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. 2023 Apr 29;22(1):98.
doi: 10.1186/s12933-023-01834-3.

Serum triglyceride glucose index is a valuable predictor for visceral obesity in patients with type 2 diabetes: a cross-sectional study

Qing Yang  1 , Huichao Xu  1 , Hongli Zhang  2 , Yanying Li  2   3   4 , Shuxiong Chen  3   4   5 , Dongye He  3   4   5 , Guangzhi Yang  2   3 , Bo Ban  2   3   4 , Mei Zhang  6   7   8 , Fupeng Liu  9   10   11
Affiliations

Serum triglyceride glucose index is a valuable predictor for visceral obesity in patients with type 2 diabetes: a cross-sectional study

Qing Yang et al. Cardiovasc Diabetol. .

Abstract

Background: Since the triglyceride glucose (TyG) index can reflect insulin resistance, it has been proven to be an efficient predictor of glycolipid-metabolism-related diseases. Therefore, this study aimed to investigate the predictive value of the TyG index for visceral obesity (VO) and body fat distribution in patients with type 2 diabetes mellitus (T2DM).

Methods: Abdominal adipose tissue characteristics in patients with T2DM, including visceral adipose area (VAA), subcutaneous adipose area (SAA), VAA-to-SAA ratio (VSR), visceral adipose density (VAD), and subcutaneous adipose density (SAD), were obtained through analyses of computed tomography images at the lumbar 2/3 level. VO was diagnosed according to the VAA (> 142 cm2 for males and > 115 cm2 for females). Logistic regression was performed to identify independent factors of VO, and receiver operating characteristic (ROC) curves were used to compare the diagnostic performance according to the area under the ROC curve (AUC).

Results: A total of 976 patients were included in this study. VO patients showed significantly higher TyG values than non-VO patients in males (9.74 vs. 8.88) and females (9.59 vs. 9.01). The TyG index showed significant positive correlations with VAA, SAA, and VSR and negative correlations with VAD and SAD. The TyG index was an independent factor for VO in both males (odds ratio [OR] = 2.997) and females (OR = 2.233). The TyG index ranked second to body mass index (BMI) for predicting VO in male (AUC = 0.770) and female patients (AUC = 0.720). Patients with higher BMI and TyG index values showed a significantly higher risk of VO than the other patients. TyG-BMI, the combination index of TyG and BMI, showed significantly higher predictive power than BMI for VO in male patients (AUC = 0.879 and 0.835, respectively) but showed no significance when compared with BMI in female patients (AUC = 0.865 and 0.835, respectively).

Conclusions: . TyG is a comprehensive indicator of adipose volume, density, and distribution in patients with T2DM and is a valuable predictor for VO in combination with anthropometric indices, such as BMI.

Keywords: Triglyceride glucose index; Type 2 diabetes mellitus; Visceral obesity.

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Conflict of interest statement

The authors report no conflicts of interest.

Figures

Fig. 1
Fig. 1
CT image analysis at the lumbar 3 level using Slice-O-Matic software. Blue: subcutaneous adipose tissue; yellow: visceral adipose tissue; grey: unprocessed CT image
Fig. 2
Fig. 2
Correlations between adipose tissue and clinical characteristics. (A) male patients; (B) female patients. Abreviations: SBP, Systolic blood pressure; DBP, Diastolic blood pressure; Hb, hemoglobin; ALB, Albumin; ALT, alanine transaminase; Cr, creatinine; BUN, Blood urea nitrogen; TG, triglyceride; TC, Total cholesterol; HDL, high-density lipoproteins; LDL, low-density lipoproteins; FT3, free triiodothyronine; FT4, free thyroxine; TSH, thyroid-stimulating hormone; HbA1c, glycated hemoglobin; FBG, fasting blood glucose; TyG, triglyceride glucose index; VAA, visceral adipose area; SAA, subcutaneous adipose area; VSR, VAA-to-SAA ratio; VAD, visceral adipose density; SAD, subcutaneous adipose density. ALT and TG were log-transformed in the analysis
Fig. 3
Fig. 3
Forest plot of independent factors identified from logistic linear regression for VO.
Fig. 4
Fig. 4
ROC analyses of independent factors for VO. (A) ROC analyses in male patients; (B) ROC analyses in female patients; (C) Cut-off values of BMI and TyG index in male and female patients
Fig. 5
Fig. 5
Scatter diagram of the distribution of VO and non-VO patients according to their BMI and TyG index. (A) male patients; (B) female patients
Fig. 6
Fig. 6
ROC analyses of TyG-BMI for VO.(A) male patients; (B) female patients
See this image and copyright information in PMC

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