Estimate of reduced glomerular filtration rate by triglyceride-glucose index: insights from a general Chinese population

Objectives: Recent studies have identified triglyceride-glucose index (TyG) as a surrogate of insulin resistance. Since insulin resistance correlates with renal damage, our study aims to investigate the impact of TyG on the risk of reduced eGFR and explore its value to improve the risk stratification and prevention of reduced eGFR.Methods: This cross-sectional study included 6466 participants (mean age:59.57years, 60.2% females) from rural areas of northeast China between September 2017 to May 2018. TyG was calculated as ln[fasting triglyceride (mg/dL)xfasting plasma glucose (mg/dL)/2]. Reduced eGFR was defined as eGFR<60ml/min per 1.73m(2).Results: The prevalence of reduced eGFR was 2.94%. After full adjustment, each SD increase of TyG caused 42.6% additional risk for reduced eGFR. When dividing TyG into quartiles, the top quartile had a 1.934 times risk than the bottom quartile. Furthermore, the risk of reduced eGFR increased linearly with the increment of TyG. Subgroup analysis also revealed the association was robust to several risk factors of renal damage. Finally, category-free net reclassification index (0.204, 95% CI: 0.060-0.349, p =0.005) and integrated discrimination index (0.010, 95% CI: 0.005-0.016, p <0.001) demonstrated the value of TyG to refine the risk stratification of reduced eGFR.Conclusion: Our work reveals the robust association between TyG and reduced eGFR. Moreover, the present study implicates the potential role of TyG as a risk indicator to optimize the prevention of reduced eGFR. Lastly, the findings also suggest the importance of simultaneous glycemic and lipid control to avoid the development and progression of reduced eGFR.