Abstract
BACKGROUND: In patients ≥60 years with hypertension and type 2 diabetes mellitus, triglyceride-glucose index (TyG), TyG-BMI, uric acid to high-density lipoprotein cholesterol ratio (UHR), atherogenic index of plasma (AIP), single point insulin sensitivity estimator (SPISE Index) and their cumulative averages are linked to rapid kidney function decline (RD). This study aimed to identify the parameter most strongly independently associated with RD. METHODS: A retrospective cohort study used electronic records from Shanghai Chuansha Huaxia Community Health Service Center. Consecutive patients ≥60 years with both diseases (January 2020-December 2023) were enrolled and divided into RD (n=151) and Non-RD (n=499) groups based on 4-year eGFR trajectory. RESULTS: RD group had higher age, cum TyG, UHR, cum UHR, and cum AIP (all P<0.05). Multivariable logistic regression showed UHR, cum UHR, and cum AIP were independently associated with RD (P<0.001, P<0.001, P=0.015). Cum UHR had the strongest association (AUC=0.724, 95% CI 0.675-0.773) and non-linear relations with incident RD and absolute eGFR decline. CONCLUSION: Elevated cum UHR is significantly associated with RD in these patients and may serve as a valuable biomarker for high-risk individual identification.