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甘油三酯-葡萄糖指数作为一种新的标志物与非糖尿病维持性血液透析患者的肌肉减少症相关。

The triglyceride-glucose index as a novel marker associated with sarcopenia in non-diabetic patients on maintenance hemodialysis.

机构信息

Institute of Nephrology, Zhongda Hospital, Southeast University School of Medicine, Nanjing, China.

Institute of Nutrition, Zhongda Hospital, Southeast University School of Medicine, Nanjing, China.

出版信息

Ren Fail. 2022 Dec;44(1):1615-1621. doi: 10.1080/0886022X.2022.2128373.

Abstract

OBJECTIVE

Sarcopenia is a common complication in patients with end-stage kidney disease. Insulin resistance is present in non-diabetic patients undergoing maintenance hemodialysis (MHD) and is an important factor leading to sarcopenia. The triglyceride-glucose (TyG) index, a reliable indicator for evaluating insulin resistance, is widely used in clinical practice. The present study investigated the association between the TyG index and sarcopenia in non-diabetic patients undergoing MHD.

METHODS

Relevant clinical data of non-diabetic patients undergoing MHD at our center were collected. The TyG index was calculated using the following formula: ln(fasting triglycerides(mg/dL)×fasting blood glucose(mg/dL)/2). Multivariate logistic regression analyses were used to evaluate the associations. The receiver-operating characteristic curve was used to analyze the predictive value of the TyG index in sarcopenia.

RESULTS

Of the 142 patients undergoing MHD who were included, 75 (52.82%) were men, the mean age was 54.05 ± 13.97 years, and 40 (28.17%) patients satisfied the diagnostic criteria for sarcopenia. The TyG index of participants with sarcopenia was higher compared with those without sarcopenia (8.83 ± 0.45 vs. 8.49 ± 0.50,  < 0.001). The prevalence of sarcopenia increased with increasing TyG index tertile (T1, 8.51%; T2, 31.91%; T3, 43.75%;  = 0.001). Logistic regression analysis indicated that the TyG index was an independent risk factor for sarcopenia (odds ratio, 4.21 [95% confidence interval, 1.85-9.59],  = 0.001).

CONCLUSION

A higher TyG index was associated with an increased risk of sarcopenia in non-diabetic patients undergoing MHD; it may be used as a novel marker to reflect the presence of sarcopenia.

摘要

目的

肌少症是终末期肾病患者的常见并发症。非糖尿病维持性血液透析(MHD)患者存在胰岛素抵抗,是导致肌少症的重要因素。甘油三酯-葡萄糖(TyG)指数是评估胰岛素抵抗的可靠指标,在临床实践中得到广泛应用。本研究旨在探讨非糖尿病 MHD 患者 TyG 指数与肌少症的关系。

方法

收集我院行 MHD 的非糖尿病患者的相关临床资料。TyG 指数采用以下公式计算:ln(空腹甘油三酯(mg/dL)×空腹血糖(mg/dL)/2)。采用多变量 logistic 回归分析评估相关性。采用受试者工作特征曲线分析 TyG 指数对肌少症的预测价值。

结果

共纳入 142 例行 MHD 的患者,其中男 75 例(52.82%),年龄(54.05±13.97)岁,40 例(28.17%)患者符合肌少症的诊断标准。伴肌少症患者的 TyG 指数高于不伴肌少症患者(8.83±0.45比 8.49±0.50, < 0.001)。随着 TyG 指数三分位(T1:8.51%;T2:31.91%;T3:43.75%)的升高,肌少症的患病率逐渐增加( = 0.001)。Logistic 回归分析表明,TyG 指数是肌少症的独立危险因素(比值比 4.21,95%置信区间 1.85-9.59, = 0.001)。

结论

非糖尿病 MHD 患者 TyG 指数升高与肌少症风险增加相关,可能作为反映肌少症的新标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/96bb/9543127/9193f530290f/IRNF_A_2128373_F0001_B.jpg

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