Stronger association of triglyceride glucose index than the HOMA-IR with arterial stiffness in patients with type 2 diabetes: a real-world single-centre study

Abstract

Background The triglyceride-glucose index (TyG index) has been proposed as a simple and reliable alternative insulin resistance (IR) marker, while the homeostasis model assessment for IR (HOMA-IR) is the most frequently used index. Few studies have evaluated the role of IR assessed by the TyG index and HOMA-IR on arterial stiffness in a type 2 diabetes (T2D) population with a high risk of increased arterial stiffness. We aimed to investigate the association of the TyG index and HOMA-IR with arterial stiffness in patients with T2D. Methods We recruited 3185 patients with T2D, who underwent brachial-ankle pulse wave velocity (baPWV), an indicator of arterial stiffness, but without previous cardiovascular disease. Increased arterial stiffness was defined as a baPWV value greater than the 75th percentile (18.15 m/s) in the present study. The TyG index was determined as ln(fasting triglycerides [mg/dL] × fasting glucose [mg/dL]/2), and the HOMA-IR was calculated as (fasting insulin [μIU/mL] × fasting glucose [mmol/L])/22.5. Results The mean age of the study participants was 54.6 ± 12.0 years, and 1954 (61.4%) were men. Seemingly unrelated regression estimation analysis demonstrated that the TyG index had stronger associations with baPWV than the HOMA-IR (all P < 0.001). In the multivariable logistic analyses, each one-unit increase in the TyG index was associated with a 1.40-fold (95% CI 1.16–1.70, P < 0.001) higher prevalence of increased arterial stiffness, but the prominent association of the HOMA-IR with the prevalence of increased arterial stiffness was not observed. Subgroup analyses showed that a more significant association between the TyG index and the prevalence of increased arterial stiffness was detected in older patients with a longer duration of diabetes and poor glycaemic control (all P < 0.05). Conclusions Compared with the HOMA-IR, the TyG index is independently and more strongly associated with arterial stiffness in patients with T2D.

Triglyceride Glucose Index Associated With Arterial Stiffness in Chinese Community-Dwelling Elderly

“…Given the diminished reliability of baPWV measurement in subjects with severe atherosclerosis in lower extremities ( 7 ), we excluded subjects with bilateral ABIs < 0.9, for subjects with unilateral ABI < 0.9, we recorded contralateral baPWV, and for subjects with no ABI < 0.9, the mean of right and left baPWV was recorded for the analysis. Additionally, we defined high baPWV as a value greater than the 75th percentile of the baPWV values, which was 2,248 cm/s in this study ( 16 , 19 , 21 , 22 ).…”

“…Several previous studies indicated that IR assessed by the TyG index is associated with arterial stiffness measured by the baPWV ( 16 – 22 ); however, discrepancies remain due to study population, sample size, and potential confounders. In this study, we investigated the association between the TyG index and the baPWV in a population of Chinese community-dwelling elderly.…”

Triglyceride–Glucose Index as a Novel Biomarker in the Occurrence of Kidney Stones: A Cross-Sectional Population-Based Study

“…[17][18][19] Different from HOMA-IR, the TyG index was universally adaptable in all patients due to the calculation without quantification of insulin. 20,21 It was well distinguished that an increased TyG index would contributing to diagnosing T2DM and predicting related adverse outcomes. 22,23 Kidney as a metabolic organ is easy to be damaged by glucose metabolism disorders and diabetic nephropathy has been considered as a huge burden in population.…”

Comparison of various insulin resistance surrogates on prognostic prediction and stratification following percutaneous coronary intervention in patients with and without type 2 diabetes mellitus

“…In addition, a large number of studies have shown that the TyG index is closely related to vascular calcification [ 41 – 43 ], and arterial stiffness assessed by pulse wave velocity [ 44 , 45 ], both of which were important risk predictors for ASCVD. Moreover, the association between the TyG index and a variety of risk factors for ASCVD, for example, hypertension [ 46 ], renal dysfunction [ 47 ], and hyperuricemia [ 48 ], was also confirmed by previous studies.…”