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

Abstract

Background The triglyceride-glucose (TyG) index is a reliable alternative biomarker of insulin resistance (IR) and is associated with renal dysfunction. We aimed to investigate the correlation between TyG index and the incidence of acute kidney injury (AKI) in critically ill patients. Methods A total of 2,716 participants were recruited to the study from the Medical Information Mart for Intensive Care III (MIMIC-III) database. Patients were divided into four groups according to quartiles (Q1–Q4) of TyG index. The TyG index was calculated as ln [fasting triglycerides (mg/dL) × fasting blood glucose (mg/dL)/2]. Logistic regression analysis was performed to evaluate the relationship between TyG index and AKI. The restricted cubic spline (RCS) regression model was used to outline the relationships between the TyG index and outcomes. Results A total of 1,335 (49.15%) participants were identified with AKI. The incidence of AKI was 44.56% in Q1, 45.13% in Q2, 51.34% in Q3, and 55.67% in Q4 (P < 0.001). In the multivariable model, the highest quartile (Q4 group) of TyG index was more strongly correlated with the risk of AKI than the lowest quartile (Q1 group) after adjusting for potential confounding risk factors (adjusted odds ratio = 1.98, 95% confidence interval = 1.39 − 2.83; P < 0.001). The RCS regression model revealed that the risk of AKI increased linearly with increasing TyG index (P for non-linearity = 0.969). Conclusions The findings showed that a high TyG index was significantly and independently associated with an increased risk of AKI in critically ill patients.