Aug 2026· International Journal of Health Sciences and Research· 0 citations· 17 references
TL;DR
The findings suggest that the TyG index and vitamin D status are associated with cardiometabolic risk factors; however, the cross-sectional design precludes causal inference, and prospective studies are needed to confirm these associations.
Abstract
Introduction: Insulin resistance, dyslipidemia, and increased risk of developing cardiovascular diseases have been identified in patients with type 2 diabetes mellitus (T2DM). Triglyceride – Glucose (TyG) index has been identified as the surrogate marker for insulin resistance and vitamin D deficiency is known to contribute to poor metabolic profile. This study aimed at exploring the relation between TyG index and vitamin D and their association with cardiovascular disease risk factors in patients with T2DM.
Materials and Methods: Hospital-based cross-sectional study was carried out on 156 patients with T2DM presenting in tertiary care hospital. Anthropometry, fasting blood glucose, HbA1c, lipid profile, and serum vitamin D were determined. TyG index, Cardiac Risk Ratio (CRR), Atherogenic Coefficient (AC) and Atherogenic Index of Plasma (AIP) were calculated. Group comparisons based on vitamin D deficiency and correlations were carried out using one-way ANOVA, Chi square and Spearman’s rank correlation.
Results: The mean age of participants was 52.1 ± 10.4 years, mean BMI was 27.3 ± 3.2 kg/m², mean TyG index was 9.85 ± 0.24, and mean serum vitamin D concentration was 18.0 ± 7.3 ng/mL. Vitamin D deficiency was observed in 94 (60.3%) participants. Patients with vitamin D deficiency had higher BMI (28.6 ± 4.3 vs. 25.1 ± 3.2 kg/m²), TyG index (10.01 ± 0.25 vs. 9.63 ± 0.21), HbA1c (8.1 ± 1.6% vs. 7.5 ± 1.3%), Cardiac Risk Ratio (5.4 ± 1.7 vs. 4.5 ± 1.3), and Atherogenic Index of Plasma (0.32 ± 0.26 vs. 0.18 ± 0.20) than vitamin D-sufficient participants. One-way ANOVA demonstrated significant differences in BMI (F (2,153) = 7.58, p < 0.001), TyG index (F (2,153) = 13.42, p < 0.001), Cardiac Risk Ratio (F (2,153) = 3.40, p = 0.036), and Atherogenic Index of Plasma (F (2,153) = 3.27, p = 0.040), whereas differences in HbA1c were not statistically significant (F (2,153) = 1.55, p = 0.216). Vitamin D status showed significant associations with gender (χ² = 10.03, df = 2, p = 0.007) and BMI category (χ² = 15.44, df = 4, p = 0.004), whereas no significant association was observed with age group (χ² = 1.23, df = 4, p = 0.873). Spearman correlation analysis demonstrated that the TyG index was positively correlated with HbA1c (ρ = 0.46), Cardiac Risk Ratio (ρ = 0.52), and Atherogenic Index of Plasma (ρ = 0.61), and negatively correlated with vitamin D (ρ = −0.41) (all p < 0.001).
Conclusions: The TyG index was significantly associated with adverse glycemic and atherogenic markers and inversely associated with vitamin D levels in patients with type 2 diabetes mellitus. These findings suggest that the TyG index and vitamin D status are associated with cardiometabolic risk factors; however, the cross-sectional design precludes causal inference, and prospective studies are needed to confirm these associations.
Key words: TyG index, Vitamin D, Insulin resistance, Type 2 diabetes mellitus, Cardiovascular risk
Background: Type 2 Diabetes Mellitus (T2DM) is associated with increased cardiovascular risk due to chronic inflammation and atherogenic dyslipidemia. Highsensitivity C-reactive Protein (hsCRP) and the Atherogenic Index of Plasma (AIP) have emerged as potential biomarkers for identifying cardiometabolic risk, however, their combined relationship with ischemic heart disease remains inadequately explored. To evaluate the association of hsCRP and Atherogenic Index of Plasma with lipid profile and ischemic heart disease among patients with type 2 diabetes mellitus.
Materials and methods: A hospital-based cross-sectional observational study was carried out in the Department of Biochemistry, Chittagong Medical College, Department of Endocrinology of Chittagong Medical College Hospital and Chattogram Diabetic Hospital. ‘One hundred (100) type 2 diabetes mellitus patient were included in the study by nonprobability consecutive sampling. Serum hsCRP, lipid profile parameters and AIP were measured using standard laboratory methods.’ ‘Comparative analysis, Pearson correlation, independent sample t-test, and multiple logistic regression were performed to assess relationships between inflammatory status and atherogenic lipid indices.’
