The Triglyceride–Glucose Index is Associated with Diabetic Retinopathy in Chinese Patients with Type 2 Diabetes: A Hospital-Based, Nested, Case–Control Study
Received 27 November 2020
Accepted for publication 20 March 2021
Published 9 April 2021 Volume 2021:14 Pages 1547—1555
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Professor Ming-Hui Zou
Litong Yao,1,2,* Xinyu Wang,2,* Yifan Zhong,3,* Yan Wang,4,* Jingyang Wu,3 Jin Geng,3 Yun Zhou,3 Jun Chen,3 Peng Guan,5 Yingying Xu,1 Lei Chen,3 Lei Liu,3 Yuedong Hu3
1Department of Breast Surgery, First Affiliated Hospital of China Medical University, Shenyang, 110001, People’s Republic of China; 2China Medical University, Shenyang, 110001, People’s Republic of China; 3Department of Ophthalmology, First Affiliated Hospital of China Medical University, Shenyang, 110001, People’s Republic of China; 4Department of Radiology, General Hospital of Liaohe Oil Field, Panjin, 124010, People’s Republic of China; 5Department of Epidemiology, School of Public Health, China Medical University, Shenyang, 110122, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Lei Liu; Yuedong Hu
Department of Ophthalmology, First Affiliated Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, Liaoning Province, People’s Republic of China
Email [email protected]; [email protected]
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, triglyceride–glucose index, type 2 diabetes, hospital-based nested case–control study
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