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Journal of Peking University (Health Sciences) ›› 2024, Vol. 56 ›› Issue (4): 610-616. doi: 10.19723/j.issn.1671-167X.2024.04.011

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Association between the triglyceride-glucose index and the incidence of nephrolithiasis in male individuals

Shengqi ZHENG1,Tianchi HUA1,Guicao YIN1,Wei ZHANG1,Ye YAO2,*(),Yifan LI1,*()   

  1. 1. Department of Urology, Affiliated Hospital of Yangzhou University, Yangzhou 225001, Jiangsu, China
    2. Department of Hernia and Pediatric Surgery, Northern Jiangsu People's Hospital, Yangzhou 225001, Jiangsu, China
  • Received:2024-03-15 Online:2024-08-18 Published:2024-07-23
  • Contact: Ye YAO,Yifan LI E-mail:821301725@qq.com;yfli@bjmu.edu.cn
  • Supported by:
    the National Natural Science Foundation of China(82002675);Jiangsu Natural Science Research of Colleges and Universities-General Project(20KJB320014);Jiangsu Science and Technology Program-Youth Fund Project(BK2020938)

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Abstract:

Objective: To analyze the association between the triglyceride-glucose (TyG) index and the risk of nephrolithiasis across various demographic and clinical subgroups, aiming to enhance early diagnosis and treatment of nephrolithiasis and promote personalized care in diverse populations. Methods: This cross-sectional study analyzed the medical records of 84 968 adults, stratified into three categories (low, middle, high) according to their TyG index scores. To evaluate the association between the TyG index and nephrolithiasis risk, multivariable Logistic regression models were employed, adjusting for potential confounders. Additionally, piecewise linear regression models were used to investigate the non-linear dynamics of the TyG index's relationship with nephrolithiasis risk. Subgroup analyses were performed to explore variations in the effects of the TyG index across different demographic and clinical populations. Results: Increasing TyG index was associated with a higher risk of nephrolithiasis, rising from 4.36% in the low group to 8.96% in the high group (P < 0.001). In adjusted models, males in the middle and high TyG index categories demonstrated significantly elevated risks of nephrolithiasis, with odds ratios of 1.18 (95%CI: 1.07-1.31, P=0.002) and 1.29 (95%CI: 1.15-1.45, P < 0.001), respectively. Conversely, in females, the association was not statistically significant post-adjustment (OR=0.98, 95%CI: 0.82-1.16, P=0.778). Among males, for each unit increment in the TyG index below the critical threshold of 8.98, there was a notable 40% escalation in the risk of developing nephrolithiasis (OR=1.40, 95%CI: 1.24-1.58, P < 0.001). Surpassing this threshold, the TyG index no longer conferred a significant increase in risk (OR=0.91, 95%CI: 0.78-1.06, P=0.24). Subgroup analyses indicated that this association remained stable regardless of age, BMI, or hypertension status. Conclusion: The TyG index is positively associated with the risk of nephrolithiasis in males, demonstrating a nonlinear dose-response relationship that becomes especially pronounced at certain index levels. This biomarker could potentially serve as a valuable clinical tool for identifying males who are at a high risk of developing nephrolithiasis, thereby enabling targeted preventive strategies. Further research is urgently needed to explore the underlying mechanisms and to verify the applicability of these results across different populations.

Key words: Nephrolithiasis, Triglyceride-glucose index, Metabolic syndrome, Insulin resistance

CLC Number: 

  • R692.4

Figure 1

Flowchart of sample selection"

Table 1

Baseline characteristics of the study population by triglyceride-glucose (TyG) index tertiles"

