Triglyceride Glucose Index in Predicting the Development of Diabetic Kidney disease

Introduction: Chronic kidney disease (CKD) related to diabetes, known as diabetic kidney disease (DKD), affects 20–40% of adults living with diabetes. Although the exact causes are still being explored, factors like insulin resistance (IR), high blood sugar levels, and genetic predispositions seem to play significant roles. DKD is typically diagnosed by checking protein levels in urine and assessing kidney function, with microalbuminuria serving as an early warning sign. However, this can be influenced by other health issues. IR contributes to the progression of DKD by promoting inflammation and harming kidney cells. Researchers are currently investigating the triglyceride-glucose (TyG) index as a promising marker for IR, which could assist in the early detection and management of DKD. Aims & objectives: The aim of this study is to explore how the TyG index can predict the development of diabetic kidney disease. Materials & Methods: This cross-sectional, case-control study took place at a tertiary hospital in northern India and involved 160 patients. They were divided into three groups based on their levels of albuminuria: 79 patients in the normoalbuminuric DKD group (Group I), 37 in the microalbuminuria group (Group II), and 44 in the macroalbuminuria group (Group III). Results: As albuminuria levels increased, we noticed significant changes in several factors: mean age, blood pressure, serum urea, serum creatinine, uric acid, and HbA1c all rose, while haemoglobin levels decreased. In the macroalbuminuria group, cholesterol, triglycerides, LDL, and VLDL levels increased, but HDL levels remained stable. The TyG Index also showed a significant increase across all groups, particularly when comparing those with normoalbuminuric to those with micro- and macroalbuminuria. We found positive correlations between the TyG Index and levels of urea, creatinine, HbA1c, and urine albumin-to-creatinine ratio, while eGFR showed an inverse correlation. Conclusion: This study emphasizes a strong link between a higher TyG Index and an increased risk of microalbuminuria and declining kidney function. The TyG Index appears to be a reliable marker for insulin resistance, offering potential as an early tool for predicting DKD progression. Regular monitoring of the TyG Index may help detect kidney issues sooner and guide preventive measures Key words: Dyslipidaemia, Diabetic Nephropathy, Proteinuria, Cardiovascular risk