Investigation of the association between Triglyceride - Glucose index (TyG) and renal injury among hypertensive patients at Can Tho University of Medicine and Pharmacy Hospital in 2024 - 2025
Main Article Content
Abstract
Renal injury is a common complication among patients with hypertension, and insulin resistance is considered an important pathogenic mechanism. The Triglyceride - Glucose (TyG) index has been proposed as a surrogate marker of insulin resistance; however, the association between the TyG index and renal injury in patients with hypertension remains unclear, particularly in Vietnam. A cross - sectional study was conducted among 327 hypertensive patients at Can Tho University of Medicine and Pharmacy Hospital between May and October 2025 to determine the prevalence of renal injury and to examine the association between the TyG index and renal injury. The results shows that 23.9% of patients had renal injury, and those with a high TyG index (≥ 9.39) have a 1,64 - fold higher risk of renal injury compared with the remaining group (RR = 1.64; 95% CI: 1.05 - 2.54; p = 0.023). These findings suggest a potential role of the TyG index in risk stratification for renal injury among patients with hypertension.
Article Details
Keywords
Triglyceride - Glucose Index, TyG, renal injury, hypertension
References
1. Poudel B, Yadav BK, Nepal AK, Jha B, Raut KB. Prevalence and association of microalbuminuria in essential hypertensive patients. N Am J Med Sci. 2012 Aug; 4(8): 331-5. doi: 10.4103/1947-2714.99501.
2. Bùi Thị Mỹ Lệ, Nguyễn Minh Nguyệt, Trần Thị Hải Hà, Nguyễn Thế Anh. Khảo sát kết quả xét nghiệm UACR ở bệnh nhân tăng huyết áp tại khoa khám bệnh - Bệnh viện Hữu Nghị. Tạp chí Y học Việt Nam. 2025; 552(2). doi: 10.51298/vmj.v552i2.15009.
3. Guthrie RM, Lott JA. Screening for proteinuria in patients with hypertension or diabetes mellitus. J Fam Pract. 1993 Sep; 37(3): 253-6. PMID: 8409876.
4. Hsu CC, Chang HY, Huang MC, Hwang SJ, Yang YC, Tai TY, et al. Association between insulin resistance and development of microalbuminuria in type 2 diabetes: a prospective cohort study. Diabetes Care. 2011 Apr; 34(4): 982-7. doi: 10.2337/dc10-1718.
5. Falkner B, Sherif K, Kushner H. Hypertensive vascular disease and insulin resistance. Diabetes Res Clin Pract. 2001; 54(1): 17-24. doi:10.1016/s0168-8227(01)00228-5.
6. Andronico G, Ferraro-Mortellaro R, Mangano M, Romé M, Raspanti F, Pinto A, et al. Insulin resistance and glomerular hemodynamics in essential hypertension. Kidney Int. 2002; 62(3): 1005-1009. doi: 10.1046/j.1523-1755.2002.00529.x.
7. Nistala R, Whaley-Connell A. Resistance to insulin and kidney disease in the cardiorenal metabolic syndrome; role for angiotensin II. Mol Cell Endocrinol. 2013 Sep 25; 378(1-2): 53-8. doi: 10.1016/j.mce.2013.02.005.
8. Kobayashi H, Tokudome G, Hara Y, Sugano N, Endo S, Suetsugu Y, et al. Insulin resistance is a risk factor for the progression of chronic kidney disease. Clin Nephrol. 2009 Jun; 71(6): 643-51. doi: 10.5414/cnp71643.
9. Sun Y, Ji H, Sun W, An X, Lian F. Triglyceride glucose (TyG) index: A promising biomarker for diagnosis and treatment of different diseases. Eur J Intern Med. 2025; 131: 3-14. doi: 10.1016/j.ejim.2024.08.026.
10. Guerrero-Romero F, Simental-Mendía LE, González-Ortiz M, Martínez-Abundis E, Ramos-Zavala MG, Hernández-González SO, et al. The product of triglycerides and glucose, a simple measure of insulin sensitivity. Comparison with the euglycemic-hyperinsulinemic clamp. J Clin Endocrinol Metab. 2010 Jul; 95(7): 3347-51. doi: 10.1210/jc.2010-0288.
11. Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension. 2018; 71(6): e13-e115. doi: 10.1161/HYP.0000000000000065.
12. Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney Int. 2024 Apr; 105(4S): S117-S314. doi: 10.1016/j.kint.2023.10.018.
13. Kaze FF, Kengne AP, Magatsing CT, Halle MP, Yiagnigni E, Ngu KB. Prevalence and Determinants of Chronic Kidney Disease Among Hypertensive Cameroonians According to Three Common Estimators of the Glomerular Filtration Rate. J Clin Hypertens (Greenwich). 2016 May; 18(5): 408-14. doi: 10.1111/jch.12781.
14. WHO expert consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. The Lancet. 2004 Jan; 363(9403): 157-163. doi: 10.1016/S0140-6736(03)15268-3.
