Study On The Correlation Between Triglyceride-Glucose Index And Diabetic Kidney Disease In Patients With Type2Diabetes Mellitus

Background and Objective:Diabetic kidney disease(DKD)is one of the most common chronic microvascular complications of type 2 diabetes(T2DM)and the main cause of end-stage renal disease(ESRD).Controlling blood sugar,improving lipid metabolism disorders and controlling hypertension,especially blocking the renin-angiotensin system(RAAS)slowed the progression of DKD,but did not substantially reduce the annual incidence of DKD progression to ESRD.Therefore,clinical emphasis on early detection,diagnosis and intervention is of great significance for controlling its progression and the onset of ESRD。Studies have found that the triglyceride glucose(TyG)index is associated with an increased risk of cardiovascular disease(CVD),but the relationship with DKD is not clear.This study aims to explore the correlation between TyG index and DKD,and to evaluate the value of TyG index in predicting DKD.MethodA total of 420 T2DM patients who were hospitalized in the Endocrinology Department of the Second Affiliated Hospital of Nanchang University from December 2019 to December 2020 were collected.According to the interquartile range of the TyG index of the research object,it is divided into the lowest quartile group(Q1 group,n=104),the second quartile group(Q2 group,n=107),and the third quartile group(Q3Group,n=104),the highest quartile group(Q4 group,n=105).According to the urine microalbumin/creatinine ratio(UACR),it is divided into: simplicity diabetes mellitus(SDM)group(n=159),early diabetic Kidney disease(EDKD)group(n=179),clinical diabetic Kidney disease(CDKD)group(n=82).The SDM group is the non-DKD group,and the combination of EDKD and CDKD is the DKD group.Compare the general data of gender,age,body mass index(BMI),systolic blood pressure(SBP),diastolic blood pressure(DBP)and homeostasis model2(HOMA2-IR),diabetes course,fasting blood glucose(FPG),glycation among the above groups Hemoglobin(Hb Alc),triglycerides(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),serum uric acid(SUA),Blood creatinine(SCr),estimated glomerular filtration rate(e GFR),carotid artery intima-media thickness(CIMT)and other indicators.Analyze the correlation between TyG index and UACR;analyze the correlation between TyG index and HOMA2-IR;logistic regression analysis of risk factors affecting DKD;receiver operating characteristic(ROC)curve analysis of the value of TyG index predicting the occurrence of DKD.Results:1.Comparison of general data and clinical indicators among the four groups of TyG indexCompared with the Q1 group,the BMI,LDL-C,SUA,TC,Hb Alc,ACR of the Q3 and Q4 groups were higher(P<0.001),and the HDL-C and age were younger(P<0.001).The systolic blood pressure and diastolic blood pressure of the Q4 group were higher than those of the Q1 group(P<0.001).Q2 group had higher LDL-C and lower HDL-C than Q1 group(P<0.05).UACR,TG,FPG,CIMT,HOMA2-IR gradually increased with the increase of TyG index(P<0.001).There were also significant differences in the proportion of SDM,EDKD,and CDKD patients among the four groups of TyG index(P<0.001).2.Comparison of data among SDM group,EDKD group and CDKD group1)Compared with the SDM group,the disease course,SBP,HOMA2-IR,Hb A1 c,FPG,SUA,TG increased significantly(P<0.05),and HDL-C decreased significantly(P<0.05)in the EPKD group;FPG,FCP,TG,TC,LDL-C and SUA were significantly increased(P<0.05),and HDL-C was significantly decreased(P<0.05).The systolic blood pressure and SCR gradually increased with the increase of UACR(P<0.05),and e GFR gradually decreased.2)The TyG index of patients in the EDKD group and the CDKD group was significantly higher than that in the SDM group(P<0.05),but there was no statistical difference between the two groups in the EDKD and CDKD groups.3.The correlation between TyG index and various indicators1)The correlation scatter plot of TyG index and HOMA2-IR shows that TyG index and HOMA2-IR are obviously linearly correlated(r=0.55,P<0.001).2)TyG index is positively correlated with SBP,DBP,TG/HDL-C,TC/HDL-C,BMI,Hb A1 C,TC,SUA,CIMT,UACR(P<0.05),and negatively correlated with HDL-C(P< 0.05).After adjusting for age,gender,disease course,and BMI,the TyG index was still significantly positively correlated with SBP,DBP,Hb Alc,TC,LDL-C,CIMT,and UACR(P<0.001),and significantly negatively correlated with HDL-C(P<0.05).4.The relationship between TyG index and DKD1)Binary Logistic regression analysis showed that increased TyG index(OR=3.553,95%CI: 2.319～5.444,P < 0.001)was an independent risk factor for DKD.2)TyG index predicts the area under the curve(AUC)for DKD to be 0.765(95%CI 0.717,0.813),which is better than HOMA2-IR’s 0.634(95% CI 0.579,0.689)(P<0.001).Dangyoden When the index reaches the maximum value of 0.5,the best intercept point of the TyG index is 7.76.The corresponding sensitivity and specificity were 68.4% and 81.46%,respectively.Conclusion:TyG index is significantly correlated with DKD in patients with T2 DM and is an independent risk factor for DKD.The TyG index has a good predictive value for the occurrence of DKD.