Association of Triglyceride Glucose Index with Prevalence and Incidence of Diabetic Retinopathy in a Singaporean Population

Figures & data

Table 1 Patient Baseline Characteristics Between Follow-Up Diabetic Retinopathy (N=1339)

	NDR (N=935)	DR (N=404)	P value
Age (Mean ± SD)	56.1 ± 10.7	56.5 ± 9.4	0.5
Gender
Male	50.7%	55.9%	0.08
Female	49.3%	44.1%
Ethnicity
Chinese	55.1%	48.3%	0.06
Malay	17.2%	22.5%
Indian	23.5%	25.7%
Others	4.2%	3.5%
TyG Index	9.04 ± 0.6	9.24 ± 0.7	<0.001
Duration of Type 2 Diabetes (Year)	8.8 ± 7.3	15.1 ± 9.3	<0.001
SBP (mmHg)	136.7 ± 16.5	143.7 ± 19.4	<0.001
DBP (mmHg)	78.8 ± 9.3	79.5 ± 9.8	0.2
BMI	27.8 ± 5.4	27.7 ± 4.9	0.7
Waist–Hip Ratio	0.97 ± 0.07	0.96 ± 0.06	0.03
HDL Cholesterol	1.3 ± 0.4	1.26 ± 0.4	0.1
LDL Cholesterol	2.8 ± 0.8	2.7 ± 0.8	0.6
HbA1C	7.5 ± 1.2	8.4 ± 1.4	<0.001
eGFR	91.9 ± 21.9	79.7 ± 30.7	<0.001
uACR	99.6 ± 409	475.5 ± 1064.1	<0.001

Abbreviations: NDR, no diabetic retinopathy; DR, diabetic retinopathy; TyG Index, triglyceride glucose index; SBP, systolic blood pressure; DBP, diastolic blood pressure; BMI, body mass index; HDL, high-density lipoprotein; LDL, low-density lipoprotein; HbA1C, glycated hemoglobin; eGFR, estimated glomerular filtration rate; uACR, urinary albumin-to-creatinine ratio.

Table 2 Logistic Regression Analysis of the TyG Index and Other Risk Factor for the Prevalence of DR

Variable	Model 1		Model 2		Model 3 (HbA1C<7)		Model 3 (HbA1C≥7)
	OR (95% CI)	P	OR (95% CI)	P	OR (95% CI)	P	OR (95% CI)	P
TyG Index	1.6 (1.3–1.9)	<0.001	1.7 (1.4–1.9)	<0.001	2.0 (1.1–3.8)	0.03	1.1 (0.8–1.4)	0.5
Age	NM	NM	1.01 (1.0–1.02)	0.06	0.9 (0.9–1.0)	0.7	0.9 (0.9–0.99)	0.008
Gender (Male)	NM	NM	1.2 (0.9–1.6)	0.07	0.8 (0.4–1.5)	0.4	1.03 (0.8–1.4)	0.8
Ethnicity	NM	NM
Chinese			1		1		1
Malay			1.5 (1.1–2.0)	0.01	1.7 (0.7–4.0)	0.2	1.9 (1.3–2.9)	0.001
Indian			1.3 (1.001–1.8)	0.05	1.7 (0.8–3.8)	0.2	1.7 (1.2–2.4)	0.006
Others			1.0 (0.5–1.9)	0.9	0.0 (0–0)	0.9	1.4 (0.7–3.0)	0.3
Duration of Type 2 Diabetes	NM	NM	NM	NM	1.1 (1.1–1.02)	0.002	1.1 (1.1–1.1)	<0.001
BMI	NM	NM	NM	NM	0.9 (0.9–1.1)	0.9	0.9 (0.9–1.0)	0.9
eGFR	NM	NM	NM	NM	1.0 (0.9–1.0)	0.5	0.9 (0.9–1.0)	0.04
uACR	NM	NM	NM	NM	1.001(1–1.002)	0.001	1.001(1–1.001)	0.001
SBP	NM	NM	NM	NM	1.01 (0.9–1.03)	0.3	1.02 (1.01–1.03)	<0.001
Waist–Hip Ratio	NM	NM	NM	NM	0.00 (0.00–0.04)	0.006	0.1 (0.01–2.5)	0.2

