Introduction: Triglyceride glycemic index (TGI), a product of the serum triglyceride and fasting blood glucose, is a documented better marker of insulin resistance than the validated homeostasis model assessment (HOMA). A detailed understanding could minimize the pan-systemic inflammatory changes associated with its elevation. This study assessed the relationship between TGI and metabolic/cardiovascular dysfunctions in type 2 diabetes mellitus (T2DM).
Method: This cross-sectional study analyzed the data of 192 T2DM patients to assess the TGI and determined its sociodemographic, clinical, and laboratory correlates.
Results: The mean age (which included 6.2% females) was 60.4±11.6 years. Central obesity, microalbuminuria and elevated TGI were more common in women, p=0.04, p=0.04 and p=0.32 respectively. TGI was associated with aging (p=0.002), hypertension (p<0.001), hyperhomocysteinemia (p<0.001), poor glycemic control (p=0.07) and microalbuminuria(p=0.06). The higher TGI in women (who had lower fasting glucose levels) reflects the disproportionately higher hypertriglyceridemia in them compared to the men. Age-related TGI reflected the large proportion (56.2%) of post-menopausal women among the elderly population. The pan-systemic inflammatory effect of elevated TGI was highlighted by its positive relationship with LVH (p<0.001), elevated fasting insulin (p=0.04), and declining kidney function (p=0.33). Predictors of elevated TGI were central obesity, hypertension, hyperhomocysteinemia, atherogenic index of plasma, cardiac risk ratio and left ventricular hypertrophy
Conclusion: Elevated TGI is common in T2DM and is associated with cardiometabolic and kidney function derangements. An optimized control of hyperhomocysteinemia and metabolic syndrome (MetS) in association with lifestyle modification is imperative in reducing the TGI and the dysfunctions associated with its elevation.