The Triglyceride-Glucose Index is Associated with Diabetic Retinopathy in Chinese Patients with Type 2 Diabetes: A Hospital-Based, Nested, Case-Control Study

Litong Yao; Xinyu Wang; Yifan Zhong; Yan Wang; Jingyang Wu; Jin Geng; Yun Zhou; Jun Chen; Peng Guan; Yingying Xu; Lei Chen; Lei Liu; Yuedong Hu

doi:10.2147/DMSO.S294408

The Triglyceride-Glucose Index is Associated with Diabetic Retinopathy in Chinese Patients with Type 2 Diabetes: A Hospital-Based, Nested, Case-Control Study

Diabetes Metab Syndr Obes. 2021 Apr 9:14:1547-1555. doi: 10.2147/DMSO.S294408. eCollection 2021.

Authors

Litong Yao^#^{1

2}, Xinyu Wang^#², Yifan Zhong^#³, Yan Wang^#⁴, Jingyang Wu³, Jin Geng³, Yun Zhou³, Jun Chen³, Peng Guan⁵, Yingying Xu¹, Lei Chen³, Lei Liu³, Yuedong Hu³

Affiliations

¹ Department of Breast Surgery, First Affiliated Hospital of China Medical University, Shenyang, 110001, People's Republic of China.
² China Medical University, Shenyang, 110001, People's Republic of China.
³ Department of Ophthalmology, First Affiliated Hospital of China Medical University, Shenyang, 110001, People's Republic of China.
⁴ Department of Radiology, General Hospital of Liaohe Oil Field, Panjin, 124010, People's Republic of China.
⁵ Department of Epidemiology, School of Public Health, China Medical University, Shenyang, 110122, People's Republic of China.

^# Contributed equally.

Abstract

Background: This study aimed to investigate the association between the triglyceride-glucose (TyG) index and diabetic retinopathy (DR) in Chinese patients with type 2 diabetes.

Methods: In this nested case-control study, all diabetic participants were registered hospitalizations during 2012-2018, including 596 with DR as cases and three matching controls per case. DR was assessed using Early Treatment Diabetic Retinopathy Study criteria. The TyG index was calculated: Ln (fasting blood glucose [mg/dL] × fasting triglycerides [mg/dL] ÷ 2). Multivariate logistic regression, a receiver-operating characteristic (ROC) curve, linear regression models, and mediation analysis were used to explore associations.

Results: The TyG index was lower in DR and decreased as its severity advanced among 2,112 subjects (P=0.005). After confounders (sex, duration of diabetes, use of antidiabetic agents, heart rate, systolic blood pressure, pulse pressure, height, weight, body-mass index, and glycated hemoglobin) had been accounted for, there were significant associations between the TyG index and any-severity DR (OR 0.83, 95% CI 0.73-0.95; P=0.006), as well as vision-threatening DR (VTDR; OR 0.53, 95% CI 0.36-0.76; P=0.001). ROC analysis indicated that the TyG index showed significant discriminatory ability in any-severity DR (area under curve [AUC] 0.534, P=0.015) and VTDR (AUC 0.624, P=0.001).

Conclusion: The TyG index was associated with the presence and severity of DR. Our findings suggest that the TyG index may become a useful biomarker in evaluating and following the presence of DR and VTDR.

Keywords: diabetic retinopathy; hospital-based nested case–control study; triglyceride–glucose index; type 2 diabetes.

Grants and funding

This research was supported by the National Natural Science Foundation of China (81300783), China Postdoctoral Science Foundation (2019TQ0358, 2019M661162), LiaoNing Revitalization Talents Program (XLYC1807082), and General Research Project of Liaoning Provincial Department of Education (LQNK201707). Sponsors/funding organizations had no role in the design or conduct of this study.