A Population-Based Study of the Mediating Role of WBC, NEUT and PLT in the Relationship Between Triglyceride-Glucose Index and Urinary Albumin Excretion

Xu Sun,1– 3 Jun Zhu,2,3 Zhuyin Qian,4 Xiaowei Chen,5 Jie Zhang,6 Cheng Ji,7,&ast; Li Zhao1,&ast; 1China Pharmaceutical University, Nanjing, 211198, People’s Republic of China; 2Department of Pharmacy, Nanjing Luhe People’s Hospital, Nanjing, 211500, People’s Republic of China; 3Department of Pharmacy, Nanjing Luhe People’s Hospital, Yangzhou University, Nanjing, 211500, People’s Republic of China; 4Department of General Surgery, Nanjing Luhe People’s Hospital, Yangzhou University, Nanjing, 211500, People’s Republic of China; 5Department of Central Laboratory, Nanjing Luhe People’s Hospital, Yangzhou University, Nanjing, 211500, People’s Republic of China; 6Department of Endocrinology, Nanjing Luhe People’s Hospital, Yangzhou University, Nanjing, 211500, People’s Republic of China; 7Department of Pharmacy, Drum Tower Hospital Affiliated to Nanjing University Medical School, Nanjing, Jiangsu, 210000, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Cheng Ji; Li Zhao, Email [email protected]; [email protected]: To assess the potential association between the TyG index and the risk of abnormal UACR. Additionally, we aimed to determine the role and degree of influence of inflammatory biomarkers between the TyG index and abnormal UACR.Materials and Methods: A cross-sectional study recruited 1021 participants from a health management center between 2021 and 2022. Logistic or linear regression models, as well as mediation analysis, were employed to investigate the associations between the TyG index, inflammatory biomarkers (total and differential white blood cell counts, platelet, mean platelet volume(MPV), C-reactive protein(CRP)), and the risk of abnormal UACR.Results: The study included 1021 participants, of whom 55.0% were men. The median age (interquartile range [IQR]) was 61.0 (53, 70) years. In multivariable-adjusted logistic regression models, both with and without the inclusion of smoking, alcohol drinking, BMI, Lipid-lowering drugs using, TC, SUA, ALT, and AST as potential covariates, the TyG index was associated with the risk of UACR, both with the odds ratios (ORs) per 1-standard deviation (SD) increase were 1.32 (95% CI, 1.08– 1.62) and 1.27 (95% CI, 1.05– 1.52), respectively. This study also demonstrated a significant indirect effect of the TyG index on the risk of abnormal UACR through total white blood cell counts, neutrophil counts and platelet (P values < 0.05); The proportions mediated was 11.2%, 3.5% and 29.6% for each respective variable.Conclusion: Insulin resistance and inflammation are associated with an increased risk of kidney insufficiency. And indicators of inflammation weakly mediate insulin resistance and risk of kidney insufficiency.Keywords: TyG index, urinary albumin-to-creatinine ratio, UACR, white blood cell counts, systemic inflammation, neutrophil counts, platelet