Association between the triglyceride-glucose index and urinary albumin-to-creatinine ratio in patients with early-onset type 2 diabetes.
TL;DR
In patients with early-onset type 2 diabetes, an elevated TyG index was independently associated with increased UACR levels and served as a potential indicator for early diabetic kidney injury.
Abstract
Background
Patients with early-onset type 2 diabetes mellitus (T2DM) face a significantly elevated risk of developing diabetic kidney disease (DKD) in the early stages, attributable to their prolonged disease duration. The urinary albumin-to-creatinine ratio (UACR) serves as a critical marker for screening incipient renal injury. While insulin resistance (IR) is a pivotal driver of this pathological progression, the triglyceride-glucose (TyG) index, a simple and effective surrogate marker for IR, has not been thoroughly investigated in this specific population. The association between TyG index and UACR, along with its potential discriminatory ability for early renal damage in patients with early-onset T2DM, remained unclear.
Objective
This study aimed to explore the correlation between the TyG index and UACR in patients with early-onset type 2 diabetes. RESEARCH
Design
AND
Methods
A dual-center, retrospective cross-sectional study was conducted. Clinical data from a total of 596 adult patients (aged 18-40 years) with early-onset type 2 diabetes mellitus, admitted to the First Medical Center of the Chinese PLA General Hospital and Hainan Hospital of the Chinese PLA General Hospital between January 2012 and December 2022, were collected and retrospectively analyzed. Participants were stratified into three groups based on the tertiles of the TyG index: Q1 (< 7.67), Q2 (7.67-8.33), and Q3 (> 8.33). They were also categorized into two groups according to UACR levels: <30 mg/g and ≥ 30 mg/g. The association between TyG index, traditional glucose/lipid parameters, and elevated UACR (≥ 30 mg/g) was assessed using correlation analysis and binary logistic regression models. Receiver operating characteristic (ROC) curves were plotted to evaluate the discriminatory ability of these indicators for elevated UACR. Subgroup analyses were further performed based on gender, blood pressure status, and estimated glomerular filtration rate (eGFR).
Results
The mean age of the 596 participants was 31.78 ± 9.99 years. A significant positive correlation was observed between the TyG index and UACR (r = 0.250, P < 0.001). Binary logistic regression analysis revealed that after adjustment for multiple confounding factors, patients in the highest TyG tertile (Q3) had a 1.366-fold increased risk of elevated UACR (≥ 30 mg/g) compared to those in the lowest tertile (Q1) (OR: 1.366, 95% CI: 1.015-1.838, P = 0.039). The discriminatory ability of TyG index for elevated UACR was evaluated using the receiver operating characteristic curve, yielding an area under the curve of 0.649 (95% CI: 0.609-0.687). At the optimal cut-off value of 8.18, the sensitivity and specificity were 69.47% and 61.08%, respectively. Notably, the TyG index demonstrated superior discriminatory efficacy compared to traditional lipid parameters, including triglycerides, total cholesterol, LDL-C, and HDL-C.
Conclusion
In patients with early-onset type 2 diabetes, an elevated TyG index was independently associated with increased UACR levels and served as a potential indicator for early diabetic kidney injury. Specifically, for individuals aged 18-40 years, a TyG index exceeding 8.18 was associated with an elevated association of developing diabetic kidney disease. CLINICAL TRIAL REGISTRATION Not applicable.