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.
目的: 评估甘油三酯葡萄糖(triglyceride-glucose，TyG)指数与肾结石风险间的关联性，并探讨在不同人群中的效应差异。
方法: 通过横断面研究分析84 968名成年体检者的受检记录，将体检者根据TyG指数分为三个分位组(低、中、高)。采用多因素Logistic回归模型评估TyG指数与肾结石风险之间的关联，使用分段线性回归模型探讨TyG指数与肾结石风险之间的非线性剂量-反应关系，并进行亚组分析以探究不同人群中的效应差异。
结果: 随着TyG指数的增加，肾结石的患病率呈上升趋势，从低TyG指数组的4.36%增加到高TyG指数组的8.96%(P < 0.001)。在调整了多种因素后，中、高TyG指数组的男性与低TyG指数组男性相比，肾结石的风险分别增加了1.18倍(95%CI: 1.07~1.31，P=0.002)和1.29倍(95%CI: 2.08~2.47，P < 0.001)。然而，在女性中，这一关联在调整后并不显著(OR=0.98，95%CI: 0.82~1.16，P=0.778)。非线性分析显示，在男性中，TyG指数在8.98的折点以下存在显著关联(OR=1.40，95%CI: 1.24~1.58，P < 0.001)，而在该折点及以上则不显著(OR=0.91，95%CI: 0.78~1.06，P=0.24)。亚组分析表明，TyG指数与肾结石风险之间的关系在不同年龄、不同BMI和高血压状态下均较为稳定。
结论: TyG指数与男性肾结石风险呈正相关，且这种关系表现为非线性剂量-反应关系; TyG指数有助于识别高风险的肾结石男性患者，但需进一步探讨其潜在机制及在不同人群的普遍性。
Keywords: Insulin resistance; Metabolic syndrome; Nephrolithiasis; Triglyceride-glucose index.