Chronic kidney disease (CKD) is a growing global health concern, contributing to increased morbidity, mortality, and healthcare costs. Early identification of individuals at risk for renal dysfunction is crucial for implementing preventive strategies and slowing disease progression (1). Traditional risk factors for CKD include hypertension, diabetes mellitus, and dyslipidemia; however, emerging metabolic markers are being investigated for their predictive value in assessing renal function decline (2).

The triglyceride-glucose (TyG) index, calculated using fasting triglyceride and glucose levels, has been validated as a surrogate marker for insulin resistance (3). It is simple, cost-effective, and correlates well with established methods of assessing insulin sensitivity, such as the hyperinsulinemic-euglycemic clamp technique (4). Increasing evidence links insulin resistance not only with metabolic syndrome and cardiovascular disease but also with renal dysfunction through mechanisms involving endothelial damage, oxidative stress, and glomerular hyperfiltration (5,6).

Several recent studies have explored the association between TyG index and renal outcomes. Elevated TyG index has been linked with increased urinary albumin excretion, declining estimated glomerular filtration rate (eGFR), and progression of CKD in diverse populations (7,8). Moreover, the TyG index may outperform traditional lipid parameters in predicting microvascular complications, including nephropathy, especially in patients with diabetes or metabolic syndrome (9).

Despite these associations, data on the utility of TyG index in predicting renal function in the general population remain limited. This study aims to evaluate the relationship between TyG index and renal function as measured by eGFR, and to assess its potential as an early predictor of kidney dysfunction in a general adult cohort.

A total of 200 adult participants, aged between 30 and 65 years, were enrolled through convenient sampling. Individuals with known chronic kidney disease, current infections, pregnancy, or those on medications affecting glucose or lipid metabolism (e.g., statins, corticosteroids) were excluded to avoid confounding effects.

Data Collection:

Demographic data including age, sex, body mass index (BMI), blood pressure, smoking status, and presence of comorbidities such as diabetes or hypertension were recorded through structured interviews and clinical examination.

Laboratory Investigations:

After an overnight fast of at least 8 hours, venous blood samples were collected to measure fasting plasma glucose and triglyceride levels using standard enzymatic methods. The TyG index was calculated using the following formula:

TyG index = ln [fasting triglycerides (mg/dL) × fasting glucose (mg/dL) / 2]

Renal function was assessed by estimating the glomerular filtration rate (eGFR) using the CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) equation. Based on eGFR, participants were categorized into three groups:

• Group A: Normal renal function (eGFR ≥90 mL/min/1.73 m²)
• Group B: Mildly decreased renal function (eGFR 60–89 mL/min/1.73 m²)
• Group C: Moderately to severely decreased renal function (eGFR <60 mL/min/1.73 m²)

Statistical Analysis

ata were analyzed using SPSS version 26.0. Continuous variables were expressed as mean ± standard deviation (SD), and categorical variables as percentages. Pearson correlation was used to assess the relationship between TyG index and eGFR. Multivariate linear regression was performed to adjust for confounding variables including age, sex, BMI, and presence of hypertension or diabetes. A p-value of <0.05 was considered statistically significant

A total of 200 participants were included in the study, with a mean age of 48.6 ± 9.1 years. Among them, 108 (54%) were male and 92 (46%) were female. The overall mean TyG index was 8.82 ± 0.51, and the average estimated glomerular filtration rate (eGFR) was 88.2 ± 17.4 mL/min/1.73 m². Participants were classified into three groups based on eGFR levels: Group A (normal renal function) included 82 participants (41%), Group B (mildly decreased) had 92 participants (46%), and Group C (moderate-to-severe reduction) included 26 participants (13%) (Table 1).

A significant inverse correlation was found between TyG index and eGFR (r = -0.43, p < 0.001), indicating that higher TyG values were associated with lower renal function (Table 2). Additionally, participants in Group C had significantly higher TyG index values (9.11 ± 0.42) compared to Group A (8.56 ± 0.33) and Group B (8.78 ± 0.41), with p < 0.001 (Table 3).

Multivariate linear regression analysis, after adjusting for age, sex, BMI, hypertension, and diabetes, revealed that the TyG index was an independent predictor of eGFR (β = -2.12, p = 0.004). Participants in the highest TyG tertile had a 3.1-fold increased risk of having eGFR <60 mL/min/1.73 m² compared to those in the lowest tertile (adjusted OR: 3.10; 95% CI: 1.42–6.78; p = 0.005).

Table 1: Baseline Characteristics of Study Participants (N = 200)

Table 2: Correlation Between TyG Index and eGFR

Table 3: Comparison of TyG Index Across Renal Function Categories

These findings suggest that an elevated TyG index is significantly associated with reduced renal function, even after accounting for traditional risk factors.

This study investigated the association between the triglyceride-glucose (TyG) index and renal function in a general adult population. The findings revealed a significant inverse relationship between the TyG index and estimated glomerular filtration rate (eGFR), indicating that higher TyG values are associated with lower kidney function. These results suggest that the TyG index may serve as a useful, non-invasive marker for identifying individuals at risk for chronic kidney disease (CKD).

The TyG index, a product of fasting triglyceride and glucose levels, is a well-established surrogate for insulin resistance (1). Unlike more complex and costly tests such as the hyperinsulinemic-euglycemic clamp, the TyG index is simple, reproducible, and applicable in large-scale screenings (2,3). Insulin resistance has been implicated in the pathogenesis of renal dysfunction through mechanisms including glomerular hyperfiltration, oxidative stress, and endothelial dysfunction (4,5).

In our study, individuals in the highest TyG tertile had a significantly greater risk of moderate-to-severe renal impairment, even after adjusting for confounding factors. This finding aligns with previous studies which demonstrated that higher TyG index values were independently associated with decreased eGFR and increased albuminuria (6,7). A study by Zhao et al. in a Chinese cohort reported that a high TyG index was linked to a greater incidence of CKD over a 5-year follow-up period (8).

Several cross-sectional studies have confirmed the association between TyG index and kidney damage. In patients with type 2 diabetes mellitus, the TyG index has been shown to correlate with microalbuminuria and early-stage diabetic nephropathy (9,10). Similarly, in hypertensive populations, elevated TyG levels were associated with a higher risk of renal dysfunction, suggesting its utility beyond diabetic cohorts (11).

The biological plausibility of the TyG index as a renal risk marker lies in its strong association with systemic insulin resistance and metabolic inflammation. Both these factors play a crucial role in initiating and sustaining renal microvascular injury, which contributes to glomerulosclerosis and tubulointerstitial fibrosis (12,13). Furthermore, the TyG index has been shown to be a better predictor of metabolic complications than isolated lipid or glucose parameters, making it an integrative marker of cardiometabolic stress (14,15).

Our study has some limitations. Being cross-sectional in design, it cannot establish causality. Additionally, the sample size, though adequate, was limited to a single center and may not be generalizable to the broader population. Despite these limitations, the consistent association of TyG index with declining renal function underscores its potential clinical relevance.

Future prospective studies are warranted to validate these findings and to explore whether interventions targeting the TyG index could help prevent or delay CKD progression. Integrating TyG index screening in routine clinical practice, especially in primary care settings, could facilitate early detection and management of individuals at high risk for renal impairment.

The study demonstrates a significant inverse association between the triglyceride-glucose (TyG) index and renal function, suggesting that higher TyG values are linked with reduced eGFR. As a simple and cost-effective marker of insulin resistance, the TyG index may serve as a useful tool for early identification of individuals at risk for chronic kidney disease in the general population

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