Abstract
We aimed to characterize the role of triglyceride-glucose index (TyG index), a surrogate marker of insulin resistance (IR), and renal function decline (RFD) in a large community-based prospective cohort study. A sum of 85,569 participants were included in the current study, all participants were categorized based on quartiles of the TyG index levels. The primary outcome of this study was future RFD, which was defined as a reduction of ≥ 25% in the estimated glomerular filtration rate from the baseline to below 60 mL/min/1.73 m2. Incidence rate was expressed as cases per 1,000 person-years. The association between the TyG index and the risk of RFD was investigated using Cox proportional hazards models. During a median follow-up period of 14.01 years (interquartile range: 13.63-14.21 years), a total of 3668 cases RFD were recorded. The incidence rate of incident RFD increased substantially with the quartiles of TyG index, presenting 2.529, 3.110, 3.431, and 4.050 per 1,000-person year in quartile 1 to quartile 4. Multivariate Cox regression analysis revealed that the hazard ratio of RFD risk was 1.656 (95% confidence interval: 1.479-1.854) in quartile 4 compared with the quartile 1. The findings of this study indicate that an elevated TyG index correlates with an increased risk of future RFD, suggesting that IR could play a pivotal role in the onset of RFD.