Evidence map›Paper›PMID 41316179›Full record

ArticleCardiovascular diabetology2025

Joint association of urinary albumin-to-creatinine ratio within normal range and triglyceride-glucose index with incident cardiovascular disease: a prospective cohort study.

Du Fengjun, Tang Junli, Lu Zilong, Chen Xiaorong, Zhang Jiyu, Xu Jianwei, Zhang Binyin, Dong Jing, Ren Jie, Xu Chunxiao and 4 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Cardiovascular diabetology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Du FengjunSchool of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250100, China.
Tang JunliThe Department for Chronic and Non-Communicable Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, 250014, China.
Lu ZilongThe Department for Chronic and Non-Communicable Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, 250014, China.
Chen XiaorongNational Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 100050, China.
Zhang JiyuThe Department for Chronic and Non-Communicable Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, 250014, China.
Xu JianweiNational Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 100050, China.
Zhang BinyinThe Department for Chronic and Non-Communicable Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, 250014, China.
Dong JingThe Department for Chronic and Non-Communicable Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, 250014, China.
Ren JieThe Department for Chronic and Non-Communicable Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, 250014, China.
Xu ChunxiaoThe Department for Chronic and Non-Communicable Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, 250014, China.
Gao CongcongThe Department for Chronic and Non-Communicable Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, 250014, China.
Guo XiaoleiThe Department for Chronic and Non-Communicable Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, 250014, China. guoxiaolei@126.com.
Wu JingNational Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 100050, China. wujing@ncncd.chinacdc.cn.
Ma JixiangShandong Provincial Chronic Disease Hospital (Shandong Provincial Rehabilitation Center), Qingdao, 266071, China. majix@163.com.

Funding

Provincial Technical Development Plan Grant 2012GSF11828Shandong Provincial Salt and Hypertension Prevention and Control Intervention Project 1311400010601
6 · The paper itself

Abstract

backgroundElevated urinary albumin-to-creatinine ratio (UACR) within the normal range (< 30 mg/g) and the triglyceride-glucose (TyG) index are associated with cardiovascular disease (CVD) incidence, yet their joint effect remains underexplored.

methodsThis prospective cohort study used data from the 2016 Shandong-MOH Salt and Hypertension (SMASH) project, linked to CVD records until September 30, 2023, including 14,481 adults with normal UACR. Participants were stratified by TyG index and UACR quantiles. Multivariable Cox proportional hazards models and restricted cubic splines (RCS) were employed to evaluate individual and joint effects on overall CVD, coronary heart disease (CHD), and stroke. The incremental predictive value was assessed using the C-index, Net Reclassification Improvement (NRI), and Integrated Discrimination Improvement (IDI). Additionally, an exploratory mediation analysis was performed to examine the potential bidirectional effects between the TyG index and UACR.

resultsMean age was 41.75 ± 13.06 years, with median follow-up of 7.2 years. Among 420 incident overall CVD cases (309 stroke, 111 CHD), Compared to the Low TyG & Low UACR group, the High TyG & High UACR group demonstrated the highest risks for overall CVD (HR = 2.632, 95% CI: 1.695-4.085, P < 0.001), CHD (HR = 2.680, 95% CI: 1.144-6.282, P = 0.023), and stroke (HR = 2.628, 95% CI: 1.573-4.392, P < 0.001). The TyG index showed nonlinear associations with overall CVD and stroke risk but a linear association with CHD, while UACR exhibited linear positive correlations with all outcomes. The model combining the TyG index and UACR significantly enhanced the predictive ability for CVD events. Mediation analysis revealed that elevated UACR significantly mediated 4.9% of the association between TyG index and CVD, while elevated TyG index mediated 11.2% of the association between UACR and CVD.

conclusionThe study demonstrates that both elevated UACR (within normal range) and higher TyG index are jointly associated with increased CVD risk, with evidence suggesting potential bidirectional mediation. Their combined assessment provides significant incremental predictive value, supporting its integration into high-risk population screening for precise CVD prevention and management.

Indexed as

AlbuminuriaBlood GlucoseCardiovascular DiseasesCreatinineTriglyceridesAdultBiomarkersChinaFemaleHumansIncidenceMaleMiddle AgedPredictive Value of TestsPrognosisProspective StudiesBiomarkersBlood GlucoseCreatinineTriglyceridesCardiovascular diseaseInsulin resistanceTriglyceride-glucose (TyG) indexUrinary albumin-to-creatinine ratio(UACR)

Identifiers

PMID41316179
PMCPMC12664133

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.