Association of the triglyceride glucose index with acute renal failure in diabetes mellitus: a cross-sectional study based on participants from the MIMIC-iv database

Background: The triglyceride glucose (TyG) index serves as a dependable surrogate biomarker for evaluating insulin resistance. However, the role of the TyG index in patients with diabetes mellitus who also suffer from acute renal failure warrants further investigation. This study sought to investigate the association between the TyG index and the incidence of acute renal failure in individuals with diabetes.

Methods: This study utilized data from the MIMIC-IV database, categorizing patients into tertiles according to their TyG index. Employing multivariate logistic regression models, we analyzed the relationship between the TyG index and the occurrence of acute renal failure among diabetic patients. To assess non-linear relationships, restricted cubic splines were utilized, and upon detection of non-linearity, a recursive algorithm was implemented to determine inflection points.

Results: The study comprised a total of 1074 participants diagnosed with diabetes mellitus. In the model adjusted for all covariates, the odds ratio (OR) for the association between the TyG index and acute renal failure, accompanied by a 95% confidence interval (CI), was 1.22 (0.82, 1.82), which did not reach statistical significance. However, analysis using restricted cubic splines revealed a U-shaped relationship between the TyG index and acute renal failure, with an inflection point at 9.26. The relationship between the TyG index and acute renal failure was inverse before reaching the inflection point and became directly proportional thereafter, with an OR (95% CI) of 1.86 (1.12, 3.09) after the point.

Conclusion: In individuals diagnosed with diabetes mellitus, our analysis revealed a non-linear relationship between the TyG index and the incidence of acute renal failure. Beyond the inflection point, elevated TyG index levels were markedly linked to a higher prevalence of acute renal failure.