Triglycerides–glucose index and the risk of cardiovascular events in persons with non-diabetic chronic kidney disease

Background Chronic kidney disease (CKD) is associated to high rates of cardiovascular events. We here explored whether the recently described triglycerides-glucose index (TyG) predicted the incidence of major adverse cardiovascular events (MACE) in these patients. Methods Observational study of 1142 persons with CKD and free from diabetes and 460 controls from the prospective NEFRONA study. The study exposure was the TyG index at cohort inclusion. The study outcome was MACE (cardiovascular death, nonfatal myocardial infarction, nonfatal stroke and hospitalization for unstable angina). Covariates included demographics, comorbidities, lipid profile, renal function and glycemic control. Cox regression models evaluated the association between TyG index and 4-point MACE in Patients with CKD. Results TyG was higher (median 8.63 IQR [8.32-8.95] in patients with CKD compared to controls (p<0.001). TyG increased across albuminuria categories but was similar for glomerular filtration rate categories among patients with CKD stages 3-5. During 46±13 months of follow-up, 49 (4.3%) MACE were registered. TyG predicted the occurrence of MACE (HR 1.95, 95%CI [1.11-3.40] per TyG unit increase; and HR 2.29, 95%CI [1.24-4.20] for TyG values above the median of 8.63 units). Sensitivity analysis for subgroups of participants according to age, kidney function, body mass index and imaging evidence of atherosclerosis yielded similar results, as did adjusted analysis. Neither triglycerides nor glucose alone were associated with MACE. Conclusions The TyG index is associated with the occurrence of major cardiovascular events in persons free from diabetes with non-dialysis dependent CKD.