한국 성인의 공복혈당, 당화혈색소, TG/HDL-C 비율, TyG 지수와 만성 콩팥병의 관련성 = Associations of Fasting Blood Glucose, Hemoglobin A1c, TG/HDL-C ratio, and TyG index with Chronic Kidney Disease in Korean Adults

다국어 초록 (Multilingual Abstract)

Objective: This study aimed to investigate the associations of fasting blood glucose (FBG), hemoglobin A1c (HbA1c), triglyceride-to–high-density lipoprotein cholesterol (TG/HDL-C) ratio, and triglyceride–glucose (TyG) index with chronic kidney disease (CKD) among Korean adults, and to compare the discriminative ability of these metabolic indicators for CKD. Methods: This cross-sectional study used data from the 9th Korea National Health and Nutrition Examination Survey (KNHANES, 2022–2023). A total of 10,667 adults aged ≥19 years were included after excluding individuals with missing laboratory data. CKD was defined as an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m² calculated using the CKD-EPI 2021 equation. Associations between metabolic indicators and CKD were assessed using multivariable logistic regression models. Model 1 was adjusted for sex, age, household income, education level, and living with a partner, while Model 2 was further adjusted for body mass index, drinking status, walking activity, systolic blood pressure, and diastolic blood pressure. Discriminative ability for CKD was evaluated using Harrell’s C-index. Results: The prevalence of CKD was 3.0%. In Model 1, higher levels of HbA1c, TG/HDL-C ratio, and TyG index were significantly associated with increased odds of CKD. However, after full adjustment (Model 2), only HbA1c ≥6.5% remained independently associated with CKD (odds ratio 1.72, 95% confidence interval 1.20–2.47). FBG, TG/HDL-C ratio, and TyG index were not independently associated with CKD after adjustment. In discriminative ability analysis, HbA1c showed the highest Harrell’s C-index (0.73), followed by TG/HDL-C ratio (0.63), FBG (0.63), and TyG index (0.61). HbA1c demonstrated significantly superior discriminative performance compared with the other indicators (all p<0.001). Conclusion: Among Korean adults, HbA1c was independently associated with CKD and showed the best discriminative ability for identifying CKD compared with FBG, TG/HDL-C ratio, and TyG index. These findings suggest that HbA1c may be the most useful metabolic indicator for assessing CKD risk in the general population. Key words: Chronic kidney disease(CKD), fasting blood glucose, HbA1c, TG/HDL-C ratio, TyG index

목차 (Table of Contents)

• I. 서론 1
• II. 연구방법 3
• A. 이용자료 및 연구대상 3
• B. 이용변수 4
• 1. 만성 콩팥병 여부 4
• 2. 일반적 특성 4
• 3. 건강 관련 특성 4
• 4. 임상적 특성 5
• C. 자료 분석 6
• Ⅲ. 연구결과 7
• A. 대상자 특성 분포 7
• 1. 일반적 특성 7
• 2. 건강 관련 특성 9
• 3. 임상적 특성 10
• 4. 연구 대상자의 만성 콩팥병 유병률 12
• B. 대상자의 특성에 따른 만성 콩팥병 관련성 13
• 1. 일반적 특성에 따른 만성 콩팥병 관련성 13
• 2. 건강 관련 특성에 따른 만성 콩팥병 관련성 15
• 3. 임상적 특성에 따른 만성 콩팥병 관련성 16
• C. 연구 대상자의 특성에 따라 공복혈당, 당화혈색소, TG/HDL-C 비율, TyG 지수와 만성 콩팥병의 관련성 18
• D. 공복혈당, 당화혈색소, TG/HDL-C 비율, TyG 지수에 따른 만성 콩팥병 판별력 비교 20
• IV. 고찰 22
• V. 요약 및 결론 25
• 참고문헌 26