15. Nabipoorashrafi SA, Adeli A, Seyedi SA, Rabizadeh S, Arabzadeh Bahri R, Mohammadi F, et al. Comparison of insulin resistance indices in predicting albuminuria among patients with type 2 diabetes. Eur J Med Res. 2023 May 10; 28(1): 166. doi: 10.1186/s40001-023-01134-2.
16. Bùi Thị Ánh Nguyệt, Bùi Thiên Hương, Nguyễn Văn Trường, Nguyễn Trọng Hưng, Trần Thị Hà Thu, Đỗ Nam Khánh. Thừa cân béo phì và một số đặc điểm hóa sinh của người bệnh tăng huyết áp điều trị tại Trung tâm Y tế Thành phố Vĩnh Yên, tỉnh Vĩnh Phúc. VMJ. 2025; 546(1). doi:10.51298/vmj.v546i1.12558.
17. Hall JE, do Carmo JM, da Silva AA, Wang Z, Hall ME. Obesity-induced hypertension: interaction of neurohumoral and renal mechanisms. Circ Res. 2015 Mar 13; 116(6): 991-1006. doi: 10.1161/CIRCRESAHA.116.305697.
18. Kovesdy CP, Furth SL, Zoccali C. Obesity and kidney disease: hidden consequences of the epidemic. Braz J Med Biol Res. 2017 Apr 13; 50(5): e6075. doi: 10.1590/1414-431X20166075.
19. Ismayilova M, Demirci Y, Sener EF, Oltulu F, Yildirim A, Kustimur S. The role of NLRP3 inflammasome in diabetic neuropathy and its therapeutic potential. Front Endocrinol (Lausanne). 2022; 13: 1038758. doi: 10.3389/fendo.2022.1038758.
20. Reaven GM. Insulin resistance: the link between obesity and cardiovascular disease. Med Clin North Am. 2011 Sep; 95(5): 875-92. doi: 10.1016/j.mcna.2011.06.002. PMID: 21855697.
21. Temimovic R, Rasic S, Muslimovic A. High prevalence of early chronic kidney disease in high risk outpatients. Mater Sociomed. 2015 Apr; 27(2): 79-82. doi: 10.5455/msm.2015.27.79-82.
22. Shimobayashi M, Albert V, Woelnerhanssen B, Frei IC, Weissenberger D, Meyer-Gerspach AC, et al. Insulin resistance causes inflammation in adipose tissue. J Clin Invest. 2018 Apr 2; 128(4): 1538-1550. doi: 10.1172/JCI96139.
23. Reaven GM. Insulin resistance: from bit player to centre stage. CMAJ. 2011 Mar 22;183(5):536-7. doi: 10.1503/cmaj.101430.
24. Nakashima A, Kato K, Ohkido I, Yokoo T. Role and Treatment of Insulin Resistance in Patients with Chronic Kidney Disease: A Review. Nutrients. 2021; 13(12): 4349. https://doi.org/10.3390/nu13124349.
25. Spoto B, Pisano A, Zoccali C. Insulin resistance in chronic kidney disease: a systematic review. American Journal of Physiology-Renal Physiology. 2016 311:6, F1087-F1108. doi: 10.1152/ajprenal.00340.2016.
2. Bùi Thị Mỹ Lệ, Nguyễn Minh Nguyệt, Trần Thị Hải Hà, Nguyễn Thế Anh. Khảo sát kết quả xét nghiệm UACR ở bệnh nhân tăng huyết áp tại khoa khám bệnh - Bệnh viện Hữu Nghị. Tạp chí Y học Việt Nam. 2025; 552(2). doi: 10.51298/vmj.v552i2.15009.
3. Guthrie RM, Lott JA. Screening for proteinuria in patients with hypertension or diabetes mellitus. J Fam Pract. 1993 Sep; 37(3): 253-6. PMID: 8409876.
4. Hsu CC, Chang HY, Huang MC, Hwang SJ, Yang YC, Tai TY, et al. Association between insulin resistance and development of microalbuminuria in type 2 diabetes: a prospective cohort study. Diabetes Care. 2011 Apr; 34(4): 982-7. doi: 10.2337/dc10-1718.
5. Falkner B, Sherif K, Kushner H. Hypertensive vascular disease and insulin resistance. Diabetes Res Clin Pract. 2001; 54(1): 17-24. doi:10.1016/s0168-8227(01)00228-5.
6. Andronico G, Ferraro-Mortellaro R, Mangano M, Romé M, Raspanti F, Pinto A, et al. Insulin resistance and glomerular hemodynamics in essential hypertension. Kidney Int. 2002; 62(3): 1005-1009. doi: 10.1046/j.1523-1755.2002.00529.x.
7. Nistala R, Whaley-Connell A. Resistance to insulin and kidney disease in the cardiorenal metabolic syndrome; role for angiotensin II. Mol Cell Endocrinol. 2013 Sep 25; 378(1-2): 53-8. doi: 10.1016/j.mce.2013.02.005.
