The clinical evaluation of the triglyceride-glucose index as a risk factor for coronary artery disease and severity of coronary artery stenosis in patients with chronic kidney disease

Abstract

Introduction

Insulin resistance (IR) plays an important role in the occurrence and development of cardiovascular disease (CVD) in patients with chronic kidney disease (CKD). The triglyceride-glucose (TyG) index is a simple and effective tool to evaluate IR. This study aimed to evaluate the association of the TyG index with coronary artery disease (CAD) and the severity of coronary artery stenosis (CAS) in nondialysis patients with stages 3–5 CKD.

Methods

Nondialysis patients with stages 3–5 CKD who underwent the first coronary angiography at Zhongda Hospital affiliated with Southeast University from August 2015 to January 2017 were retrospectively analyzed. CAS was measured by coronary angiography, and the CAS score was calculated as the Gensini score. Logistic regression analysis was used to determine the related factors of CAD and severe CAS.

Results

A total of 943 patients were enrolled in this cross-sectional study and 720 (76.4%) of these patients were diagnosed with CAD. The TyG index in the CAD group (7.29 ± 0.63) was significantly higher than that in the non-CAD group (7.11 ± 0.61) (p < 0.001). Multivariate logistic regression analysis showed that a higher TyG index was an independent risk factor for CAD in CKD patients after adjusting for related confounding factors (OR = 2.865, 95% CI 1.681–4.885, p < 0.001). Patients in the CAD group were divided into three groups according to the Gensini integral quantile level. Multivariate logistic regression analysis showed that the TyG index was an independent related factor for severe CAS after adjusting for relevant confounding factors (p < 0.001).

Conclusions

The TyG index is associated with CAD and the severity of CAS in patients with nondialysis stages 3–5 CKD. A higher TyG index is an independent factor for CAD and severe CAS.

Keywords:

• TyG index
• coronary artery disease
• severity of coronary artery stenosis
• chronic kidney disease

Acknowledgments

The authors would like to thank AJE (https://www.aje.com) for the English language review.

Author contributions

Dan Liu designed the study, performed the experiments, collected clinicopathological data, contributed to the statistical analysis, and wrote the article. Xiaoyang Guan, Ruoxin Chen and Shengchun Xu contributed to clinical data acquisition, analyzed the data, and participated in drafting the work. Ci Song and Shanhu Qiu participated in drafting the work. Hong Liu and Jingyuan Cao contributed to design of this study and revised the draft.

Statement of ethics

This study complied with the guidelines for human studies and includes evidence that the research was conducted ethically in accordance with the World Medical Association Declaration of Helsinki. In the manuscript, authors state that subjects have given their written informed consent and that the study protocol was approved by the institute’s committee on human research (2020ZDSYLL215-Y01).

Disclosure statement

The authors have no conflicts of interest to declare.

Additional information

Funding

This study was supported by National Natural Science Foundation of China (82100721, 81600513), the Open Project Programme of the Key Base for Standardized Training for General Physicans (ZDZYJD-QK-2022-9), Zhongda Hospital, Southeast University, the Foundation of Jiangsu Commission of Health (No. M2021048), and the Project of Taizhou Clinical Medical School of Nanjing Medical University (No. TZKY20220209).