Notes: Model 1: unadjusted; Model 2: adjusted for age, gender, ethnicity; Model 3: adjusted for type 2 diabetes duration, BMI, eGFR, uACR, SBP and Waist–Hip ratio (stratified by HbA1c cut-off level 7.0%).

Abbreviation: NM, not measurable.

Figure 1 Area under the ROC curve (AUC) of the DR prevalence.

Table 3 Patient Baseline Characteristics: Diabetic Retinopathy Incidence (N=210)

	DR Incidence (No) (N=180)	DR Incidence (Yes) (N=30)	P value
Age (Mean ± SD)	50.5 ± 12.5	52.4 ± 12.3	0.4
Gender
Male	61.1%	46.7%	0.09
Female	38.9%	53.3%
Ethnicity
Chinese	58.3%	56.7%	0.7
Malay	14.4%	16.7%
Indian	22.8%	26.7%
Others	4.4%	0.0%
TyG Index	9.2 ± 0.7	9.5 ± 0.9	0.03
Duration of Type 2 Diabetes (Year)	8.6 ± 7.7	11.1 ± 8.4	0.1
SBP (mmHg)	135.1 ± 15.9	137.0 ± 16.1	0.5
DBP (mmHg)	80.6 ± 10.3	80.1 ± 11.4	0.8
BMI	28.4 ± 5.9	27.5 ± 4.5	0.4
Waist–Hip Ratio	0.96 ± 0.07	0.96 ± 0.08	0.9
HDL Cholesterol	1.3 ± 0.4	1.2 ± 0.4	0.5
LDL Cholesterol	2.8 ± 0.7	2.8 ± 0.9	0.7
HbA1C	7.7 ± 1.5	8.6 ± 1.7	0.01
eGFR	98.3 ± 21.0	93.9 ± 28.7	0.3
uACR	120.3 ± 541.6	199.3 ± 523.2	0.5

Note: Of the 30 subjects who developed DR, 29 (96.6%) developed non-proliferative DR and one (3.4%) developed proliferative DR.

Table 4 Cox Regression Analysis of TyG Index and Other Risk Factors for DR Incidence

Variable	Model 1		Model 2		Model 3
	OR (95% CI)	P	OR (95% CI)	P	OR (95% CI)	P
TyG Index	1.6 (1.06–2.5)	0.02	1.8 (1.1–2.9)	0.01	1.8 (1.13–2.9)	0.01
Age	NM	NM	1.02 (0.9–1.1)	0.2	1.02 (0.9–1.1)	0.2
Gender (Male)	NM	NM	0.5 (0.3–1.2)	0.1	0.6 (0.3–1.2)	0.2
Ethnicity	NM	NM
Chinese			1		1
Malay			0.5 (0.2–1.4)	0.2	0.5 (0.2–1.5)	0.2
Indian			0.9 (0.4–2.1)	0.8	0.9 (0.4–2.1)	0.8
Duration of Type 2 Diabetes	NM	NM	NM	NM	1.0 (0.9–1.1)	0.7
BMI	NM	NM	NM	NM	1.0 (0.9–1.1)	0.9
eGFR	NM	NM	NM	NM	1.0 (0.9–1.0)	0.7
uACR	NM	NM	NM	NM	1.0 (0.9–1.0)	0.7

Notes: Model 1: unadjusted; Model 2: adjusted for age, gender, ethnicity; Model 3: adjusted for duration of type 2 diabetes, BMI, eGFR, and uACR.

Abbreviation: NM, not measurable.

Figure 2 Area under the ROC curve (AUC) of the DR incidence.