Triglyceride-glucose Index is Prospectively Associated with Chronic Kidney Disease Progression in Type 2 Diabetes at Non Sung Hospital: A Follow up 10 Years
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Abstract
Background: Insulin resistance (IR) is a crucial risk factor for chronic kidney disease (CKD) and diabetes. The triglyceride-glucose (TyG) index emerges as an alternative method for prediction.
Objective: This study aims to explore the association between the TyG index and the severity of CKD in diabetic patients.
Methods: This study is a retrospective data analysis conducted on a population of patients diagnosed with type 2 diabetes at Non-Sung Hospital between 2012 and 2014. Follow-up assessments were based on laboratory results, specifically triglyceride-glucose values calculated using the TyG index (TyG = ln[Fasting triglyceride (mg/dl) x Fasting glucose (mg/dl)] / 2). The patients were monitored for an additional ten years to observe the progression of chronic kidney disease using survival analysis for data analysis.
Results: Out of the 115 diabetic patients tracked over a 10-year period, 70 patients (60.9%) were identified as having chronic kidney disease. The median time for progression to chronic kidney disease was 5.2 years. The cutoff point for prediction was determined as a baseline triglyceride-glucose index value of 5.1, demonstrating a sensitivity of 54.0%, specificity of 58.0%, and an ROC value of 0.6. In the analysis of multiple Cox regression factors, it was observed that older age, particularly over 60 years, significantly influences the development of chronic kidney disease in diabetic patients (adjusted Hazard Ratio (ad.HR) = 3.4, 95% CI 1.8-6.5, p-value < 0.01). Additionally, high blood pressure was identified as a contributing factor (ad.HR = 2.0, 95% CI 1.0-3.7, p-value = 0.03), and an increase in the triglyceride-glucose index value during the first year also exhibited a significant association (ad.HR = 2.5, 95% CI 1.0-6.3, p-value = 0.04).
Conclusions: Diabetic patients may develop chronic kidney disease after an average duration of 5.2 years. It is essential to monitor patients aged 60 years and over who also have chronic high blood pressure and elevated baseline triglyceride-glucose levels. This proactive approach aims to reduce the likelihood of chronic kidney disease development in diabetic patients.
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