Associations between cardiometabolic indices and the risk of diabetic kidney disease in patients with type 2 diabetes
Authors' conclusion
Elevated AIP, SHR, TyG index and HOMA-IR are associated with a greater risk of DKD in patients with T2D. Among these indices, the HOMA-IR score demonstrated the strongest association with and predictive value for DKD incidence.
Study context
- Population
- Patients with T2D; Diabetic kidney disease (DKD) defined as urine albumin/creatinine ratio >30 mg/g or eGFR <60 mL/min per 1.73 mconsecutively enrolled
- Participants
- 4,351 patients
- Exposure
- Highest vs lowest tertile of atherogenic index of plasma (AIP), stress hyperglycemia ratio (SHR), triglyceride-glucose (TyG) index and homeostasis model assessment of insulin resistance (HOMA-IR)
- Outcome
- DKD
Methodological detailsconsecutive enrolment, multivariate logistic regression, restricted cubic splines, ROC analysis
- Consecutive enrolment
- Multivariate logistic regression
- Restricted cubic splines
- ROC analysis
Main finding
As reported in the abstract
DKD, highest vs lowest tertile of each index
Highest tertile vs Lowest tertileOdds ratio (95% CI)P value
AIP
1.08(1.02–1.14)
P = 0.005SHR
1.42(1.12–1.81)
P = 0.004TyG index
1.86(1.42–2.45)
P < 0.001HOMA-IR
2.24(1.52–3.30)
P < 0.001Observational data: associations, not effects.
Further findings
Prevalence of DKD
- Patients diagnosed with DKD
- 1371 (31.5%)
Shape of association (restricted cubic spline)
- J-shaped association of AIP and TyG index with DKD
- Log-shaped association between HOMA-IR and DKD
- U-shaped association between SHR and DKD
Prediction of DKD (ROC)
- HOMA-IR better than other indices at predicting DKD; optimal cutoff
- 3.532
Original publication
Associations between cardiometabolic indices and the risk of diabetic kidney disease in patients with type 2 diabetes. Cardiovasc Diabetol. Published 25 April 2024. doi:10.
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