Association between the Triglyceride Glucose Index and All-Cause Mortality in Critically Ill Patients with Acute Kidney Injury
Introduction: The triglyceride glucose (TyG) index is a reliable alternative biomarker of insulin resistance, but the association between the TyG index and acute kidney injury (AKI) in critically ill patients remains unclear. Methods: The data for the study were extracted from the Medical Informatio...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Karger Publishers
2023-12-01
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| Series: | Kidney Diseases |
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| Online Access: | https://beta.karger.com/Article/FullText/535891 |
| _version_ | 1797352448028835840 |
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| author | Liangjing Lv Jiachuan Xiong Yinghui Huang Ting He Jinghong Zhao |
| author_facet | Liangjing Lv Jiachuan Xiong Yinghui Huang Ting He Jinghong Zhao |
| author_sort | Liangjing Lv |
| collection | DOAJ |
| description | Introduction: The triglyceride glucose (TyG) index is a reliable alternative biomarker of insulin resistance, but the association between the TyG index and acute kidney injury (AKI) in critically ill patients remains unclear. Methods: The data for the study were extracted from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. Cox regression and restricted cubic spline (RCS) analysis were performed to analyze the association between the TyG index and all-cause mortality. Besides, Cox regression was carried out in subgroups of age, gender, BMI, diabetes history, and dialysis status. Results: A total of 7,508 critically ill participants with AKI from the MIMIC-IV database were included in this study, with 3,688 (49.12%) participants failed to survive. In Cox regression, after confounder adjustment, patients with a higher TyG index had a higher risk of all-cause mortality (HR = 1.845, 95% CI = 1.49–2.285, p < 0.001). In RCS, after confounder adjustment, the risk of death was positively correlated with the increased value of the TyG index when TyG index surpassed 10.014. This relationship was validated in age, gender, BMI, diabetes subgroups but not in the dialysis subgroup. Interestingly, RCS analysis demonstrated that, in patients undertaking dialysis, there is a “U”-shaped curve for the value of TyG index and risk of all-cause mortality. When TyG index is less than 10.460, the risk of all-cause mortality would decrease with the increased value of TyG index, while when TyG index is higher than 11.180, the risk of all-cause mortality would increase firmly with the increased value of TyG index. Conclusion: Overall, a higher TyG index is associated with a higher risk of all-cause mortality in critically ill AKI. Interestingly, the relationship in the dialysis subgroup follows a “U”-shaped curve, indicating the importance of proper clinical blood glucose and lipid management in this particular population. |
| first_indexed | 2024-03-08T13:15:43Z |
| format | Article |
| id | doaj.art-bed50e5566e14c8b8b2c53d35b539eab |
| institution | Directory Open Access Journal |
| issn | 2296-9357 |
| language | English |
| last_indexed | 2024-03-08T13:15:43Z |
| publishDate | 2023-12-01 |
| publisher | Karger Publishers |
| record_format | Article |
| series | Kidney Diseases |
| spelling | doaj.art-bed50e5566e14c8b8b2c53d35b539eab2024-01-18T07:42:00ZengKarger PublishersKidney Diseases2296-93572023-12-01101697710.1159/000535891535891Association between the Triglyceride Glucose Index and All-Cause Mortality in Critically Ill Patients with Acute Kidney InjuryLiangjing Lv0Jiachuan Xiong1Yinghui Huang2Ting He3Jinghong Zhao4Department of Nephrology, the Key Laboratory for the Prevention and Treatment of Chronic Kidney Disease of Chongqing, Chongqing Clinical Research Center of Kidney and Urology Diseases, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, ChinaDepartment of Nephrology, the Key Laboratory for the Prevention and Treatment of Chronic Kidney Disease of Chongqing, Chongqing Clinical Research Center of Kidney and Urology Diseases, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, ChinaDepartment of Nephrology, the Key Laboratory for the Prevention and Treatment of Chronic Kidney Disease of Chongqing, Chongqing Clinical Research Center of Kidney and Urology Diseases, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, ChinaDepartment of Nephrology, the Key Laboratory for the Prevention and Treatment of Chronic Kidney Disease of Chongqing, Chongqing Clinical Research Center of Kidney and Urology Diseases, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, ChinaDepartment of Nephrology, the Key Laboratory for the Prevention and Treatment of Chronic Kidney Disease of Chongqing, Chongqing Clinical Research Center of Kidney and Urology Diseases, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, ChinaIntroduction: The triglyceride glucose (TyG) index is a reliable alternative biomarker of insulin resistance, but the association between the TyG index and acute kidney injury (AKI) in critically ill patients remains unclear. Methods: The data for the study were extracted from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. Cox regression and restricted cubic spline (RCS) analysis were performed to analyze the association between the TyG index and all-cause mortality. Besides, Cox regression was carried out in subgroups of age, gender, BMI, diabetes history, and dialysis status. Results: A total of 7,508 critically ill participants with AKI from the MIMIC-IV database were included in this study, with 3,688 (49.12%) participants failed to survive. In Cox regression, after confounder adjustment, patients with a higher TyG index had a higher risk of all-cause mortality (HR = 1.845, 95% CI = 1.49–2.285, p < 0.001). In RCS, after confounder adjustment, the risk of death was positively correlated with the increased value of the TyG index when TyG index surpassed 10.014. This relationship was validated in age, gender, BMI, diabetes subgroups but not in the dialysis subgroup. Interestingly, RCS analysis demonstrated that, in patients undertaking dialysis, there is a “U”-shaped curve for the value of TyG index and risk of all-cause mortality. When TyG index is less than 10.460, the risk of all-cause mortality would decrease with the increased value of TyG index, while when TyG index is higher than 11.180, the risk of all-cause mortality would increase firmly with the increased value of TyG index. Conclusion: Overall, a higher TyG index is associated with a higher risk of all-cause mortality in critically ill AKI. Interestingly, the relationship in the dialysis subgroup follows a “U”-shaped curve, indicating the importance of proper clinical blood glucose and lipid management in this particular population.https://beta.karger.com/Article/FullText/535891insulin resistanceacute kidney injuryall-cause mortalitymimic-iv databasetriglyceride glucose index |
| spellingShingle | Liangjing Lv Jiachuan Xiong Yinghui Huang Ting He Jinghong Zhao Association between the Triglyceride Glucose Index and All-Cause Mortality in Critically Ill Patients with Acute Kidney Injury Kidney Diseases insulin resistance acute kidney injury all-cause mortality mimic-iv database triglyceride glucose index |
| title | Association between the Triglyceride Glucose Index and All-Cause Mortality in Critically Ill Patients with Acute Kidney Injury |
| title_full | Association between the Triglyceride Glucose Index and All-Cause Mortality in Critically Ill Patients with Acute Kidney Injury |
| title_fullStr | Association between the Triglyceride Glucose Index and All-Cause Mortality in Critically Ill Patients with Acute Kidney Injury |
| title_full_unstemmed | Association between the Triglyceride Glucose Index and All-Cause Mortality in Critically Ill Patients with Acute Kidney Injury |
| title_short | Association between the Triglyceride Glucose Index and All-Cause Mortality in Critically Ill Patients with Acute Kidney Injury |
| title_sort | association between the triglyceride glucose index and all cause mortality in critically ill patients with acute kidney injury |
| topic | insulin resistance acute kidney injury all-cause mortality mimic-iv database triglyceride glucose index |
| url | https://beta.karger.com/Article/FullText/535891 |
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