Elevated Triglyceride-Glucose Index as a Risk Stratification Marker for Diabetic Retinopathy in Type 2 Diabetes Mellitus: The Influence of Glycemic Control.

IF 2.8 3区医学 Q3 ENDOCRINOLOGY & METABOLISM

Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy Pub Date : 2025-03-11 eCollection Date: 2025-01-01 DOI:10.2147/DMSO.S503672

Xiaohua Wan, Ruihuan Zhang, Adilan Abudukeranmu, Wei Wei, Hong Zhu, Lin Zhang, Yanwei Hu

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Abstract

Background: Diabetic retinopathy (DR) is a common microvascular complication observed in people with type 2 diabetes mellitus (T2DM). The triglyceride-glucose (TyG) index, an indicator of insulin resistance, has an uncertain role in glycemic management in T2DM patients at risk for DR. This study aimed to evaluate the association between the TyG index and DR risk across different glycemic control status.

Methods: A total of 4,372 T2DM in-patients from Beijing Tongren Hospital (2013-2024) were included in this study. The patients were categorized into four groups based on TyG index quartiles (Q1-Q4). Participants were stratified by TyG index quartiles (Q1-Q4) and glycemic control status (HbA1c <7%, 7-9%, and >9%). Restricted cubic spline (RCS) analysis, logistic regression, and subgroup analyses were employed to explore the associations among the TyG index, glycemic control and DR risk.

Results: Overall, there were positive association of the TyG index and DR risk. The highest TyG Q4 was significantly associated with an increased risk of DR (odds ratio [OR]: 1.289; 95% confidence interval [CI]: 1.008-1.648, P<0.05), compared with the lowest TyG Q1. Significant interaction was observed between the TyG index and glycemic control (P for interaction <0.05). Notably, the association was strongest in patients with HbA1c >9%.

Conclusion: The relationship between high TyG index and DR risk was more pronounced in patients with HbA1c >9% group, indicating that TyG index may serve as a useful tool for making risk stratification on glycemic control in T2DM patients.

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背景：糖尿病视网膜病变（DR）是 2 型糖尿病（T2DM）患者常见的微血管并发症。甘油三酯-葡萄糖（TyG）指数是胰岛素抵抗的一个指标，它在有糖尿病视网膜病变风险的 T2DM 患者的血糖管理中起着不确定的作用。本研究旨在评估不同血糖控制状况下 TyG 指数与 DR 风险之间的关联：本研究共纳入北京同仁医院（2013-2024 年）4372 名 T2DM 住院患者。根据 TyG 指数四分位数（Q1-Q4）将患者分为四组。根据 TyG 指数四分位数（Q1-Q4）和血糖控制状况（HbA1c 9%）对参与者进行分层。采用限制立方样条（RCS）分析、逻辑回归和亚组分析来探讨TyG指数、血糖控制和DR风险之间的关系：总体而言，TyG指数与DR风险呈正相关。结果：总体而言，TyG 指数与 DR 风险呈正相关：1.289；95% 置信区间 [CI]：结论：结论：高TyG指数与DR风险之间的关系在HbA1c>9%组患者中更为明显，这表明TyG指数可作为T2DM患者血糖控制风险分层的有用工具。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy Pharmacology, Toxicology and Pharmaceutics-Pharmacology

CiteScore

5.90

自引率

6.10%

发文量

431

审稿时长

16 weeks

期刊介绍： An international, peer-reviewed, open access, online journal. The journal is committed to the rapid publication of the latest laboratory and clinical findings in the fields of diabetes, metabolic syndrome and obesity research. Original research, review, case reports, hypothesis formation, expert opinion and commentaries are all considered for publication.