Clinical Scorecard: Assessment of the Combined Utility of TyG Index and Systemic Immune-Inflammation Index for Identifying Diabetic Kidney Disease in Hospitalized Type 2 Diabetes Patients

At a Glance

Key Highlights

• TyG and lgSII levels were significantly higher in DKD patients compared to non-DKD patients (P<0.001).
• The final model achieved an AUC of 0.850 for DKD prediction.
• Optimal cut-off values were TyG >10.03 and lgSII >2.76, with sensitivity of 74.3% and specificity of 85.0%.
• The high-risk group (both indicators above cut-offs) had a DKD prevalence of 96.8%.
• Bootstrap validation yielded a mean AUC of 0.855, indicating robust model stability.

Guideline-Based Recommendations

Diagnosis

• DKD diagnosed based on KDIGO 2022 criteria: persistent UACR ≥30 mg/g and/or eGFR <60 mL/min/1.73m².

Management

• Early detection and timely intervention are crucial to slow disease progression.

Monitoring & Follow-up

• Regular assessment of UACR and eGFR in T2DM patients.

Risks

• Approximately 20%-40% of T2DM patients may develop DKD.

Patient & Prescribing Data

335 hospitalized T2DM patients (175 with DKD, 160 without DKD).

Combination of TyG index and SII may serve as a low-cost tool for risk stratification.

Clinical Best Practices

• Utilize TyG and SII for early identification of high-risk DKD patients.
• Incorporate routine laboratory data for risk assessment.

Related Resources & Content

• KDIGO 2022 Clinical Practice Guideline for Diabetes Management in CKD