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Abstract: SA-PO1122

Longitudinal Trajectory Triglyceride-Glucose (TyG) Index Associated with Adverse Renal Outcome in Metabolic Dysfunction-Associated Fatty Liver Disease

Session Information

Category: CKD (Non-Dialysis)

  • 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

  • Cho, Janghee, Yonsei University College of Medicine, Seodaemun-gu, Korea (the Republic of)
  • Kim, Chae Won, Yonsei University College of Medicine, Seodaemun-gu, Korea (the Republic of)
  • Kim, Hyo Jeong, Yonsei University College of Medicine, Seodaemun-gu, Korea (the Republic of)
  • Jhee, Jong Hyun, Yonsei University College of Medicine, Seodaemun-gu, Korea (the Republic of)
  • Park, Hyeong cheon, Yonsei University College of Medicine, Seodaemun-gu, Korea (the Republic of)
  • Choi, Hoon Young, Yonsei University College of Medicine, Seodaemun-gu, Korea (the Republic of)
Background

Nonalcoholic fatty liver disease (NAFLD) is considered a multisystem disease that is significantly associated with an increased risk of chronic kidney disease (CKD), cardiovascular disease and extrahepatic malignancies. Recent study demonstrated that the metabolic dysfunction-associated fatty liver disease (MAFLD) definition identified a higher proportion of individuals at risk of developing incident CKD than the NAFLD definition. Triglyceride-glucose (TyG) index is a marker for predicting metabolic syndrome and also shows an insulin resistance state.
This study aimed to evaluate the association between the longitudinal trajectory TyG index and CKD progression in patients with MAFLD.

Methods

In the data from the medical records database in Gangnam Severance Hospital from 2006 through 2020, a longitudinal analysis included participants with CKD. MAFLD was diagnosed in patients with was diagnosed in individuals with hepatic steatosis and at least one of the conditions as follows: 1) overweight or obese (defined as body mass index [BMI] ≥ 23 kg/m2), 2) type 2 diabetes mellitus, or 3) two or more metabolic abnormalities. Adverse renal outcome was defined by a reduction in the estimated glomerular filtrations rate (eGFR) ≥30% of baseline. The changing trend of TyG index over time was classified using latent variable mixture modeling with TyG index during the exposure period. Logistic regression analyses were used to determine the association between TyG index and progression of CKD by adjusting for the influence of confounders.

Results

The study included 4,286 patients, of whom 1287 had MAFLD. Mean age was 52.3 ± 10.9 years. Two distinct groups of TyG index trajectories were identified during the exposure period: decreasing (n= 649) and increasing (n=638). During the event accrual period, 136 patients (10.57 %) developed adverse renal outcomes, and the risk was higher in the increasing TyG trajectory group than in the decreasing TyG trajectory group (hazard ratio 2.265, 95% CI (1.114-4.608), P=0.024). The results were similar after adjustment for baseline clinical characteristics, comorbidities, anthropometric and laboratory findings, and eGFR.

Conclusion

An increasing tendency of TyG index was associated with a higher risk of adverse renal outcomes in patient with MAFLD.