Relationship Between Triglyceride-Glucose Index and Microvascular Complications in Hospitalized Patients with Type 2 Diabetes Mellitus
Abstract
Aim: The increasing prevalence of diabetes mellitus (DM) brings about a rise in nephropathy, retinopathy, and neuropathy, which
are microvascular complications of diabetes. The triglyceride-glucose (TyG) index is a convenient indicator of insulin resistance. It is
related to microvascular and macrovascular complications among nonhospitalized patients with diabetes. However, it is unclear if the
TyG index poses risks for vascular complications of type 2 DM in hospitalized patients. This study aims to investigate possible relations
between this index and the risk of microvascular complications in hospitalized patients with type 2 DM.
Material and Methods: The present study included 420 type 2 DM patients who were hospitalized in our clinic between February 2019
and May 2022. The TyG index was measured as fasting triglycerides mg/dL × fasting glucose mg/dL/2. The presence of microalbuminuria
(MAU), diabetic neuropathy, chronic kidney disease (CKD), and retinopathy (DR) were evaluated. The data were analzed using IBM
SPSS 22.0 statistical software. The level of statistical significance was taken as p<0.05.
Results: Among the patients (164 males, 256 females), the median age was 61 years (20-91).. Diabetic nephropathy, retinopathy, and
neuropathy rates were 34.0%, 35.4%, and 50.5%, respectively. Patients with diabetic nephropathy had significantly higher TyG index
values (9.67±0.84) compared to those without (9.48±0.75, p=0.019). No significant associations were found between the TyG index and
retinopathy or neuropathy.
Conclusion: High TyG index values were associated with diabetic nephropathy in hospitalized patients with T2DM. The TyG index may
be a useful, easy-to-measure marker for early detection and prevention of diabetic nephropathy in clinical settings.
References
- 1. Seid MA, Akalu Y, Gela YY, Belsti Y, Diress M, Fekadu SA, Dagnew B, Getnet M. Microvascular complications and its predictors among type 2 diabetes mellitus patients at Dessie town hospitals, Ethiopia. Diabetol Metab Syndr. 2021;13(1):86.
- 2. Zou J, Tian F, Zhang Y, Li Z, Yang C, Chen H, Zhai J, Shi M, Xu C, Zhang J, Li W, Xie Y, Li X. Association between Thyroid Hormone Levels and Diabetic Kidney Disease in Euthyroid Patients with Type 2 Diabetes. Sci Rep. 2018;8(1):4728.
- 3. Zou J, Li Z, Tian F, Zhang Y, Xu C, Zhai J, Shi M, Wu G, Zhang Z, Yang C, Chen H, Li. X Association between normal thyroid hormones and diabetic retinopathy in patients with type 2 diabetes. Biomed Res Int. 2020;2020:8161797.
- 4. Myron AB, Matthew V. Diabetic neuropathy. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2018 Jan.
- 5. Pan Y, Zhong S, Zhou K, Tian Z, Chen F, Liu Z, Geng Z, Li S, Huang R, Wang H, Zou W, Hu J. Association between Diabetes Complications and the Triglyceride-Glucose Index in Hospitalized Patients with Type 2 Diabetes. J Diabetes Res. 2021;2021:8757996.
- 6. Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985;28(7):412- 419.
- 7. Kang B, Yang Y, Lee EY, Yang HK, Kim HS, Lim SY, Lee JH, Lee SS, Suh BK, Yoon KH. Triglycerides/glucose index is a useful surrogate marker of insulin resistance among adolescents. Int J Obes (Lond). 2017;41(5):789-792.
- 8. Guerrero-Romero F, Simental-Mendía LE, González-Ortiz M, Martínez-Abundis E, Ramos-Zavala MG, Hernández- González SO, Jacques-Camarena O, Rodríguez-Morán M. The product of triglycerides and glucose, a simple measure of insulin sensitivity. Comparison with the euglycemic-hyperinsulinemic clamp. J Clin Endocrinol Metab. 2010;95(7):3347- 3351.
- 9. Liu L, Xia R, Song X, Zhang B, He W, Zhou X, Li S, Yuan G. Association between the triglyceride-glucose index and diabetic nephropathy in patients with type 2 diabetes: A cross-sectional study. J Diabetes Investig. 2021;12(4):557-565.
