Backround: The triglycerides-glucose index (TyG) is a simple indicator of insulin resistance. The TyG is independently associated with stroke occurrence. Previous studies have investigated the relationship between the TyG in stroke and hemodialysis patients.
Aim: There is no study investigating the relationship between stroke and TyG in hemodialysis patients. Therefore, we wanted to examine whether the TyG predicts stroke in hemodialysis
Methods: We retrostprctively analyzed 149 end-stage kidney disease (ESKD) who had been on hemodialysis for more than six months were included. The patients were divided into groups, stroke, and non-stroke, according to their MR images and clinics. Binary logistic regression analysis was performed to identify independent predictors for stroke.
Results: The mean TyG value was 9.13 ± 0.74 and significantly higher in patients with stroke (p= 0.003). The number of patients with stroke was higher in the group above the median value (OR= 1.981, p= 0.039). In the bivariate correlation analysis, the TyG value was positively correlated with C-reactive protein and negatively associated with HDL. As a result of our multivariable analysis, age and TyG values were independent predictors of stroke.
Conclusion: The determination of the TyG index as an independent predictor for stroke in the regression analysis in our study proves that the TyG index is a helpful indicator for stroke in patients undergoing hemodialysis.
Cite this Article As : Ozturk Y, Baloglu I, Ozer H, Yonet F, Altaş M, Selcuk NY, Tonbul HZ, Turkmen K.Triglycerides-Glucose Index as Predictor of Stroke Risk in Hemodialysis Patients. Mev Med Sci. 2024; 4(1): 7-12
Conflict of interest : The authors declare that they have no conflict of interest.
Mevlana Tıp Bilimleri 2024, Vol4, Issue1 E-ISSN: 2757-976X
Received : , Accepted : , Published Online :
References
1. Esmail A, Ibrahim M, Nage S. Efficacy of topical insulin for recurrent epithelial corneal erosions. Irish Journal of Medical Science (1971-). 2023:1-7.
2. Toyoda K, Ninomiya T. Stroke and cerebrovascular diseases in patients with chronic kidney disease. The Lancet Neurology. 2014;13(8):823-33.
3. Deng X-L, Liu Z, Wang C, et al. Insulin resistance in ischemic stroke. Metabolic brain disease. 2017;32:1323-34.
4. Forero R, Nahidi S, De Costa J, et al. Application of four-dimension criteria to assess rigour of qualitative research in emergency medicine. BMC health services research. 2018;18(1):1-11.
5. Friedwald W, Leve R, Fredrichson D. Estimation of concentration of low density lipoproteins separated by three different methods. Clin Chem. 1972;18:499-502.
6. Simental-Mendía LE, Rodríguez-Morán M, Guerrero-Romero F. The product of fasting glucose and triglycerides as surrogate for identifying insulin resistance in apparently healthy subjects. Metabolic syndrome and related disorders. 2008;6(4):299-304.
7. Quiroga B, Muñoz Ramos P, Sánchez Horrillo A, et al. Triglycerides–glucose index and the risk of cardiovascular events in persons with non-diabetic chronic kidney disease. Clinical Kidney Journal. 2022;15(9):1705-12.
8. Du Z, Xing L, Lin M, et al. Estimate of prevalent ischemic stroke from triglyceride glucose-body mass index in the general population. BMC cardiovascular disorders. 2020;20(1):1-9.
9. Deng X-L, Liu Z, Wang C, et al. Insulin resistance in ischemic stroke. Metabolic brain disease. 2017;32:1323-34.
10. Guo Y, Zhao J, Zhang Y, et al. Triglyceride glucose index influences platelet reactivity in acute ischemic stroke patients. BMC neurology. 2021;21(1):1-8.
11. Patrono C, Baigent C, Hirsh J, et al. Antiplatelet drugs: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2008;133(6):199S-233S.
12. Moore SF, Williams CM, Brown E, et al. Loss of the insulin receptor in murine megakaryocytes/platelets causes thrombocytosis and alterations in IGF signalling. Cardiovascular research. 2015;107(1):9-19.
13. Topçuoglu MA, Arsava EM, Ay H. Antiplatelet resistance in stroke. Expert review of neurotherapeutics. 2011;11(2):251-63.
14. Gupta J, Mitra N, Kanetsky PA, et al. Association between albuminuria, kidney function, and inflammatory biomarker profile in CKD in CRIC. Clinical journal of the American Society of Nephrology: CJASN. 2012;7(12):1938.
15. Kumai Y, Kamouchi M, Hata J, et al. Proteinuria and clinical outcomes after ischemic stroke. Neurology. 2012;78(24):1909-15.
16. Mao Q, Zhou D, Li Y, et al. The triglyceride-glucose index predicts coronary artery disease severity and cardiovascular outcomes in patients with non-ST-segment elevation acute coronary syndrome. Disease markers. 2019;2019.
17. Wu S, Xu L, Wu M, et al. Association between triglyceride-glucose index and risk of arterial stiffness: a cohort study. Cardiovascular diabetology. 2021;20:1-8.
18. Sozio SM, Armstrong PA, Coresh J, et al. Cerebrovascular disease incidence, characteristics, and outcomes in patients initiating dialysis: the choices for healthy outcomes in caring for ESRD (CHOICE) study. American journal of kidney diseases. 2009;54(3):468-77.
19. Hu L, Bao H, Huang X, et al. Relationship between the triglyceride glucose index and the risk of first stroke in elderly hypertensive patients. International Journal of General Medicine. 2022:1271-9.
20. Ma X, Han Y, Jiang L, et al. Triglyceride-glucose index and the prognosis of patients with acute ischemic stroke: a meta-analysis. Hormone and Metabolic Research. 2022;54(06):361-70.
21. Harada S, Fujita-Hamabe W, Tokuyama S. Ischemic stroke and glucose intolerance: a review of the evidence and exploration of novel therapeutic targets. Journal of pharmacological sciences. 2012;118(1):1-13.
22. Narici MV, Maffulli N. Sarcopenia: characteristics, mechanisms and functional significance. British medical bulletin. 2010;95(1):139-59.
23. Sung K-C, Wild SH, Kwag HJ, et al. Fatty liver, insulin resistance, and features of metabolic syndrome: relationships with coronary artery calcium in 10,153 people. Diabetes care. 2012;35(11):2359-64.
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KeywordsTriglyceride glucose index, end-stage kidney disease, hemodialysis, stroke