Discordance between the triglyceride glucose index and HOMA-IR in incident albuminuria: a cohort study from China

Wei Gao,Tiange Wang,Hongmei Qiao,Yan Chen,Mian Li,Zhiyun Zhao,Yufang Bi,Zhuojun Xin,Jialu Wang,Yu Xu,Jinli Gao,Min Xu,Xiaozhong Qian

doi:10.1186/s12944-021-01602-w

Abstract

BackgroundTo date, there have no study comparing the associations between TyG index and HOMA-IR on the risk of incident albuminuria. Accordingly, the objective of the present study is to use discordance analysis to evaluate the diverse associations between TyG index and HOMA-IR on the risk of incident albuminuria.MethodsA community-based prospective cohort study was performed with 2446 Chinese adults. We categorized participants into 4 concordance or discordance groups. Discordance was defined as a TyG index equal to or greater than the upper quartile and HOMA-IR less than the upper quartile, or vice versa.ResultsDuring a median follow-up period of 3.9 years, 203 of 2446 participants developed incident albuminuria (8.3%). In the multivariable logistic analyses, the high TyG index tertile group was associated with a 1.71-fold (95% confidence interval (CI) 1.07–2.72) higher risk of incident albuminuria, comparing with the low tertile group. Participants in TyG (+) & HOMA-IR (−) group had a greater risk of incident albuminuria compared with those in TyG (−) & HOMA-IR (−) group after multivariate adjustment. Subgroup analyses showed that low HOMA-IR and discordantly high TyG index was closely related to a highest risk of incident albuminuria in cardiovascular metabolic disorder subjects.ConclusionsParticipants with a discordantly high TyG index had a significantly greater risk of incident albuminuria, especially in metabolic dysfunction subjects. The TyG index might be a better predictor of early stage of chronic kidney disease than HOMA-IR for subjects with metabolic abnormality.

Highlights

To date, there have no study comparing the associations between TyG index and HOMA-Insulin resistance (IR) on the risk of incident albuminuria
Scatterplots and prevalence of discordance and concordance defined according to the upper quartile values of TyG index and homeostasis model assessment of IR (HOMA-IR) were depicted in Supplementary Fig. 2
Relationship of the TyG index, HOMA-IR and concordance or discordance groups with new-onset albuminuria and Chronic kidney disease (CKD) Table 2 shows the odds ratios (ORs) of newonset albuminuria in participants according to TyG index

Summary

Introduction

There have no study comparing the associations between TyG index and HOMA-IR on the risk of incident albuminuria. The objective of the present study is to use discordance analysis to evaluate the diverse associations between TyG index and HOMA-IR on the risk of incident albuminuria. Large-scale studies have proven that albuminuria is a sensitive biological marker of progression of kidney diseases in early stage of CKD [6], and increased urinary albumin excretion is an important indicator of cardiovascular metabolic risk factors [7, 8]. Previous studies have reported that lipid ratios, such as TG/HDL cholesterol, the non-HDL cholesterol/HDL cholesterol and triglyceride-glucose (TyG) index, are good indicators of the early identification of IR and have been widely used in clinical practice [11]. The TyG index, calculated by fasting glucose and triglycerides, has been shown to perform better than HOMA-IR [12] and to be significantly correlated with HIEC [13]

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Conclusion