Triglyceride-glucose index is prospectively associated with chronic kidney disease progression in Type 2 diabetes - mediation by pigment epithelium-derived factor.

IF 2.8 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Diabetes & Vascular Disease Research Pub Date : 2022-07-01 DOI:10.1177/14791641221113784

Serena Low, Sharon Pek, Angela Moh, Keven Ang, Jonathon Khoo, Yi-Ming Shao, Wern E Tang, Ziliang Lim, Tavintharan Subramaniam, Chee F Sum, Su C Lim

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引用次数: 3

Abstract

Background: Triglyceride-glucose (TyG) index is a surrogate marker of insulin resistance. Its role in chronic kidney disease (CKD) progression in Type 2 Diabetes Mellitus (T2DM) is unclear. We investigated the association between TyG index and CKD progression, and possible mediation of the association by pigment epithelium-derived factor (PEDF).

Methods: This was a prospective study on 1571 patients with T2DM. CKD progression was defined as worsening across KDIGO estimated glomerular filtration rate (eGFR) categories with ≥25% reduction from baseline. PEDF was quantitated using enzyme-linked immunosorbent assay method. Cox proportional hazards regression model was used to assess the relationship between TyG index and CKD progression.

Results: Over a follow-up period of up to 8.6 years (median 4.6 years, IQR 3.0-3.6), 42.7% of subjects had CKD progression. Every unit increase in TyG was associated with hazards of 1.44 (95%CI 1.29-1.61; p < 0.001) in unadjusted analysis and 1.21 (1.06-1.37; p = 0.004) in fully adjusted model. Compared to tertile 1, tertiles 2 and 3 TyG index were positively associated with CKD progression with corresponding hazard ratios HRs 1.24 (1.01-1.52; p = 0.037) and 1.37 (1.11-1.68; p = 0.003) in fully adjusted models. PEDF accounted for 36.0% of relationship between TyG index and CKD progression.

Conclusions: Higher TyG index independently predicted CKD progression in T2DM. PEDF mediated the association between TyG index and CKD progression.

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甘油三酯-葡萄糖指数与2型糖尿病慢性肾病进展有前瞻性关联——由色素上皮衍生因子介导

背景:甘油三酯-葡萄糖(TyG)指数是胰岛素抵抗的替代指标。它在2型糖尿病(T2DM)慢性肾脏疾病(CKD)进展中的作用尚不清楚。我们研究了TyG指数与CKD进展之间的关系，以及色素上皮衍生因子(PEDF)可能介导的关联。方法:对1571例T2DM患者进行前瞻性研究。CKD进展定义为KDIGO估计肾小球滤过率(eGFR)类别恶化，与基线相比下降≥25%。采用酶联免疫吸附法定量PEDF。采用Cox比例风险回归模型评估TyG指数与CKD进展的关系。结果:在长达8.6年的随访期间(中位4.6年，IQR 3.0-3.6)， 42.7%的受试者出现CKD进展。TyG每增加一个单位与1.44 (95%CI 1.29-1.61;P < 0.001)和1.21 (1.06-1.37;P = 0.004)。与1分位相比，2分位和3分位的TyG指数与CKD进展呈正相关，相应的风险比HRs为1.24 (1.01-1.52;P = 0.037)和1.37 (1.11-1.68;P = 0.003)。PEDF占TyG指数与CKD进展关系的36.0%。结论:较高的TyG指数独立预测T2DM患者CKD进展。PEDF介导TyG指数与CKD进展之间的关联。

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来源期刊

Diabetes & Vascular Disease Research ENDOCRINOLOGY & METABOLISM-PERIPHERAL VASCULAR DISEASE

CiteScore

4.40

自引率

0.00%

发文量

审稿时长

>12 weeks

期刊介绍： Diabetes & Vascular Disease Research is the first international peer-reviewed journal to unite diabetes and vascular disease in a single title. The journal publishes original papers, research letters and reviews. This journal is a member of the Committee on Publication Ethics (COPE)