACCORD trial were used. The Cox proportional hazards model was employed to calculate hazard ratios (HRs), while generalized additive mixed models were used to capture the non-linear eGFR slope in each group. The primary outcome was CKD.

Results

9360 participants were included in this study, divided into tertiles based on their TyG index, with 3 119, 3 121, and 3 120 individuals in T1 (low), T2 (medium), and T3 (high), respectively. After a median follow-up of 4 years, 1 229 cases of CKD (13.30 %) occurred. Among women rather than men, CKD risk increased across ascending TyG index groups (adjusted HR for T3, Model 3, 1.46 [95 % CI, 1.13–1.88]) (p for interaction = 0.03). Additionally, longitudinal analysis revealed a rapid eGFR decline in women in the T3 group (−4.79 mL/min/1.73 m²) than the T1 group (−3.07 mL/min/1.73 m², p < 0.05), but not in men.

Conclusions

A higher TyG index was associated with elevated CKD risk and accelerated eGFR decline, particularly in women.

Abstract Image

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性别差异对2型糖尿病患者甘油三酯-葡萄糖指数和肾功能下降之间关系的影响：ACCORD试验的见解

甘油三酯-葡萄糖（TyG）指数已成为胰岛素抵抗的替代标志物，并与2型糖尿病患者慢性肾脏疾病（CKD）的发病率和进展相关。方法采用ACCORD试验数据。采用Cox比例风险模型计算风险比（hr），采用广义加性混合模型捕捉各组eGFR的非线性斜率。主要结局是CKD。结果共纳入9360名受试者，按TyG指数分为三类，T1（低）、T2（中）、T3（高）分别为3 119人、3 121人和3 120人。中位随访4年后，发生了1229例CKD（13.30%）。在女性而非男性中，TyG指数升高组的CKD风险增加（T3校正HR，模型3,1.46 [95% CI, 1.13-1.88]）（相互作用p = 0.03）。此外，纵向分析显示，T3组女性eGFR下降迅速（- 4.79 mL/min/1.73 m2），而T1组(- 3.07 mL/min/1.73 m2, p <；0.05)，但在男性中没有。结论较高的TyG指数与CKD风险升高和eGFR下降加速相关，尤其是在女性中。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetes research and clinical practice 医学-内分泌学与代谢

CiteScore

10.30

自引率

3.90%

发文量

862

审稿时长

32 days

期刊介绍： Diabetes Research and Clinical Practice is an international journal for health-care providers and clinically oriented researchers that publishes high-quality original research articles and expert reviews in diabetes and related areas. The role of the journal is to provide a venue for dissemination of knowledge and discussion of topics related to diabetes clinical research and patient care. Topics of focus include translational science, genetics, immunology, nutrition, psychosocial research, epidemiology, prevention, socio-economic research, complications, new treatments, technologies and therapy.