The cholesterol-HDL-glucose (CHG) index and traditional adiposity markers in predicting diabetic retinopathy and nephropathy.

Objective: To investigate the relationship between four metabolic indices-visceral adiposity index (VAI), lipid accumulation product (LAP), triglyceride glucose (TyG) index, and cholesterol-HDL-glucose (CHG) index-and the presence of diabetic nephropathy (DN) and diabetic retinopathy (DR) in patients with long-standing type 2 diabetes mellitus (T2DM).

Materials and methods: This prospective cross-sectional study included 175 T2DM patients with disease duration >10 years who attended an endocrinology outpatient clinic between July 2021 and January 2022. DR was assessed via fundus photography, and DN was defined using the urinary albumin-to-creatinine ratio and eGFR. VAI, LAP, TyG, and CHG indices were calculated using anthropometric and biochemical parameters. Logistic regression was used to identify independent predictors.

Results: The mean age was 60 ± 10.1 years; 63.4% were female. DR and DN were observed in 50.3% and 38.9% of patients, respectively. VAI, LAP, and TyG were significantly higher in patients with DN but not with DR. CHG was elevated in both DN and DR (P < 0.05), and was the only independent predictor of DN (P = 0.005). Notably, CHG was significantly higher in proliferative vs non-proliferative DR (P = 0.009), unlike the other indices.

Conclusions: While VAI, LAP, and TyG were associated only with nephropathy, CHG was linked to both DN and DR. Its integration of glycemic and lipid parameters may offer greater sensitivity for microvascular risk stratification in T2DM.