What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Type 2 diabetes mellitus (n=976). Intervention: Triglyceride glucose (TyG) index vs. Lower TyG index. Primary outcome: Visceral obesity (VO) (OR 2.997, p=< 0.001).

April 29, 2023Cardiovascular Diabetology48 citationsOpen Access

Serum triglyceride glucose index is a valuable predictor for visceral obesity in patients with type 2 diabetes: a cross-sectional study

Q: What are the key findings of this study?

The triglyceride glucose index was an independent predictor of visceral obesity in patients with type 2 diabetes, with an odds ratio of 2.997 in males and 2.233 in females.

QYQing Yang HXHuichao Xu HZHongli Zhang

Key Result

The triglyceride glucose index was an independent predictor of visceral obesity in patients with type 2 diabetes, with an odds ratio of 2.997 in males and 2.233 in females.

Study Design

Type

Cross-Sectional (n=976)

Multicenter

Structured PICO

Does the TyG index predict visceral obesity in patients with type 2 diabetes mellitus?

Population

976 hospitalized adults with type 2 diabetes mellitus underwent abdominal CT scans and blood analyses to evaluate the triglyceride glucose index as a predictor of visceral obesity.

Exposure

Triglyceride glucose (TyG) index and TyG-BMI

Outcome

Visceral obesity (VO) diagnosed by computed tomography (visceral adipose area > 142 cm2 for males and > 115 cm2 for females)surrogate

The TyG index, particularly when combined with BMI, serves as a valuable and accessible predictor for visceral obesity in patients with type 2 diabetes mellitus.

Main Result

Odds Ratio: 2.997

p-value: p=< 0.001

Limitations

More than 80% of the patients were under antidiabetic treatment, and nearly 20% received statins, which inevitably affected the stability of the results.
Participants represent hospitalized patients with T2DM, not the general population with T2DM.
Only 25% of included patients had a record of waist circumference and waist-hip ratio.
The predictive ability of HOMA-IR for visceral obesity was not compared because serum C-peptide and insulin were susceptible to antidiabetic drugs.
The study was conducted in Chinese adults with T2DM, so findings may not be readily generalizable to other populations or ethnicities.

Abstract

Abstract Background Since the triglyceride glucose (TyG) index can reflect insulin resistance, it has been proven to be an efficient predictor of glycolipid-metabolism-related diseases. Therefore, this study aimed to investigate the predictive value of the TyG index for visceral obesity (VO) and body fat distribution in patients with type 2 diabetes mellitus (T2DM). Methods Abdominal adipose tissue characteristics in patients with T2DM, including visceral adipose area (VAA), subcutaneous adipose area (SAA), VAA-to-SAA ratio (VSR), visceral adipose density (VAD), and subcutaneous adipose density (SAD), were obtained through analyses of computed tomography images at the lumbar 2/3 level. VO was diagnosed according to the VAA (> 142 cm 2 for males and > 115 cm 2 for females). Logistic regression was performed to identify independent factors of VO, and receiver operating characteristic (ROC) curves were used to compare the diagnostic performance according to the area under the ROC curve (AUC). Results A total of 976 patients were included in this study. VO patients showed significantly higher TyG values than non-VO patients in males (9.74 vs. 8.88) and females (9.59 vs. 9.01). The TyG index showed significant positive correlations with VAA, SAA, and VSR and negative correlations with VAD and SAD. The TyG index was an independent factor for VO in both males (odds ratio OR = 2.997) and females (OR = 2.233). The TyG index ranked second to body mass index (BMI) for predicting VO in male (AUC = 0.770) and female patients (AUC = 0.720). Patients with higher BMI and TyG index values showed a significantly higher risk of VO than the other patients. TyG-BMI, the combination index of TyG and BMI, showed significantly higher predictive power than BMI for VO in male patients (AUC = 0.879 and 0.835, respectively) but showed no significance when compared with BMI in female patients (AUC = 0.865 and 0.835, respectively). Conclusions . TyG is a comprehensive indicator of adipose volume, density, and distribution in patients with T2DM and is a valuable predictor for VO in combination with anthropometric indices, such as BMI.

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