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Background <p>Type 2 diabetes mellitus (T2DM) is a chronic metabolic illness distinguished by insulin resistance (IR), impaired production of insulin, and elevated blood sugar concentration. Prevention focuses on healthy living &amp; managing risks. Peripheral artery disease (PAD) shares risk factors with type 2 diabetes, but diabetes significantly contributes to its development &amp; progression. Chronic high blood sugar and IR worsen microvascular &amp; macrovascular complications, potentially leading to limb amputation. We aimed in this research to assess the serum triglyceride glucose index (TyG index) level as possible screening &amp; severity biomarker of IR &amp; in prediction of PAD. We further tried to correlate the level of this biomarker with different clinical features of the cases &amp; other laboratory tests.</p> Methods <p>This case-control study was conducted on 110 subjects, classified into two groups: 55 T2DM with no known PAD manifestations and 55 apparently healthy subjects as a control group recruited from the internal medicine, diabetes, and endocrinology outpatient clinics at Kasr Al Ainy Hospital, Cairo University, across a 20-month duration from October 2022 to March 2024. Data collection included the lipid profile, fasting insulin, fasting blood glucose (FBS), &amp; glycated hemoglobin (HbA1c). Homeostatic model assessment of insulin resistance (HOMA IR) has been determined with regard to formula: HOMA-IR = {fasting glucose (milligram per decilitre) ×fasting insulin (international unit per millilitres)} /405. The TyG index has been determined as: ln (fasting triglycerides [milligram per decilitre] × fasting blood glucose [milligram per decilitre] /2). The ankle-brachial index (ABI) has been calculated utilizing a high-resolution color-coded Doppler Ultrasonography and the presence of PAD was described as right or left ABI ≤ 0.9. Statistical analyses focused on exploring the efficacy of TyG index for diagnosis of IR and PAD.</p> Results <p>PAD is significantly greater among diabetic cases in comparison with control group (p value &lt; 0.001). In diabetic cases, a significant positive association has been detected between triglyceride glucose index (TyG index) &amp; (duration of diabetes, total cholesterol, Hb A1c, fasting insulin, and HOMA IR) with a significant negative association has been found among TyG index &amp; ABI with p value &lt; 0.001. ROC curve was done for TyG index for diagnosis of IR showed that a cut off value above nine had a sensitivity &amp; specificity 98% and 93% respectively with area under the curve (AUC) 0.98 with p value &lt; 0.001. ROC curve was done for TyG index + for diagnosis of PAD showed that a cut off value &gt; 9.7 showed a higher sensitivity &amp; specificity 89%and 90% respectively with AUC 0.9 with p value &lt; 0.001. The logistic regression model showed that TyG index is the only indicator of PAD.</p> Conclusion <p>We report a significant correlation among TyG index &amp; both of IR &amp; PAD. TyG index is an inexpensive, rapid marker that may be applied in the determination of IR&amp; the prediction of PAD in type 2 diabetic cases.</p>

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Triglyceride-glucose index (TyG) as a predictor of insulin resistance and peripheral artery disease in patients with type 2 diabetes mellitus

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  • 发表日期：

    2026年4月2日

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  • Aya Tarabay,
  • Tasneem Halaby,
  • Hoda Amin,
  • Heba M Sharaf-Edin,
  • Eslam Abu-Naeima,
  • Mai Elshenoufy

摘要

Background

Type 2 diabetes mellitus (T2DM) is a chronic metabolic illness distinguished by insulin resistance (IR), impaired production of insulin, and elevated blood sugar concentration. Prevention focuses on healthy living & managing risks. Peripheral artery disease (PAD) shares risk factors with type 2 diabetes, but diabetes significantly contributes to its development & progression. Chronic high blood sugar and IR worsen microvascular & macrovascular complications, potentially leading to limb amputation. We aimed in this research to assess the serum triglyceride glucose index (TyG index) level as possible screening & severity biomarker of IR & in prediction of PAD. We further tried to correlate the level of this biomarker with different clinical features of the cases & other laboratory tests.

Methods

This case-control study was conducted on 110 subjects, classified into two groups: 55 T2DM with no known PAD manifestations and 55 apparently healthy subjects as a control group recruited from the internal medicine, diabetes, and endocrinology outpatient clinics at Kasr Al Ainy Hospital, Cairo University, across a 20-month duration from October 2022 to March 2024. Data collection included the lipid profile, fasting insulin, fasting blood glucose (FBS), & glycated hemoglobin (HbA1c). Homeostatic model assessment of insulin resistance (HOMA IR) has been determined with regard to formula: HOMA-IR = {fasting glucose (milligram per decilitre) ×fasting insulin (international unit per millilitres)} /405. The TyG index has been determined as: ln (fasting triglycerides [milligram per decilitre] × fasting blood glucose [milligram per decilitre] /2). The ankle-brachial index (ABI) has been calculated utilizing a high-resolution color-coded Doppler Ultrasonography and the presence of PAD was described as right or left ABI ≤ 0.9. Statistical analyses focused on exploring the efficacy of TyG index for diagnosis of IR and PAD.

Results

PAD is significantly greater among diabetic cases in comparison with control group (p value < 0.001). In diabetic cases, a significant positive association has been detected between triglyceride glucose index (TyG index) & (duration of diabetes, total cholesterol, Hb A1c, fasting insulin, and HOMA IR) with a significant negative association has been found among TyG index & ABI with p value < 0.001. ROC curve was done for TyG index for diagnosis of IR showed that a cut off value above nine had a sensitivity & specificity 98% and 93% respectively with area under the curve (AUC) 0.98 with p value < 0.001. ROC curve was done for TyG index + for diagnosis of PAD showed that a cut off value > 9.7 showed a higher sensitivity & specificity 89%and 90% respectively with AUC 0.9 with p value < 0.001. The logistic regression model showed that TyG index is the only indicator of PAD.

Conclusion

We report a significant correlation among TyG index & both of IR & PAD. TyG index is an inexpensive, rapid marker that may be applied in the determination of IR& the prediction of PAD in type 2 diabetic cases.