- 10. Unger G, Benozzi SF, Perruzza F, Pennacchiotti GL. Triglycerides and glucose index: a useful indicator of insulin resistance. Endocrinol Nutr. 2014;61(10):533-540.
- 11. Srinivasan S, Singh P, Kulothungan V, Sharma T, Raman R. Relationship between triglyceride glucose index, retinopathy and nephropathy in Type 2 diabetes. Endocrinol Diabetes Metab. 2020;4(1):e00151.
- 12. Kwai NCG, Nigole W, M Poynten A, Brown C, V Krishnan A. The relationship between dyslipidemia and acute axonal function in Type 2 diabetes mellitus In Vivo. PLoS ONE. 2016;11(4):e0153389.
- 13. Akbar M, Bhandari U, Habib A, Ahmad R. Potential Association of Triglyceride Glucose Index with Cardiac Autonomic Neuropathy in Type 2 Diabetes Mellitus Patients. J Korean Med Sci. 2017;32(7):1131-1138.
- 14. Zhao S, Yu S, Chi C, Fan X, Tang J, Ji H, Teliewubai J, Zhang Y, Xu Y. Association between macro- and microvascular damage and the triglyceride glucose index in community-dwelling elderly individuals: the Northern Shanghai Study. Cardiovasc Diabetol. 2019;18(1):95.
Hastanemizde Yatan Tip 2 Diyabetli Hastalarda Trigliserid/Glukoz İndeksi ile Diyabetin Mikrovasküler Komplikasyonları Arasındaki İlişki
Abstract
Amaç: Diyabetes melitusun (DM) prevalansındaki artış, diyabete bağlı mikrovasküler (nefropati, retinopati ve nöropati)
komplikasyonların artışını da beraberinde getirmektedir. Trigliserid/glukoz indeksi (TyG) insülin direncini yansıtmakta kullanışlı bir
göstergedir. Ayakta tedavi alan diyabetli hastalarda mikrovasküler ve makrovasküler komplikasyonlar ile arasındaki ilişki gösterilmiştir.
Ancak yatan hastalarda bu ilişki net değildir. Hospitalize olan tip 2 diyabetli hastalarda trigliserid/glukoz indeksi ile diyabetin
mikrovasküler komplikasyonları arasındaki olası ilişkiyi araştırmayı amaçladık.
Gereç ve Yöntemler: Bu çalışmaya Şubat 2019-Mayıs 2022 tarihleri arasında tip 2 DM nedeniyle yatırılan toplam 420 hasta dahil edildi.
Trigliserid/glukoz indeksi açlık trigliserid mg/dl × açlık glukoz mg/dl/2 formülüne göre hesaplandı. Her bir hasta için mikroalbuminüri, kronik böbrek hastalığı (KBH), diyabetik nöropati ve retinopati (DR) varlığı değerlendirildi. Verilerin analizinde IBM SPSS 22 yazılımı
kullanıldı. Anlamlılık değeri p<0,05 olarak kabul edildi.
Bulgular: Hastaların 256’sı (%61,0) kadın, 164’ü (%39,0) erkekti. Ortanca yaş 61 (20-91) yıl olarak hesaplandı. Hastaların %34,0’ünde
nefropati, %35,4’ünde retinopati ve %50,5’inde nöropati saptandı. TyG indeksi diyabetik nefropatili hastalarda nefropatisi olmayan
hastalara göre anlamlı derecede yüksekti (9,67±0,84 vs 9,48±0,75, p=0,019). Retinopati ve nöropatinin TyG indeksi ile ilişkisi yoktu.
Sonuç: Yüksek TyG indeksi, tip 2 DM'li hastalarda nefropati varlığıyla ilişkilidir ve pratikte diyabetik nefropatinin erken tespiti ve
önlenmesi için ucuz, ölçümü kolay bir belirteç olarak kullanılabilir.
Ethical Statement
Ethical Considerations: Local ethical committee approval was obtained in accordance with the ethical standards of Helsinki declaration (Number: E.Kurul-E1-22-2682, Date: 15/06/2022).
