The U-Shape Relationship between Triglyceride-Glucose Index and the Risk of Diabetic Retinopathy among the US Population

Abstract

Objective: To explore the association of diabetic retinopathy (DR) with TyG index and TyG-related parameters among the United States population. Methods: This cross-sectional study is conducted in adults with diabetes mellitus based on the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2018. Multivariate logistic regression, restricted cubic spline, trend test, receiver operating characteristic curve and subgroup analysis are adopted to uncover the association of DR with TyG index and TyG-related parameter levels in diabetics. Results: An aggregate of 888 eligible participants with diabetes is included, involving 263 (29.6%) patients with DR. The participants are stratified according to the quartile of TyG index and TyG-related parameters (Q1–Q4). Following the adjustments of the confounding factors, a multivariate logistic regression analysis finds that TyG-BMI, TyG index and Q4-TyG index are significant risk factors for DR. The restricted cubic spline shows that TyG index and the DR risk of diabetes patients are proved to be U-shaped related (p for nonlinearity = 0.001). Conclusions: The triglyceride-glucose index has a U-shaped correlation with the risk of diabetic retinopathy, which has potential predictive value.

Association Between Triglyceride-Glucose Index and Diabetic Retinopathy: A Meta-Analysis

“…Pooled results of seven studies 23 24 26 27 28 30 33 showed that a higher TyG index was associated with a higher risk of DR (OR for the fourth versus the first quartile of TyG index: 1.91, 95% CI: 1.44 to 2.53, p<0.001; I 2 =72%; Fig. 2a ).…”

“…1. Consequently, eleven records were deemed suitable for the subsequent meta-analysis [23][24][25][26][27][28][29][30][31][32][33].…”

“…Seven studies analyzed TyG index as continuous variables [25,28,29,[31][32][33]. Since two studies reported datasets independently according to sex [28] and HbA1c of the patients [32], these datasets were included into the meta-analysis separately.…”

“…The mean ages of the patients were 51 to 64 years, and the proportion of men was 41 to 87%. The TyG index was analyzed as categorized variables 23 24 26 27 28 30 33 , or continuous variables 25 28 29 31 32 33 among the included studies. The diagnosis of DR was achieved with fundus photograph, and 4302 (26.5%) patients were diagnosed as DR.…”

“…Since one reports included a cross-sectional study (Neelam 2023a) and a prospective cohort study (Neelam 2023b), these studies were included independently in the meta-analysis [32]. Overall, 12 studies from 11 reports were available, which included one case control study [27], nine cross-sectional studies [23][24][25][26][29][30][31][32][33], one retrospective [28] and one prospective cohort study [32]. The characteristic of the studies are summarized in ▶ table 1.…”