Abstract: Objective  To investigate the relationship between Triglyceride glucose (TyG), C-reactive protein to albumin ratio (CRP/ALB) and coronary artery calcification in patients with end-stage renal disease (ESRD) who were going to start dialysis treatment.  Methods  Patients with ESRD who were admitted to the Department of Nephrology of our hospital from January 2020 to December 2023 to undergo dialysis were selected as the study objects. The patients were divided into calcification group and non-calcification group according to the coronary score. Logistic regression was used to analyze the risk factors of coronary artery calcification in ESRD patients. Receiver operating characteristic (ROC) curve was plotted to evaluate the diagnostic value of TyG, CRP/ALB and their combined detection in baseline coronary artery calcification in dialysis patients by area under ROC curve (AUC). Results  ①Among the 303 patients included in the study, 182 had vascular calcification (60.06%). The average age of the patients was 61.2 years, with 181 males (59.74%), and 199 patients (65.68%) combined with diabetes. 276 patients (91.09%) had hypertension, and 145 patients (47.85%) were smokers. There were statistically significant differences in age and the proportion of patients with diabetes between the two groups (P＜0.05). ② Comparison of laboratory examination indexes between the two groups: TyG (Z=-4.908, P＜0.001) and CRP/ALB (Z=-5.559, P＜0.001) in the calcification group were higher than those in the non-calcification group. ③Multivariate Logistic regression analysis showed that: The age of the patients with ESRD (OR =1.030, 95% CI：1.006～1.054, P=0.015), diabetes (OR=1.747, 95% CI：1.039～2.938, P=0.035), TyG (OR =1.123, 95% CI：1.046～1.207, P=0.001) and CRP/ALB ratio (OR=2.307, 95% CI：1.475～3.609, P＜0.001) were independent risk factors for coronary calcification in ESRD patients. ④ROC curve analysis results showed that the sensitivity of serum TyG, CRP/ALB and their combination for the diagnosis of coronary artery calcification in ESRD patients undergoing hemodialysis were 0.731, 0.692 and 0.896, and the specificity was 0.570, 0.628 and 0.446, respectively. The AUC was 0.666, 0.688 and 0.724, and the Jorden index was 0.301, 0.320 and 0.342, respectively. Conclusion: Serum TyG and CRP/ALB in ESRD patients undergoing dialysis are independent risk factors for coronary calcification, and serum TyG, CRP/ALB and their combined detection have high diagnostic efficacy in patients with coronary calcification.

Key words: End-stage renal disease, TyG, CRP/ALB, Coronary calcification