Relationship Between Triglyceride Glucose Index And Insulin Resistance And Vascular Complications In Type 2 Diabetes Mellitus

Objective:To study the correlation between triglyceride-glucose index（TyG）and HOMA2-IR index of steady-state model of type 2 diabetes mellitus,and to explore the relationship between TyG index and HOMA2-IR and macrovascular and microangiopathy in patients with type 2 diabetes mellitus.Methods:A total of 1041 inpatients with type 2 diabetes mellitus from January 2015to August 2017 in the First Hospital of Shanxi Medical University were included as the research objects.General data such as gender,age at hospitalization,body mass index,systolic blood pressure,diastolic blood pressure,fasting blood glucose,fasting insulin,fasting C-peptide,glycosylated hemoglobin,triglyceride,total cholesterol,urinary microalbumin ratio creatinine and creatinine were collected,and the carotid artery doppler ultrasound and lower extremity color examination,and the diagnosis of vascular complications such as atherosclerotic cardiovascular disease,cerebrovascular disease,diabetic nephropathy,diabetic retinopathy were also made.The TyG index was calculated according to the formula TyG=In[FPG（mg/d L）×TG（mg/d L）/2],and HOMA 2-IR was calculated according to FPG,FINS or fasting c-peptide value by Homa calculator published by Oxford university.The above data were processed by statistical methods,and the correlation between TyG index and HOMA2-IR was analyzed,and the relationship between these two indexes and T2DM macroangiopathy and microangiopathy was discussed.Results:1.The average age of T2DM patients in this study was 60（52～67）years old,and the average of BMI was 24.6（22.5～27.0）kg/㎡.There were 626 male patients,accounting for 60.1%,and 415 female patients,accounting for 39.9%.The HOMA2-IR level of women was lower than that of men,the incidence of microalbuminuria was higher than that of men,and the prevalence of arterial plaque in lower extremities was lower than that in men（all P<0.05）.There was no significant difference in TyG index and the prevalence of ASCVD,CVA,carotid plaque and DR between the two groups （P>0.05）.2.There was a positive correlation between TyG index and HOMA2-IR（r=0.327,P<0.001）.3.TyG index was positively correlated with BMI,Hb A1c,DBP,FPG,TG,TC and UACR（all P<0.001）,while TyG index was negatively correlated with HDL-C （P<0.001）.HOMA2-IR was positively correlated with BMI,FPG and TG（all P<0.05）,while HOMA2-IR was negatively correlated with HDL-C（P<0.001）.4.With the increase of TyG index,T2DM complicated with carotid plaque was gradually increasing(χ²_趋势=32.998,P<0.001),and with the increase of TyG index,T2DM complicated with microalbuminuria was gradually increasing(χ²_趋势=19.747,P<0.001).5.After adjusting for confounding factors,multivariate Logistic regression analysis showed that,in T2DM patients,the age（OR=1.074）,course of disease（OR=1.049）,LDL-C（OR=1.419）and TyG index（OR=2.501）were related with the risk of carotid plaque,while course of disease（OR=1.055）and TyG index（OR=2.943）were related with the risk of microalbuminuria.6.In the each subgroup of the male,female,age<60 years,age≥60 years,1 year<course of disease≤10 years,10 years<course of disease≤20 years,BMI<24 kg/㎡,BMI≥24kg/㎡,LDL-C<2.6 mmol/L,LDL-C≥2.6,the relationship between TyG index and the risk of T2DM with carotid plaque was significant（all P<0.05）,but there was no significant relationship between the TyG index and the risk of T2DM with carotid plaque in each subgroup of course of disease≤1 year、course of disease≥20years（all P>0.05）.7.In the each subgroup of male,female,age<60 years,age≥60 years,1 year< course of disease≤10 years,10 years<course of disease≤20 years,BMI<24 kg/㎡,BMI≥24kg/㎡,LDL-C<2.6 mmol/L,LDL-C≥2.6mmol/L,the relationship between TyG index and the risk of T2DM with carotid plaque was significant（all P<0.05）,but there was no significant relationship between TyG index and the risk of T2DM with microalbuminuria in each subgroup of course of disease≤1 year and course of disease>20 years、Hb A1c<7%and Hb A1c≥9%（all P>0.05）.Conclusion:In T2DM patients,there was a positive correlation between TyG index and HOMA2-IR.Compared with HOMA2-IR,the increase of TyG index was closely related to the high risk of carotid atherosclerosis and microalbuminuria.