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Research Article | Volume 30 Issue 7 (July, 2025) | Pages 54 - 57
Evaluating Triglyceride-Glucose Index in predicting Renal Function in Population
 ,
 ,
1
Junior Resident, M.D.Medicine, Department of Medicine, Government Medical College, Ratlam, M.P., India
2
Associate Professor, Department of General Medicine, People's Medical College, Bhopal, M.P.
3
Senior Resident, Department of General Medicine, Chirayu Medical College & Hospital, Bhopal, M.P., India.
Under a Creative Commons license
Open Access
Received
June 12, 2025
Revised
June 25, 2025
Accepted
July 4, 2025
Published
July 9, 2025
Abstract

Background: The triglyceride-glucose (TyG) index, a surrogate marker for insulin resistance, has gained attention as a potential indicator of metabolic and cardiovascular risk. Recent evidence suggests a possible association between TyG index and renal function decline. This study aimed to evaluate the predictive value of the TyG index in assessing renal function in a general population cohort. Materials and Methods: A cross-sectional analytical study was conducted on 200 adults aged 30–65 years attending a tertiary care hospital. Participants were categorized based on estimated glomerular filtration rate (eGFR) into normal renal function (eGFR ≥90 mL/min/1.73 m²), mildly decreased (60–89), and moderately to severely decreased (<60). Fasting blood samples were analyzed for triglycerides and glucose to calculate the TyG index using the formula: ln [fasting TG (mg/dL) × fasting glucose (mg/dL)/2]. eGFR was estimated using the CKD-EPI formula. Statistical analysis included Pearson correlation and multivariate regression to evaluate the association between TyG index and eGFR. Results: Among 200 participants (mean age: 48.6 ± 9.1 years; 54% male), the mean TyG index was 8.82 ± 0.51. A significant inverse correlation was observed between TyG index and eGFR (r = -0.43, p < 0.001). Multivariate analysis adjusted for age, sex, BMI, and hypertension showed that a higher TyG index was independently associated with reduced eGFR (β = -2.12, p = 0.004). Participants in the highest TyG tertile had a 3.1-fold increased risk of moderate-to-severe renal dysfunction compared to the lowest tertile. Conclusion: The TyG index is significantly associated with renal function decline and may serve as a simple, cost-effective marker for early detection of individuals at risk for chronic kidney disease. Its integration into routine metabolic screening may enhance preventive strategies.

Keywords
INTRODUCTION

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.

MATERIALS AND METHODS

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

RESULTS

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)

Parameter

Mean ± SD or n (%)

Age (years)

48.6 ± 9.1

Male:Female

108 (54%) : 92 (46%)

BMI (kg/m²)

26.4 ± 3.5

Hypertension

74 (37%)

Diabetes Mellitus

58 (29%)

Mean TyG Index

8.82 ± 0.51

Mean eGFR (mL/min/1.73 m²)

88.2 ± 17.4

 

Table 2: Correlation Between TyG Index and eGFR

Variable

Correlation Coefficient (r)

p-value

TyG vs. eGFR

-0.43

<0.001

 

Table 3: Comparison of TyG Index Across Renal Function Categories

eGFR Group

Number of Participants

Mean TyG Index ± SD

p-value

Group A (≥90 mL/min/1.73 m²)

82

8.56 ± 0.33

<0.001

Group B (60–89 mL/min/1.73 m²)

92

8.78 ± 0.41

 

Group C (<60 mL/min/1.73 m²)

26

9.11 ± 0.42

 

 

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

DISCUSSION

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.

CONCLUSION

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

REFERENCES
  1. Guerrero-Romero F, Simental-Mendía LE, González-Ortiz M, et al. The product of triglycerides and glucose as biomarker for screening simple insulin resistance. J Clin Endocrinol Metab. 2010;95(7):3347–51.
  2. Simental-Mendía LE, Rodríguez-Morán M, Guerrero-Romero F. TyG index, a simple surrogate marker for insulin sensitivity: comparison with euglycemic-hyperinsulinemic clamp. J Clin Endocrinol Metab. 2008;93(7):2694–8.
  3. Unger G, Benozzi SF, Perruzza F, Pennacchiotti GL. Triglycerides and glucose index: a useful tool to evaluate insulin resistance. Endocrinol Nutr. 2014;61(10):533–40.
  4. Chen H, Sullivan G, Yue LQ, Katzmarzyk PT, Wang Y. The association of TyG index with kidney function decline: evidence from NHANES 1999–2014. Front Endocrinol (Lausanne). 2022;13:849993.
  5. Reaven GM. Insulin resistance and human disease: a short history. J Basic Clin Physiol Pharmacol. 1998;9(2–4):387–406.
  6. Chen C, Shi H, Zhang M, et al. Association between TyG index and renal function among middle-aged and elderly Chinese. Clin Chim Acta. 2020;511:59–64.
  7. Ren H, Du Y, Li T, et al. The TyG index predicts incident CKD: a prospective cohort study. Endocrine. 2021;71(1):120–7.
  8. Zhao W, Gong W, Wu W, et al. Triglyceride-glucose index and incident chronic kidney disease in middle-aged and older adults: a cohort study. BMC Nephrol. 2020;21(1):1–9.
  9. Yang R, Yang E, Shen X, et al. Association of TyG index with microalbuminuria in type 2 diabetes. Diabetes Metab Syndr Obes. 2021;14:1493–500.
  10. Park K, Ahn CW, Lee SB, et al. Elevated TyG index predicts progression of diabetic nephropathy in type 2 diabetes. J Diabetes Complications. 2018;32(4):290–5.
  11. Cai X, Wang L, Wang B, et al. Association between TyG index and risk of renal dysfunction in hypertensive patients: a retrospective study. J Clin Hypertens (Greenwich). 2021;23(9):1775–82.
  12. De Boer IH, Rue TC, Hall YN, et al. Insulin resistance and chronic kidney disease progression. Diabetes Care. 2011;34(4):921–6.
  13. Kim MK, Ahn CW, Kang S, et al. Relationship between insulin resistance and renal function in non-diabetic subjects. Diabet Med. 2007;24(5):544–9.
  14. Sun D, Zhou T, Heianza Y, et al. TyG index and the risk of incident CKD: results from the UK Biobank study. J Clin Endocrinol Metab. 2022;107(4):e1644–51.
  15. Lee SB, Ahn CW, Lee BK, et al. Association between triglyceride glucose index and arterial stiffness in Korean adults. Cardiovasc Diabetol. 2018;17(1):1–9.
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