{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T23:13:47Z","timestamp":1789773227232,"version":"4.0.1"},"reference-count":50,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,7,12]],"date-time":"2024-07-12T00:00:00Z","timestamp":1720742400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The triglyceride glucose (TyG) index, a metric computed from the levels of fasting triglyceride (TG) and fasting plasma glucose (FPG), has emerged as a simple surrogate measure for insulin resistance (IR) in recent years. In multiple critical care scenarios, such as contrast-induced acute kidney injury (AKI) and cardiorenal syndrome, a high TyG index levels shows a notable correlation with AKI incidence. However, its predictive value for AKI in critically ill hypertensive patients remains uncertain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Participants were selected from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database and divided into quartiles based on the TyG index. The primary focus of the study was to investigate the risk of acute kidney injury (AKI), with in-hospital mortality as a secondary endpoint, assessed among all study subjects as well as specifically among AKI patients. The use of renal replacement therapy (RRT), indicative of AKI progression, was also considered a secondary endpoint reflecting renal outcomes. To explore the correlation between the TyG index and AKI risk in critically ill hypertensive patients, the study employed a restricted cubic splines model and Cox proportional hazards (CPH) models. Additionally, Kaplan-Meier survival analysis was utilized to assess differences in primary and secondary outcomes across groups categorized by their TyG index. Analyses were conducted to ensure the consistency of the predictive capability of TyG index across various subgroups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Our study included 4,418 participants, with 57% being male patients. AKI occurred in 56.1% of cases. Through the CPH analysis, we identified a significant association between the TyG index and AKI occurrence in critically ill hypertensive patients. With the help of a restricted cubic splines model, we observed a direct relationship between an elevated TyG index and an increased AKI. Subgroup examinations consistently proved the predictive value of the TyG index across categories. Furthermore, Kaplan-Meier survival analysis revealed notable differences in RRT among AKI patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The findings underscore the importance of the TyG index as a reliable predictor for the occurrence of AKI and adverse renal outcomes among hypertensive patients in critical ill states. Nevertheless, validating causality mandates extensive prospective investigations.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2024.1437709","type":"journal-article","created":{"date-parts":[[2024,7,12]],"date-time":"2024-07-12T04:30:46Z","timestamp":1720758646000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":14,"title":["Association between the triglyceride glucose index and the risk of acute kidney injury in critically ill patients with hypertension: analysis of the MIMIC-IV database"],"prefix":"10.3389","volume":"15","author":[{"given":"Wenbin","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zewen","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,7,12]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"2982","DOI":"10.1016\/j.jacc.2020.11.010","article-title":"Global burden of cardiovascular diseases and risk factors, 1990-2019: update from the gbd 2019 study","volume":"76","author":"Roth","year":"2020","journal-title":"J Am Coll Cardiol"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2016.0190","article-title":"The burden of hypertension and associated risk for cardiovascular mortality in China","volume":"176","author":"Lewington","year":"2016","journal-title":"JAMA Intern Med"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2016.10.110","article-title":"Burden of hypertension in China: A nationally representative survey of 174,621 adults","volume":"227","author":"Li","year":"2017","journal-title":"Int J Cardiol"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-023-07169-7","article-title":"Epidemiology of surgery associated acute kidney injury (Epis-aki): A prospective international observational multi-center clinical study","volume":"49","author":"Zarbock","year":"2023","journal-title":"Intensive Care Med"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-019-05535-y","article-title":"Acute kidney injury in trauma patients admitted to the icu: A systematic review and meta-analysis","volume":"45","author":"Sovik","year":"2019","journal-title":"Intensive Care Med"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2023.154382","article-title":"Epidemiology, patterns of care and prognosis of acute kidney injury in critically ill patients: A multicenter study in Argentina (the epira study)","volume":"78","author":"Rubatto Birri","year":"2023","journal-title":"J Crit Care"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2019.10.010","article-title":"Critical care nephrology: core curriculum 2020","volume":"75","author":"Griffin","year":"2020","journal-title":"Am J Kidney Dis"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.01300216","article-title":"Biomarkers for the early detection and prognosis of acute kidney injury","volume":"12","author":"Malhotra","year":"2017","journal-title":"Clin J Am Soc Nephrol"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.00740110","article-title":"Urinary biomarkers in the clinical prognosis and early detection of acute kidney injury","volume":"5","author":"Koyner","year":"2010","journal-title":"Clin J Am Soc Nephrol"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1002\/advs.202100275","article-title":"Emerging targets in type 2 diabetes and diabetic complications","volume":"8","author":"Demir","year":"2021","journal-title":"Adv Sci (Weinh)"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.121.17981","article-title":"Hypertension in diabetes: an update of basic mechanisms and\u00a0clinical disease","volume":"78","author":"Jia","year":"2021","journal-title":"Hypertension"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1093\/cvr\/cvaa336","article-title":"Obesity, kidney dysfunction, and inflammation: interactions in hypertension","volume":"117","author":"Hall","year":"2021","journal-title":"Cardiovasc Res"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-019-03392-x","article-title":"The triglycerides and glucose index is associated with elevated blood pressure in apparently healthy children and adolescents","volume":"178","author":"Simental-Mendia","year":"2019","journal-title":"Eur J Pediatr"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2010-0288","article-title":"The product of triglycerides and glucose, a simple measure of insulin sensitivity. 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