The Predictive Role of Triglyceride-Glucose Body Mass Index (TyG-BMI) for Acute Kidney Injury Following Coronary Artery Bypass Grafting in Patients with Type 2 Diabetes Mellitus

Abstract

Background: Acute kidney injury (AKI) that may follow coronary artery bypass grafting (CABG) is a serious problem that is aggravated in both incidence and severity by the concurrent state of perioperative dysglycemia in type 2 diabetes mellitus (T2DM) patients. Recently, it has been acknowledged that the triglyceride-glucose body mass index (TyG-BMI), a composite measure of insulin resistance, is a promising predictor of renal and cardiovascular outcomes.

Objective: In this study, we aimed to investigate the predictive role of the TyG-BMI for postoperative AKI in T2DM patients undergoing CABG.

Methods: Starting in June 2020 and continuing over the last 5 years, we enrolled 185 patients with T2DM who underwent elective CABG to correlate the preoperatively calculated TyG-BMI with the incidence of AKI occurring within the first 3 days following surgery, as defined by the kidney disease: Improving Global Outcomes (KDIGO) criteria. Logistic regression and ROC curve analyses were used to determine the association and predictive power of TyG-BMI for AKI.

Results: Fifty-five patients (29.7%) experienced AKI. TyG-BMI levels were substantially higher in patients with AKI (mean 202.4 ± 21.6 vs. 185.7 ± 18.9, p < 0.001). After controlling for age, baseline creatinine, BMI, and ejection fraction, TyG-BMI continued to be an independent predictor of AKI (adjusted OR 1.042, 95% CI: 1.017–1.068, p < 0.001). An area under the curve (AUC) of 0.78 from ROC curve analysis indicated strong predictive performance. AKI was predicted with 74.5% sensitivity and 71% specificity using a TyG-BMI cutoff of 192.5.

Conclusion: TyG-BMI is a reliable, simple, and independent predictor of AKI following CABG in T2DM patients. Preoperative TyG-BMI assessment may help identify high-risk individuals for closer monitoring and prophylactic interventions.