8. Kobayashi H, Tokudome G, Hara Y, Sugano N, Endo S, Suetsugu Y, et al. Insulin resistance is a risk factor for the progression of chronic kidney disease. Clin Nephrol. 2009 Jun; 71(6): 643-51. doi: 10.5414/cnp71643.
9. Sun Y, Ji H, Sun W, An X, Lian F. Triglyceride glucose (TyG) index: A promising biomarker for diagnosis and treatment of different diseases. Eur J Intern Med. 2025; 131: 3-14. doi: 10.1016/j.ejim.2024.08.026.
10. Guerrero-Romero F, Simental-Mendía LE, González-Ortiz M, Martínez-Abundis E, Ramos-Zavala MG, Hernández-González SO, et al. The product of triglycerides and glucose, a simple measure of insulin sensitivity. Comparison with the euglycemic-hyperinsulinemic clamp. J Clin Endocrinol Metab. 2010 Jul; 95(7): 3347-51. doi: 10.1210/jc.2010-0288.
11. Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension. 2018; 71(6): e13-e115. doi: 10.1161/HYP.0000000000000065.
12. Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney Int. 2024 Apr; 105(4S): S117-S314. doi: 10.1016/j.kint.2023.10.018.
13. Kaze FF, Kengne AP, Magatsing CT, Halle MP, Yiagnigni E, Ngu KB. Prevalence and Determinants of Chronic Kidney Disease Among Hypertensive Cameroonians According to Three Common Estimators of the Glomerular Filtration Rate. J Clin Hypertens (Greenwich). 2016 May; 18(5): 408-14. doi: 10.1111/jch.12781.
14. WHO expert consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. The Lancet. 2004 Jan; 363(9403): 157-163. doi: 10.1016/S0140-6736(03)15268-3.
15. Nabipoorashrafi SA, Adeli A, Seyedi SA, Rabizadeh S, Arabzadeh Bahri R, Mohammadi F, et al. Comparison of insulin resistance indices in predicting albuminuria among patients with type 2 diabetes. Eur J Med Res. 2023 May 10; 28(1): 166. doi: 10.1186/s40001-023-01134-2.
16. Bùi Thị Ánh Nguyệt, Bùi Thiên Hương, Nguyễn Văn Trường, Nguyễn Trọng Hưng, Trần Thị Hà Thu, Đỗ Nam Khánh. Thừa cân béo phì và một số đặc điểm hóa sinh của người bệnh tăng huyết áp điều trị tại Trung tâm Y tế Thành phố Vĩnh Yên, tỉnh Vĩnh Phúc. VMJ. 2025; 546(1). doi:10.51298/vmj.v546i1.12558.
17. Hall JE, do Carmo JM, da Silva AA, Wang Z, Hall ME. Obesity-induced hypertension: interaction of neurohumoral and renal mechanisms. Circ Res. 2015 Mar 13; 116(6): 991-1006. doi: 10.1161/CIRCRESAHA.116.305697.
18. Kovesdy CP, Furth SL, Zoccali C. Obesity and kidney disease: hidden consequences of the epidemic. Braz J Med Biol Res. 2017 Apr 13; 50(5): e6075. doi: 10.1590/1414-431X20166075.
19. Ismayilova M, Demirci Y, Sener EF, Oltulu F, Yildirim A, Kustimur S. The role of NLRP3 inflammasome in diabetic neuropathy and its therapeutic potential. Front Endocrinol (Lausanne). 2022; 13: 1038758. doi: 10.3389/fendo.2022.1038758.
20. Reaven GM. Insulin resistance: the link between obesity and cardiovascular disease. Med Clin North Am. 2011 Sep; 95(5): 875-92. doi: 10.1016/j.mcna.2011.06.002. PMID: 21855697.
21. Temimovic R, Rasic S, Muslimovic A. High prevalence of early chronic kidney disease in high risk outpatients. Mater Sociomed. 2015 Apr; 27(2): 79-82. doi: 10.5455/msm.2015.27.79-82.
22. Shimobayashi M, Albert V, Woelnerhanssen B, Frei IC, Weissenberger D, Meyer-Gerspach AC, et al. Insulin resistance causes inflammation in adipose tissue. J Clin Invest. 2018 Apr 2; 128(4): 1538-1550. doi: 10.1172/JCI96139.
23. Reaven GM. Insulin resistance: from bit player to centre stage. CMAJ. 2011 Mar 22;183(5):536-7. doi: 10.1503/cmaj.101430.
24. Nakashima A, Kato K, Ohkido I, Yokoo T. Role and Treatment of Insulin Resistance in Patients with Chronic Kidney Disease: A Review. Nutrients. 2021; 13(12): 4349. https://doi.org/10.3390/nu13124349.
25. Spoto B, Pisano A, Zoccali C. Insulin resistance in chronic kidney disease: a systematic review. American Journal of Physiology-Renal Physiology. 2016 311:6, F1087-F1108. doi: 10.1152/ajprenal.00340.2016.