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ORIGINAL RESEARCH

Relationship Between the Triglyceride-Glucose Index and Type 2 Diabetic Macroangiopathy: A Single-Center Retrospective Analysis

, ORCID Icon, , , , , & ORCID Icon show all
Pages 3483-3497 | Received 07 Sep 2022, Accepted 02 Nov 2022, Published online: 09 Nov 2022

Figures & data

Figure 1 Flow chart for inclusion of participants in this study.

Notes: A total of 1565 participants were recruited at baseline, and all patients were screened according to exclusion criteria. Of these, 216 participants were diagnosed with diabetes other than type 2 (including type 1 diabetes, gestational diabetes, secondary diabetes), 36 participants had organ insufficiency, and 19 participants had autoimmune disease or blood disease, 27 participants had malignancy, 58 had severe infection within the last three months, 2 had congenital heart disease, 364 had incomplete baseline data, and 75 had incomplete follow-up information. After excluding the above participants, a total of 858 subjects were included in the study.
Figure 1 Flow chart for inclusion of participants in this study.

Table 1 Basic Characteristics of Participants

Table 2 Baseline Characteristics of TyG Index Quartile Groups

Table 3 Correlation Between TyG Index and Other Clinical Variables

Table 4 Logistic Regression Analysis of Related Factors with T2DM Complicated with Macrovascular Disease

Figure 2 Selecting clinical features based on the least absolute shrinkage and selection operator (LASSO) logistic regression.

Notes: (A) Least Absolute Shrinkage and Selection Operator (LASSO) coefficient distribution for each variable. Variables with coefficients close to 0 are removed. Finally, 7 variables were included. (B) Cross-validation of tuning parameters in LASSO models.
Abbreviations: BMI, body mass index; WBC, white blood cell count; RBC, red blood cell count; ALT, alanine aminotransferase; AST, aspartate aminotransferase; Scr, blood creatinine; BUN, blood urea nitrogen; FPG, fasting blood glucose; TG, triglyceride; TC, total cholesterol; HDL-C, high-density lipoprotein cholesterol; INR, international normalized ratio; TyG Index, triglyceride glucose index; ACEI, angiotensin-converting enzyme inhibitors; ARB, angiotensin-converting enzyme inhibitors.
Figure 2 Selecting clinical features based on the least absolute shrinkage and selection operator (LASSO) logistic regression.

Figure 3 A nomogram was constructed to predict macrovascular complications in T2DM patients.

Notes: (A) A nomogram for predicting T2DM patients with macrovascular complications. (B) Calibration curve of nomogram risk model for T2DM with macrovascular complications.
Figure 3 A nomogram was constructed to predict macrovascular complications in T2DM patients.

Figure 4 ROC curve of TyG index, RBC, and HDL-C in predicting T2DM complicated with macrovascular complications.

Notes: The ROC curve and AUC value of the nomogram. The area under the ROC curve for the TyG index was 0.702 (95% CI 0.67–0.74), the RBC was 0.396 (95% CI 0.36–0.43), and the TG was 0.432 (95% CI 0.39–0.47). The best cut-off value of the TyG index for predicting macrovascular complications was 9.31, with a sensitivity of 59% and a specificity of 74%. The Youden Index was 0.33.
Figure 4 ROC curve of TyG index, RBC, and HDL-C in predicting T2DM complicated with macrovascular complications.

Table 5 Cox Proportional Hazards for All-Cause Mortality in T2DM with or without Macrovascular Complications

Figure 5 Association of TyG index quartiles with all-cause mortality in T2DM.

Notes: Quartile 1 is used as reference category. Model 1 was adjusted for age, duration of diabetes, hypertension, and aortic calcification; Model 2 was adjusted for age, duration of diabetes, hypertension, aortic calcification, ACEI/ARB medication history, albumin, TG, and TC.
Abbreviations: TyG Index, triglyceride glucose index; RBC, red blood cell count; HDL-C, high-density lipoprotein cholesterol; ACEI, angiotensin-converting enzyme inhibitors; ARB, angiotensin-converting enzyme inhibitors; TG, triglyceride; TC, total cholesterol; HR, hazard ratio; CI, confidence interval.
Figure 5 Association of TyG index quartiles with all-cause mortality in T2DM.

Figure 6 Prognostic analysis of patients with T2DM.

Notes: (A) Kaplan-Meier survival curves of all-cause mortality for TyG index quartiles. Q1 group (TyG ≤8.70), Q2 (TyG 8.70–9.20), Q3 (TyG 9.20–9.67), and Q4 (TyG≥9.67). (B) Kaplan-Meier survival curves for all-cause mortality in T2DM with or without macrovascular complications. aWithout macrovascular complications; bWith macrovascular complications.
Figure 6 Prognostic analysis of patients with T2DM.