What question did this study set out to answer?

This study aims to explore how the triglyceride–glucose index and its obesity derivatives associate with peripheral artery disease in type 2 diabetes patients.

June 7, 2026Open Access

Association of the Triglyceride-Glucose Index and Its Central Obesity Derivatives with Peripheral Artery Disease in Type 2 Diabetes: A Cross-Sectional Study

Key Points

This study aims to explore how the triglyceride–glucose index and its obesity derivatives associate with peripheral artery disease in type 2 diabetes patients.
Conducted in a single-center setting with 2224 T2DM patients from August 2020 to December 2024.
Peripheral artery disease was identified using ABI measurements and imaging.
Applied multivariable logistic regression and ROC curves for analysis.
The TyG index and obesity combinations were linked to greater PAD incidence (OR 1.787–2.128 for highest vs. lowest quartile).
Subgroup analysis revealed stronger ties in women and non-smokers.
TyG-WHtR showed the best discriminative ability (AUC = 0.622) among the indices.

Abstract

Aim: To investigate the associations of the triglyceride–glucose (TyG) index and TyG-related obesity indices with lower extremity peripheral artery disease (PAD) in type 2 diabetes mellitus (T2DM) patients, and to assess their discriminative ability. Methods: This single-center, retrospective cross-sectional study included 2224 T2DM patients at a university-affiliated hospital between August 2020 and December 2024. PAD was defined as a resting ankle-brachial index (ABI) ≤ 0.90, or a post-exercise ABI decrease > 20%, or imaging-confirmed lower extremity arterial stenosis or thrombosis. Multivariable logistic regression, trend tests, subgroup analyses, and receiver operating characteristic (ROC) curves were applied. Results: Among the 2,224 patients (45.0% women, mean age 61.0 ± 11.3 years), the TyG index and its combinations with central obesity indicators (TyG-WHtR, TyG-WHR, TyG-WC) were positively associated with the presence of PAD (all P < 0.05), whereas the general obesity indicator (TyG-BMI) lost its significant association after multivariable adjustment, although it remained significant in specific subgroups, such as patients with well-controlled glycemia. After multivariable adjustment, patients in the highest quartile of these significant indices had 1.787– 2.128 times higher odds of having PAD than those in the lowest quartile. Subgroup analyses identified significant interactions with sex and smoking status, showing stronger associations in women and non-smokers. Furthermore, ROC analyses indicated that TyG-WHtR had the highest discriminative ability (AUC = 0.622) among the indices, though its overall accuracy is modest. Conclusion: In T2DM patients, the TyG index and its central obesity derivatives are independently associated with PAD, whereas TyG-BMI shows weaker relevance. TyG-WHtR demonstrates relatively better discriminative performance but limited accuracy, suggesting its role as a supplementary metabolic marker rather than a standalone screening tool. Keywords: triglyceride–glucose index, central obesity, waist-to-height ratio, type 2 diabetes mellitus, lower extremity peripheral artery disease

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