Evidence mapPaperPMID 41601879Full record

ArticleFrontiers in nutrition2025

Triglyceride-glucose-body mass index predicts early-onset acute kidney injury in critically ill patients: a retrospective analysis using the MIMIC-IV database.

Qiang Zhu, Qunchuan Zong, Shiying Guo, Yonghong Ma, Miao Zhang, Ningjing Jin, Yinggui Ba, Huajie Zou, Ruixia Zhang

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Article in Frontiers in nutrition, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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9 authors.

Qiang ZhuDepartment of Endocrinology and Metabolism, The Affiliated Hospital of Qinghai University, Xining, China.
Qunchuan ZongDepartment of Traumatology and Orthopedics, The Affiliated Hospital of Qinghai University, Xining, China.
Shiying GuoDepartment of Endocrinology and Metabolism, The Affiliated Hospital of Qinghai University, Xining, China.
Yonghong MaDepartment of Endocrinology and Metabolism, The Affiliated Hospital of Qinghai University, Xining, China.
Miao ZhangDepartment of Endocrinology and Metabolism, The Affiliated Hospital of Qinghai University, Xining, China.
Ningjing JinDepartment of Endocrinology and Metabolism, The Affiliated Hospital of Qinghai University, Xining, China.
Yinggui BaDepartment of Nephrology, The Affiliated Hospital of Qinghai University, Xining, China.
Huajie ZouDepartment of Endocrinology and Metabolism, The Affiliated Hospital of Qinghai University, Xining, China.
Ruixia ZhangDepartment of Endocrinology and Metabolism, The Affiliated Hospital of Qinghai University, Xining, China.

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No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Acute kidney injury (AKI) is a common and serious complication in critically ill patients, with metabolic dysfunction playing a crucial role in its pathogenesis. The triglyceride-glucose-body mass index (TyG-BMI) has emerged as a novel marker of insulin resistance and metabolic health. However, the relationship between TyG-BMI and early-onset AKI in critically ill patients remains unclear. The aim of this study was to evaluate the association between TyG-BMI and early-onset AKI in critically ill patients, and identify optimal cutoff thresholds for risk stratification. Methods: This retrospective study analyzed 4,024 critically ill adults from the MIMIC-IV database. Patients were stratified according to TyG-BMI quartiles. Cox proportional hazards models, restricted cubic splines (RCS), and receiver operating characteristic (ROC) analyses were employed to examine associations between TyG-BMI and early-onset AKI. Optimal cutoff values were determined using the Youden index, while net reclassification improvement (NRI) assessed incremental predictive value. Results: Early-onset AKI developed in 2,535 patients (63.0%). Multivariable-adjusted hazard ratios increased across TyG-BMI quartiles, with the highest quartile showing significantly increased risk compared to the lowest (HR 1.40, 95% CI: 1.25-1.58). Risk increased approximately linearly when TyG-BMI exceeded 261.84. The optimal cutoff value was 252.50 (sensitivity 0.604, specificity 0.648). Adding TyG-BMI to traditional risk models improved prediction (NRI = 0.141, 95% CI: 0.024-0.207). Associations were stronger among males, younger patients, those with preserved eGFR, and patients with diabetes or sepsis. Conclusion: Triglyceride-glucose-body mass index independently predicts early-onset AKI in critically ill patients. The threshold of 252.50 offers a reliable reference for risk stratification in ICU settings.

Indexed as

AKIcritically illinsulin resistancemetabolic dysfunctionTyG-BMI

Identifiers

PMID41601879
PMCPMC12832482

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