Characteristics Low TyG index
(n= 28 248)		 Middle TyG index
(n=27 958)		 High TyG index
(n=28 762)		 P
Age/years, $\bar x \pm s$ 42.78±13.90 47.96±14.43 49.06±13.22 < 0.001
Gender, n(%) < 0.001
  Female 18 023 (63.80) 11 804 (42.22) 7 418 (25.79)
  Male 10 225 (36.20) 16 154 (57.78) 21 344 (74.21)
Nephrolithiasis, n(%) < 0.001
  No 27 016 (95.64) 26 150 (93.53) 26 184 (91.04)
  Yes 1 232 (4.36) 1 808 (6.47) 2 578 (8.96)
Hypertension, n(%) < 0.001
  No 23 609 (83.58) 18 757 (67.09) 15 093 (52.48)
  Yes 4 639 (16.42) 9 201 (32.91) 13 669 (47.52)
BMI category, n(%) < 0.001
  Normal 21 087 (74.65) 13 808 (49.39) 8 140 (28.30)
  Overweight 6 045 (21.40) 10 793 (38.61) 13 900 (48.33)
  Obesity 1 116 (3.95) 3 356 (12.00) 6 721 (23.37)
BMI/(kg/m2), $\bar x \pm s$ 22.26±2.95 24.25±3.25 25.87±3.25 < 0.001
FBG/(mmol/L), $\bar x \pm s$ 5.00±0.45 5.24±0.50 5.46±0.57 < 0.001
Cr/(μmol/L), $\bar x \pm s$ 61.67±18.07 67.17±18.78 70.91±20.43 < 0.001
TC/(mmol/L), $\bar x \pm s$ 4.53±0.82 4.87±0.87 5.17±0.95 < 0.001
TG/(mmol/L), $\bar x \pm s$ 0.77±0.18 1.34±0.23 2.93±1.86 < 0.001
HDL-C/(mmol/L), $\bar x \pm s$ 1.53±0.33 1.32±0.29 1.12±0.24 < 0.001
LDL-C/(mmol/L), $\bar x \pm s$ 2.52±0.66 2.89±0.71 2.90±0.78 < 0.001
SU/(μmol/L), $\bar x \pm s$ 298.77±77.09 340.55±84.22 386.92±89.47 < 0.001

Table 2

Association between triglyceride-glucose (TyG) index and risk of nephrolithiasis"

Items Model 1 Model 2 Model 3
OR (95%CI) P OR (95%CI) P OR (95%CI) P
Female
TyG index 1.25 (1.14, 1.38) < 0.001 1.09 (0.97,
1.22)		 0.150 0.98 (0.82, 1.16) 0.778
TyG index tertile
  Low Reference Reference Reference
  Middle 1.12 (0.99, 1.28) 0.081 1.00 (0.87, 1.15) 0.998 0.91 (0.78, 1.06) 0.218
  High 1.34 (1.16, 1.54) < 0.001 1.08 (0.92, 1.27) 0.362 0.91 (0.74, 1.13) 0.405
P for trend < 0.001 0.406 0.430
Male
TyG index 1.34 (1.27, 1.40) < 0.001 1.19 (1.13, 1.25) < 0.001 1.19 (1.08, 1.30) < 0.001
TyG index tertile
  Low Reference Reference Reference
  Middle 1.33 (1.21, 1.46) < 0.001 1.20 (1.09, 1.32) < 0.001 1.18 (1.07, 1.31) 0.002
  High 1.67 (1.52, 1.82) < 0.001 1.38 (1.26, 1.51) < 0.001 1.29 (1.15,
1.45)		 < 0.001
P for trend < 0.001 < 0.001 < 0.001

Figure 2

Impact of gender differences on the relationship between triglyceride-glucose index (TyG) index and nephrolithiasis risk A, the nonlinear relationship between the TyG index and the risk of nephrolithiasis in the male population; B, the linear relationship between the TyG index and the risk of nephrolithiasis in the female population. The solid black line represents the estimated relationship, with the shades of blue indicating the 95% confidence intervals."

Table 3

The result of the two-piecewise linear regression model"

Outcome: Nephrolithiasis OR (95%CI) P
Female
Fitting model by standard linear regression 0.98 (0.82, 1.16) 0.778
Inflection point of TyG index 8.99
  ＜8.99 0.90 (0.75,
1.09)		 0.283
  ≥8.99 1.43 (0.95, 2.15) 0.086
Male
Fitting model by standard linear regression 1.19 (1.08, 1.30) < 0.001
Inflection point of TyG index 8.98
  ＜8.98 1.40 (1.24, 1.58) < 0.001
  ≥8.98 0.91 (0.78,
1.06)		 0.240
P for Log-likelihood ratio test Female: 0.048, Male: < 0.001

Table 4

Stratified subgroup analysis of the association between triglyceride-glucose (TyG) index and risk of nephrolithiasis by gender"

Items Male Female
OR (95%CI) P P interaction OR (95%CI) P P interaction
Age/years 0.174 0.727
  ＜60 1.16 (1.05,
1.27)		 0.002 1.01 (0.85, 1.20) 0.932
  ≥60 1.29 (1.10, 1.51) 0.002 1.07 (0.76, 1.50) 0.700
Hypertension 0.413 0.187
  No 1.20 (1.07, 1.35) 0.002 0.91 (0.75, 1.10) 0.316
  Yes 1.13 (1.01, 1.27) 0.032 1.13 (0.84, 1.53) 0.418
BMI category 0.104 0.196
  Normal 1.33 (1.12, 1.58) 0.001 1.02 (0.82, 1.25) 0.886
  Overweight 1.20 (1.06, 1.37) 0.005 0.79 (0.57, 1.08) 0.142
  Obesity 1.00 (0.83, 1.22) 0.960 1.35 (0.79, 2.31) 0.278
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