Elevated TyG Index Predicts Incidence of Contrast-Induced Nephropathy: A Retrospective Cohort Study in NSTE-ACS Patients Implanted With DESs

Abstract

BackgroundTriglyceride-glucose (TyG) index is a reliable and specific biomarker for insulin resistance and is associated with renal dysfunction. The present study sought to explore the relationship between TyG index and the incidence of contrast-induced nephropathy (CIN) in non-ST elevation acute coronary syndrome (NSTE-ACS) patients implanted with drug-eluting stents (DESs).MethodsA total of 1108 participants were recruited to the study and assigned to two groups based on occurrence of CIN. TyG index was calculated as ln [fasting triglycerides (mg/dL) × fasting blood glucose (mg/dL)/2]. Baseline characteristics and incidence of CIN were compared between the two groups. Logistic regression analysis was performed to evaluate the relationship between TyG index and CIN.ResultsThe results showed that 167 participants (15.1%) developed CIN. Subjects in the CIN group had a significantly higher TyG index compared with subjects in the non-CIN group (8.9 ± 0.7 vs. 9.3 ± 0.7, P<0.001). TyG index was significantly correlated with increased risk of CIN after adjusting for confounding factors irrespective of diabetes mellitus status and exhibited a J-shaped non-linear association. Subgroup analysis showed a significant gender difference in the relationship between TyG index and CIN. Receiver operating characteristic (ROC) curve analysis indicated that the risk assessment performance of TyG index was superior compared with other single metabolic indexes. Addition of TyG index to the baseline model increased the area under the curve from 0.713 (0.672-0.754) to 0.742 (0.702-0.782) and caused a reclassification improvement of 0.120 (0.092-0.149).ConclusionThe findings from the present study show that a high TyG index is significantly and independently associated with incidence of CIN in NSTE-ACS patients firstly implanted with DESs. Routine preoperative assessment of TyG index can alleviate CIN and TyG index provides a potential target for intervention in prevention of CIN.

Triglyceride–Glucose Index May Predict Renal Survival in Patients with IgA Nephropathy

“…Interestingly, the result strengthened the association between the high TyG index (TyG > 8.72) and the renal outcome of IgAN. Consistent with these findings, previous epidemiologic studies have identified that TyG is positively connected with deterioration of renal function in diabetic nephropathy [ 24 ] and contrast-induced nephropathy [ 11 ], but no relevant literature confirms and compares a significant correlation between TyG indices and IgAN thus far.…”

“…It has shown the advantages of being more convenient and easily accessible in clinical practice than plasma insulin in the homeostasis model assessment of IR [ 7 ]. Epidemiological and basic science studies have shown that the elevation of the TyG index correlates well with atherosclerosis, cardiovascular risk, progression of chronic kidney disease (CKD), and renal dysfunction [ 3 , 8 , 9 , 10 , 11 , 12 ], all of which are prevalent all over the world. A previous study showed that glucose metabolism and dyslipidemia were common in IgAN patients, and IR seemed to be associated with the development of kidney dysfunction in IgAN [ 13 , 14 , 15 ].…”

The triglyceride-glucose index and contrast-induced nephropathy in non-ST elevation myocardial infarction patients undergoing percutaneous coronary intervention

“…[ 36 – 38 ] A recent study showed that; elevated TyG Index associated with CIN in NSTE-ACS patients implanted with DESs. [ 39 ] In contrast to our study, this study includes only diabetic and stent implanted patients. Furthermore, our study includes all non-diabetic patients who underwent angiography and shows the correlation between CIN and TyG index in non-diabetic patients.…”

The triglyceride-glucose index is associated with the risk of acute kidney injury in critically ill patients

“…The TyG index is derived from TG and FBG levels, and is a reliable surrogate IR marker. Thus, TyG is becoming a promising alternative indicator of IR due to its e cacy, simplicity, and low cost [12,15,25] . Studies have shown that the TyG index was highly sensitive (96.5%) and speci c (85.0%) for the detection of IR, compared to the hyperinsulinemiceuglycemic clamp technique [12] .…”