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Background <p>Atrial fibrillation (AF) is common in intensive care and often complicated by acute kidney injury (AKI). The triglyceride-glucose (TyG) index, a marker of insulin resistance, has not been studied for AKI risk in AF patients.</p> Methods <p>This retrospective cohort study analyzed 1,142 critically ill AF patients from MIMIC-IV. Patients were stratified by TyG index tertiles. Multivariable logistic regression, restricted cubic splines, and ROC curves assessed the TyG-AKI relationship, adjusting for confounders.</p> Results <p>AKI incidence was highest in the top TyG tertile (52.76%) versus middle (37.20%) and lowest (36.39%) (<i>p</i> &lt; 0.001). After adjustment, higher TyG (continuous) correlated with increased AKI risk (OR 1.21, 95% CI 1.02–1.45, <i>p</i> = 0.002). The highest tertile had greater AKI risk than the lowest (OR 1.37, 95% CI 1.29–2.02, <i>p</i> = 0.02). Spline analysis showed a near-linear dose-response relationship. The ROC AUC was 0.77, indicating moderate predictive value. Subgroup analyses confirmed consistency across age, sex, ethnicity, and comorbidities.</p> Conclusion <p>Elevated TyG index independently predicts higher AKI risk in critically ill AF patients, with a near-linear association. The TyG index may aid AKI risk stratification in this population.</p>

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Elevated triglyceride-glucose index and acute kidney injury risk in critical atrial fibrillation: an analysis from MIMIC-IV

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年9月29日

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  • Ye Lu,
  • Yifan Wu,
  • Lin Shi,
  • Yuxiang Lu

摘要

Background

Atrial fibrillation (AF) is common in intensive care and often complicated by acute kidney injury (AKI). The triglyceride-glucose (TyG) index, a marker of insulin resistance, has not been studied for AKI risk in AF patients.

Methods

This retrospective cohort study analyzed 1,142 critically ill AF patients from MIMIC-IV. Patients were stratified by TyG index tertiles. Multivariable logistic regression, restricted cubic splines, and ROC curves assessed the TyG-AKI relationship, adjusting for confounders.

Results

AKI incidence was highest in the top TyG tertile (52.76%) versus middle (37.20%) and lowest (36.39%) (p < 0.001). After adjustment, higher TyG (continuous) correlated with increased AKI risk (OR 1.21, 95% CI 1.02–1.45, p = 0.002). The highest tertile had greater AKI risk than the lowest (OR 1.37, 95% CI 1.29–2.02, p = 0.02). Spline analysis showed a near-linear dose-response relationship. The ROC AUC was 0.77, indicating moderate predictive value. Subgroup analyses confirmed consistency across age, sex, ethnicity, and comorbidities.

Conclusion

Elevated TyG index independently predicts higher AKI risk in critically ill AF patients, with a near-linear association. The TyG index may aid AKI risk stratification in this population.