Thanks
TEŞEKKÜRLER
References
- 1. Seid MA, Akalu Y, Gela YY, Belsti Y, Diress M, Fekadu SA, Dagnew B, Getnet M. Microvascular complications and its predictors among type 2 diabetes mellitus patients at Dessie town hospitals, Ethiopia. Diabetol Metab Syndr. 2021;13(1):86.
- 2. Zou J, Tian F, Zhang Y, Li Z, Yang C, Chen H, Zhai J, Shi M, Xu C, Zhang J, Li W, Xie Y, Li X. Association between Thyroid Hormone Levels and Diabetic Kidney Disease in Euthyroid Patients with Type 2 Diabetes. Sci Rep. 2018;8(1):4728.
- 3. Zou J, Li Z, Tian F, Zhang Y, Xu C, Zhai J, Shi M, Wu G, Zhang Z, Yang C, Chen H, Li. X Association between normal thyroid hormones and diabetic retinopathy in patients with type 2 diabetes. Biomed Res Int. 2020;2020:8161797.
- 4. Myron AB, Matthew V. Diabetic neuropathy. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2018 Jan.
- 5. Pan Y, Zhong S, Zhou K, Tian Z, Chen F, Liu Z, Geng Z, Li S, Huang R, Wang H, Zou W, Hu J. Association between Diabetes Complications and the Triglyceride-Glucose Index in Hospitalized Patients with Type 2 Diabetes. J Diabetes Res. 2021;2021:8757996.
- 6. Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985;28(7):412- 419.
- 7. Kang B, Yang Y, Lee EY, Yang HK, Kim HS, Lim SY, Lee JH, Lee SS, Suh BK, Yoon KH. Triglycerides/glucose index is a useful surrogate marker of insulin resistance among adolescents. Int J Obes (Lond). 2017;41(5):789-792.
- 8. Guerrero-Romero F, Simental-Mendía LE, González-Ortiz M, Martínez-Abundis E, Ramos-Zavala MG, Hernández- González SO, Jacques-Camarena O, Rodríguez-Morán M. The product of triglycerides and glucose, a simple measure of insulin sensitivity. Comparison with the euglycemic-hyperinsulinemic clamp. J Clin Endocrinol Metab. 2010;95(7):3347- 3351.
- 9. Liu L, Xia R, Song X, Zhang B, He W, Zhou X, Li S, Yuan G. Association between the triglyceride-glucose index and diabetic nephropathy in patients with type 2 diabetes: A cross-sectional study. J Diabetes Investig. 2021;12(4):557-565.
- 10. Unger G, Benozzi SF, Perruzza F, Pennacchiotti GL. Triglycerides and glucose index: a useful indicator of insulin resistance. Endocrinol Nutr. 2014;61(10):533-540.
- 11. Srinivasan S, Singh P, Kulothungan V, Sharma T, Raman R. Relationship between triglyceride glucose index, retinopathy and nephropathy in Type 2 diabetes. Endocrinol Diabetes Metab. 2020;4(1):e00151.
- 12. Kwai NCG, Nigole W, M Poynten A, Brown C, V Krishnan A. The relationship between dyslipidemia and acute axonal function in Type 2 diabetes mellitus In Vivo. PLoS ONE. 2016;11(4):e0153389.
- 13. Akbar M, Bhandari U, Habib A, Ahmad R. Potential Association of Triglyceride Glucose Index with Cardiac Autonomic Neuropathy in Type 2 Diabetes Mellitus Patients. J Korean Med Sci. 2017;32(7):1131-1138.
- 14. Zhao S, Yu S, Chi C, Fan X, Tang J, Ji H, Teliewubai J, Zhang Y, Xu Y. Association between macro- and microvascular damage and the triglyceride glucose index in community-dwelling elderly individuals: the Northern Shanghai Study. Cardiovasc Diabetol. 2019;18(1):95.
Details
| Primary Language | English |
|---|---|
| Subjects | Endocrinology |
| Journal Section | Research Article |
| Authors | |
| Publication Date | April 29, 2024 |
| Acceptance Date | January 25, 2024 |
| Published in Issue | Year 2024 Volume: 8 Issue: 1 |
