The value of triglyceride glucose-body mass index, fasting blood glucose to HDL-C ratio, and platelet to HDL-C ratio in predicting abdominal aortic calcification in maintenance hemodialysis patients

BACKGROUND: The triglyceride glucose-body mass index (TyG-BMI), fasting blood glucose (FBG) to high-density lipoprotein cholesterol (HDL-C) ratio (GHR), and platelet (PLT) to HDL-C ratio (PHR) are well-established markers of insulin resistance (IR), closely linked to cardiovascular and cerebrovascular diseases. Abdominal aortic calcification (AAC), a key indicator of subclinical atherosclerotic, is highly prevalent in maintenance hemodialysis (MHD) patients. This study aimed to explore the cross-sectional relationship between these IR indices and AAC in MHD patients and identify the most reliable predictive marker. METHODS: We recruited 391 MHD patients from two hemodialysis medical centers, with 297 meeting the inclusion criteria. AAC was detected via X-ray scanning of the lumbar spine, quantified by the Kauppila scoring system. Receiver operating characteristic (ROC) curve analysis determined optimal cutoff values for dividing the subjects into high-index and low-index groups. Multivariable logistic regression models evaluated the association between AAC and these IR indices. RESULTS: The prevalence of AAC in the whole group was 72.4%. The occurrence of AAC in the high-index group was significantly higher than that in the low-index group. Among the three IR indices, PHR demonstrated the highest predictive stability when integrated into a combined model. Subgroup analyses confirmed the robustness of this association across different age groups, sex, hypertension levels, comorbidities (CVD and stroke history), and smoking status. CONCLUSION: TyG-BMI, GHR and PHR were independently associated with the presence of AAC among MHD patients. Notably, PHR showed the strongest correlation with AAC, suggesting its potential clinical utility in risk stratification.