摘要
Abstract
Objective:To investigate the association between the dynamic trajectory of the triglyceride-glucose(TyG)index and the risk of new-onset chronic kidney disease(CKD)in patients with both hypertension and diabetes mellitus.Methods:Based on data from the National Essential Public Health Service Project(2018-2024),a retrospective cohort study was conducted,including 1 681 patients with hypertension and diabetes.Group-based trajectory modeling was used to identify TyG index change trajectories from 2018 to 2021.New-onset CKD during the 2022-2024 follow-up period was assessed,and Cox proportional hazards regression models were employed to analyze the association between different trajectory groups and CKD risk.Results:Three distinct TyG index trajectories were identified:low-stable group(n=574,34.1%),moderate-stable group(n=828,49.3%),and high-stable group(n=279,16.6%).During a median follow-up of 2.2 years,241 new CKD cases occurred(cumulative incidence:14.3%).The CKD incidence rates in the three groups were 10.1%,15.5%,and 19.7%,respectively,with statistically significant differences among groups(P<0.001).Multivariable Cox regression analysis showed that the risk of developing CKD in the moderate-stable and high-stable groups was 1.61 times(95%CI:1.16-2.23)and 1.99 times(95%CI:1.34-2.96)that of the low-stable group,respectively.Sensitivity analyses confirmed the robustness of this association.Conclusion:In patients with hypertension and diabetes,persistently moderate-to-high TyG index trajectories are independently associated with an increased risk of new-onset CKD.Monitoring the dynamic trajectory of the TyG index can help identify high-risk populations for CKD at an early stage and provide a basis for targeted interventions.关键词
甘油三酯葡萄糖指数/慢性肾脏病/高血压/糖尿病/回顾性队列研究Key words
triglyceride-glucose index/chronic kidney disease/hypertension/diabetes mellitus/retrospective cohort study分类
医药卫生
