Evaluation of the TyG, LAP, and VAI Indices as Markers of Glycemic Status in Patients with Atherosclerosis

Objective: This study aims to investigate the relationship between triglyceride-based indices (lipid accumulation product (LAP), triglyceride-glucose (TyG) index, and visceral adiposity index (VAI)) and glycated hemoglobin A (HbA1c) levels in atherosclerosis patients. Materials and Methods: The retrospective cross-sectional analysis was performed using recorded demographic, anthropometric, and laboratory data of 113 patients diagnosed with atherosclerosis. The TyG, LAP, and VAI indices were computed using standard formulas derived from available anthropometric and biochemical measurements. Participants were classified considering HbA1c levels as normoglycemic (<5.7%), prediabetic (5.7-6.4%), or diabetic (≥6.5%). Correlation analyses, group comparisons (ANOVA or Kruskal-Wallis tests), and multivariable logistic regression models adjusted for body mass index (BMI), waist-to-height ratio (WHtR), high-density lipoprotein cholesterol (HDL-C), sex, and age were applied. Results: HbA1c levels showed significant positive correlations with TyG (r = 0.32, p = 0.009), LAP (r = 0.47, p < 0.001), and VAI (r = 0.36, p = 0.004). All indices increased significantly across HbA1c categories (p < 0.001). In multivariable analysis, only the TyG index remained independently related with elevated HbA1c levels (OR = 21.57, 95% CI: 6.53-71.24, p < 0.001). Receiver operating characteristic (ROC) analysis yielded good discriminatory performance for the TyG index (AUC = 0.83), and the optimal cut-off value was 9.0. Conclusion: Among triglyceride-based metabolic indices, the TyG index demonstrated the strongest independent relationship with elevated HbA1c levels, highlighting its potential clinical utility as a simple marker of glycemic dysregulation in patients with atherosclerosis.