The triglyceride-glucose index was positively associated with carotid intima-media thickness, with a stronger effect in type 2 diabetic patients with albuminuria (ACR >30 mg/g; β=0.071, 95% CI 0.036–0.106, p<0.001) compared to those without (β=0.038, 95% CI 0.015–0.061, p=0.002).
Cross-Sectional (n=507)
No
Is the Triglyceride-Glucose (TyG) index associated with increased carotid intima-media thickness in patients with type 2 diabetes, and is this modified by albuminuria and age?
The TyG index is positively associated with carotid intima-media thickness in type 2 diabetes, with the relationship being significantly more pronounced in younger patients (<50 years) and those with early albuminuria (ACR > 30 mg/g).
Effect estimate: β coefficient 0.071 for ACR >30 mg/g vs 0.038 for ACR ≤30 mg/g (95% CI 95% CI 0.036–0.106 for ACR >30 mg/g, 0.015–0.061 for ACR ≤30 mg/g)
Absolute Event Rate: 0.071% vs 0.038%
p-value: p=<0.001 for ACR >30 mg/g, 0.002 for ACR ≤30 mg/g; P for interaction = 0.008
Background The Triglyceride-Glucose (TyG) index, a surrogate marker of insulin resistance, is associated with increased cardiovascular risk. However, its relationship with subclinical atherosclerosis in diabetic patients with early-stage kidney injury, characterized by an elevated urinary albumin-to-creatinine ratio (ACR), remains unclear. This study examined the association between carotid intima-media thickness (IMT) and the TyG index, specifically investigating how this association is modified by albuminuria status. Methods This cross-sectional study included 507 patients with type 2 diabetes and preserved kidney function who had ACR values of 0–300 mg/g. Participants were stratified into quartiles based on ACR levels. IMT was measured using high-resolution B-mode ultrasonography. The relationship between the TyG index and IMT was evaluated using partial correlation and multivariate linear regression analyses, with emphasis on assessing this relationship across ACR-based strata. Result A weak positive correlation was observed between the TyG index and IMT overall ( r = 0.12, P = 0.035), with a significant interaction effect of ACR ( p = 0.008). Stratification by ACR showed that for patients with ACR ≤ 30 mg/g, each unit increase in the TyG index was associated with a 0.038 mm increase in IMT (95% CI: 0.015–0.061, p = 0.002), while for those with ACR 30 mg/g, the increase was 0.071 mm per unit (95% CI: 0.036–0.106, p 0.001). Furthermore, a graded pattern was observed across ACR quartiles, with the positive correlation between TyG and IMT showing graded strengthening ( β values increased from 0.022 to 0.078, p for trend 0.001;). Finally, the TyG–IMT correlation exhibited age specificity, being significant in patients under 50 years (40 years: β = 0.085, p = 0.002; 40–49 years: β = 0.051, p = 0.015) and diminishing in older age groups. Conclusions The association between the TyG index and IMT exhibits stage-specific and population-heterogeneous patterns. A significant, ACR-dependent positive correlation was observed, with the association being pronounced in patients with elevated ACR (30 mg/g) and in those younger than 50 years. These findings suggest that the pro-atherogenic effect of insulin resistance is more pronounced in diabetic patients with early albuminuria or in younger individuals, underscoring the need for enhanced vascular management to reduce insulin resistance in these high-risk populations.
Lin et al. (Wed,) conducted a cross-sectional in Patients with type 2 diabetes mellitus, age 20-80, with preserved kidney function (eGFR ≥ 60 mL/min/1.73 m2) and albumin-to-creatinine ratio (ACR) between 0 and 300 mg/g (n=507). Triglyceride-glucose (TyG) index as marker of insulin resistance vs. None was evaluated on Association between TyG index and carotid intima-media thickness (IMT) with effect modification by albuminuria (ACR) and age (β coefficient 0.071 for ACR >30 mg/g vs 0.038 for ACR ≤30 mg/g, 95% CI 95% CI 0.036–0.106 for ACR >30 mg/g, 0.015–0.061 for ACR ≤30 mg/g, p=<0.001 for ACR >30 mg/g, 0.002 for ACR ≤30 mg/g; P for interaction = 0.008). The triglyceride-glucose index was positively associated with carotid intima-media thickness, with a stronger effect in type 2 diabetic patients with albuminuria (ACR >30 mg/g; β=0.071, 95% CI 0.036–0.106, p<0.001) compared to those without (β=0.038, 95% CI 0.015–0.061, p=0.002).
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