Predictive value of metabolic and inflammatory indices (TGI, TG/HDL-C, and PIV) for complications in type 2 diabetes mellitus: A retrospective cohort study

This study aimed to investigate the association between the triglyceride-to-HDL cholesterol ratio (TG/HDL-C), triglyceride-glucose index (TGI), and pan-immune-inflammation value (PIV) with the presence of complications in patients with type 2 diabetes mellitus (T2DM). This retrospective cohort study included 450 patients diagnosed with T2DM between October 2023 and April 2025 at the Department of Internal Medicine, Gaziantep City Training and Research Hospital. Demographic, clinical, and laboratory parameters were collected. TG/HDL-C, TGI, and PIV were calculated using standard formulas. Patients were divided into groups based on the presence or absence of diabetic complications. Comparative, correlation, logistic regression, and ROC analyses were performed to assess the predictive value of these indices. Diabetic complications were present in 63.3% of patients. Patients with complications had significantly higher values of TG/HDL-C (5.24 ± 1.57 vs 4.31 ± 1.21, P < .001), TGI (9.16 ± 0.53 vs 8.68 ± 0.49, P < .001), and PIV (471.2 vs 351.4, P < .001). TGI ( R = 0.68), PIV ( R = 0.65), and TG/HDL-C ( R = 0.62) showed moderate to strong statistically significant correlations with the presence of diabetic complications. In logistic regression, TGI (OR: 2.12), PIV (OR: 1.94), and TG/HDL-C (OR: 1.83) remained independent predictors (all P < .001). ROC analysis revealed high diagnostic accuracy for TGI (AUC = 0.813), PIV (AUC = 0.794), and TG/HDL-C (AUC = 0.782). TGI, TG/HDL-C ratio, and PIV are significantly associated with the presence of diabetic complications and demonstrate strong individual predictive value. Moreover, a combined model integrating all 3 indices further improved diagnostic accuracy (AUC = 0.846), supporting their potential use as complementary tools in comprehensive risk stratification for patients with type 2 diabetes mellitus.