Triglyceride-glucose index predicts the mortality risk among incident peritoneal dialysis patients in a cohort study.

Insulin resistance (IR) frequently cause higher levels of fasting glucose and triglyceride. Triglyceride- glucose (TyG) index has been suggested as a simple, reliable, and cost-effective surrogate for IR. We conducted the present study to assess whether TyG index is associated with increased risk of all-cause and cardiovascular (CV) mortality among our PD cohort. This observational study included 553 patients initiating PD between 2003 and 2017 who were divided into three groups by TyG tertiles. The study exposure was the TyG index at study enrollment. Associations of TyG index with patient mortality were examined in Cox models and the potential confounding covariates included medication use, demographic, comorbidities, PD-associated and laboratory data. The optimal cut-off points of TyG index were also determined using the receiver operating characteristic (ROC) analysis and area under ROC curve (AUC) was calculated. During follow-up, 142 patients died, of whom 89 CV deaths occurred. The risks of all-cause and CV mortality increased with tertiles of TyG index. In the multivariable-adjusted models, the hazard ratios (HRs) in tertile 3 versus tertile 1 were 2.12 (95% CI 1.31-3.43, p = 0.021) and 2.78 (95% CI 1.34-5.76, p = 0.006) for all-cause and CV mortality, respectively. Those independent associations remained even when TyG index was treated as a continuous variable, or per 1-standard deviation increase. The cut-off point of TyG index was 8.79 (62.7% sensitivity and 61.6% specificity) with AUC of 0.652 and 8.85 (66.3% sensitivity and 62.9% specificity) with AUC of 0.681 for all-cause and CV mortality, respectively. Elevated levels of TyG index significantly predicted increased risks of all-cause and CV mortality in patients initiating PD. More studies are required to compare with other surrogates of insulin sensitivity and extrapolated to other ethnic populations.