A Population-Based Study of the Mediating Role of WBC, NEUT and PLT in the Relationship Between Triglyceride-Glucose Index and Urinary Albumin Excretion

Aim: To assess the potential association between the TyG index and the risk of abnormal UACR. Additionally, we aimed to determine the role and degree of influence of inflammatory biomarkers between the TyG index and abnormal UACR. Materials and Methods: A cross-sectional study recruited 1021 participants from a health management center between 2021 and 2022. Logistic or linear regression models, as well as mediation analysis, were employed to investigate the associations between the TyG index, inflammatory biomarkers (total and differential white blood cell counts, platelet, mean platelet volume(MPV), C-reactive protein(CRP)), and the risk of abnormal UACR. Results: The study included 1021 participants, of whom 55.0% were men. The median age (interquartile range [IQR]) was 61.0 (53, 70) years. In multivariable-adjusted logistic regression models, both with and without the inclusion of smoking, alcohol drinking, BMI, Lipid-lowering drugs using, TC, SUA, ALT, and AST as potential covariates, the TyG index was associated with the risk of UACR, both with the odds ratios (ORs) per 1-standard deviation (SD) increase were 1.32 (95% CI, 1.08-1.62) and 1.27 (95% CI, 1.05-1.52), respectively. This study also demonstrated a significant indirect effect of the TyG index on the risk of abnormal UACR through total white blood cell counts, neutrophil counts and platelet (P values < 0.05); The proportions mediated was 11.2%, 3.5% and 29.6% for each respective variable. Conclusion: Insulin resistance and inflammation are associated with an increased risk of kidney insufficiency. And indicators of inflammation weakly mediate insulin resistance and risk of kidney insufficiency.