The Value Analysis Of TyG Index In Patients With Non-alcoholic Fatty Liver Disease And Chronic Kidney Disease

Objective:To evaluate the role of Triglyceride glucose index(TyG)in Non-alcoholic fatty liver disease(NAFLD).To analyze the application value of NAFLD in patients with Chronic kidney diseases(CKD).Methods:A total of 159 patients diagnosed with NAFLD who were admitted to the First Affiliated Hospital of Gannan Medical University from January 2020 to December 2021 were selected as the research objects.Estimate glomerular filtration rate(e GFR)≥90ml/min/1.73m2 was classified as NAFLD with non-CKD group,and e GFR < 90ml/min/1.73m2 was classified as NAFLD combined with CKD group.In addition,according to the median of TyG index,all NAFLD patients were classified into a low level TyG index group(TyG index < 8.88)and a high level TyG index group(TyG index ≥8.88)for subgroup analysis.The baseline data of NAFLD patients were compared.Spearman correlation analysis was used to explore the correlation between TyG index and e GFR.Univariate and multivariate Logistic regression analysis were used to explore the influencing factors of NAFLD combined with CKD.Receiver operating characteristic(ROC)curve was drawn to explore the predictive value of TyG index for NAFLD combined with CKD.Results:1.In the comparison of baseline data of patients,compared with the NAFLD non-CKD group,patients in the NAFLD combined with CKD group were older and accounted for a higher proportion of males.Among them,Gender,TyG index,Atherogenic index of plasma(AIP),Triglyceride/High density lipoprotein cholesterol(TG/HDL-C),red blood cells,hemoglobin,triglyceride,homocysteine,uric acid,creatinine and other indicators were statistically different(P < 0.05).2.In the comparison of baseline data of subgroup patients,compared with patients in the group with low TyG index,patients in the group with high TyG index were younger and accounted for a higher proportion of males,There were statistical differences in the overall distribution of total cholesterol,triglyceride,creatinine and other indicators in the analysis of the two subgroups(P < 0.05).3.In the correlation analysis,TyG index,AIP,TG/HDL-C were significantly correlated with e GFR,with statistical significance(P < 0.05).4.In univariate logistic regression analysis,TyG index,AIP,female,hemoglobin,height,total cholesterol,triglyceride,creatinine and other indicators were the influencing factors of NAFLD combined with CKD(P< 0.1).The factors with statistical differences in univariate Logistic regression analysis(Including clinical and literature reports on influencing factors related to NAFLD patients with CKD)were all included as independent variables in multivariate logistic regression analysis.The results showed that TyG index(OR=18.451,95%CI: 1.299～262.032,P=0.031),AIP(OR=0.041,95%CI: 0.002～0.984,P=0.049),Female(OR=2.583,95%CI: 1.362-4.898,P=0.004),Height(OR=0.875,95%CI: 0.789～0.971,P<0.012),GGT(OR=2.085,95%CI: 1.560～2.786,P<0.001),Scr(OR=2.085,95%CI: 1.560-2.786,P<0.001)were the influencing factors of NAFLD combined with CKD.5.ROC curve analysis showed that in patients with NAFLD combined with CKD,the NAFLD non-CKD group was used as the control,the area under the curve of TyG index for predicting NAFLD combined with CKD was 0.653(95%CI: 0.568～0.739,P=0.001).The sensitivity and specificity of predicting NAFLD combined with CKD were 91.1%and 38.7%,respectively,and the best cut-off value was 8.435.The area under the ROC curve of AIP for.predicting NAFLD combined with CKD was 0.641(95%CI: 0.555～0.728,P=0.002).The sensitivity and specificity of AIP for predicting NAFLD combined with CKD were 60.8%and 68.7%,respectively,and the best cut-off value was 0.236.Conclusion:1.Compared with the non-CKD group,TyG index,AIP,triglyceride,uric acid,creatinine and other indicators in the NAFLD patients with CKD were higher.Compared with the low TyG index group,total cholesterol,triglyceride,creatinine and other indexes in the high TyG index group were higher.2.TyG index was significantly correlated with e GFR(P < 0.05).3.TyG index had predictive value for NAFLD patients with CKD,the best cut-off value was 8.435,and the sensitivity was 91.1%.4.TyG index,AIP,female,height,GGTand creatinine were the influencing factors of NAFLD combined with CKD.5.TyG index is a simple,economical and reliable new marker,which has a certain predictive value in NAFLD patients with CKD.Establishing a link between liver and kidney injury will enhance the early identification of kidney disease,prevent disease progression,minimize complications,and improve the quality of life and survival rate of patients.