Results: ‘Patients with type 2 diabetes mellitus ischemic heart disease demonstrated significantly higher hsCRP, triglyceride, and LDL-cholesterol levels compared with those without ischemic heart disease (p < 0.01).’ ‘Correlation analysis revealed significant positive relationships between hsCRP and total cholesterol (r = 0.292) triglycerides (r = 0.325), LDL-cholesterol (r = 0.279) and AIP (r = 0.286). Individuals with hsCRP >3 mg/L showed a significantly higher prevalence of ischemic heart disease (p = 0.009) and greater mean AIP values (p = 0.0001).’ ‘Multiple logistic regression analysis identified triglycerides and LDL-cholesterol as independent predictors of elevated hsCRP, while AIP remained a strong predictor after adjustment for ischemic heart disease (OR = 9.35, p = 0.002).’
Conclusion: ‘Elevated hsCRP is strongly associated with atherogenic lipid abnormalities and increased cardiovascular risk in patients with type 2 diabetes mellitus. The combined assessment of inflammatory markers and Atherogenic Index of Plasma may enhance early cardiovascular risk stratification beyond traditional lipid profile parameters.’
JCMCTA 2026 ; 37 (1) : 169-175
Shantanu Dutta, Mahmudul Haque, Shantunu Chowdhury et al.· Journal of Chittagong Medica...· 0 citations
To evaluate the associations between lipid-related metabolic indicators and incident type 2 diabetes mellitus (T2DM).
A diabetes family cohort study of 3,726 participants was conducted in Taizhou from May to October 2021 to track incident T2DM cases. Lipid metabolism indicators included triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglyceride-glucose (TyG) and its related indices, Chinese Visceral Adiposity Index (CVAI), and homeostasis model assessment of insulin resistance (HOMA-IR). Mixed-effects Cox proportional hazards models, within-family Cox models, and quartile analyses were performed to examine the associations between these indicators and incident T2DM.
Among 1,257 participants without diabetes at baseline, 68 developed incident T2DM during the average follow-up of 3.92 years. Higher levels of TyG (HR = 1.758, 95% CI: 1.182–2.616), TyG-BMI (HR = 1.007, 95% CI: 1.002–1.013), TyG-WHtR (HR = 2.108, 95% CI: 1.468–3.027), TyG-WC (HR = 1.005, 95% CI: 1.003–1.007), CVAI (HR = 1.013, 95% CI: 1.006–1.020), and HOMA-IR (HR = 1.195, 95% CI: 1.038–1.376) were significantly associated with an increased risk of incident T2DM, whereas traditional lipid indicators showed no significant associations. These findings were consistent in within-family analyses. Furthermore, dose-response relationships were observed between TyG, TyG-WHtR, TyG-WC, CVAI and incident T2DM.
In conclusion, TyG-related indices, CVAI, and HOMA-IR were significantly associated with incident T2DM in this diabetes family-based cohort. These composite indicators may be useful for the early identification of high-risk individuals and for informing targeted prevention strategies.
Not applicable.
Haowei Li, Yilu Huang, Donghui Yang et al.· BMC Endocrine Disorders· 0 citations
The triglyceride and glucose (TyG) index is considered a biochemical marker of insulin resistance (IR) and exhibits a significant correlation with cardiovascular disease occurrence. This study aims to explore the association between TyG index and coronary artery disease (CAD) in non-diabetes patients, and further evaluate the mediating role of high density lipoprotein cholesterol (HDL-C) in this relationship. Totally 1192 subjects firstly underwent selective coronary angiography (CAG) were enrolled in the present study, including 709 first diagnosed individuals with CAD and 402 non-CAD individuals. All participants were categorized into four groups according to quartile of the TyG index. The relationships of the TyG index with CAD were validated by logistic regression analysis and restricted cubic spline analysis (RCS). Mediation analysis was conducted to determine the indirect effects through HDL-C. Multiple linear regression analysis revealed the TyG index were significantly increased with LDL-C, apolipoprotein A-1(apoA-1), apolipoprotein B (apoB), and inversely associated with HDL-C. Multivariable logistic regression analysis revealed a significant positive association between the TyG index and CAD. Logistic regression and RCS analyses showed that the association between TyG index and CAD risk was statistically significant only in the middle HDL-C tertile [OR = 2.766 for TyG Q2, OR = 3.100 for TyG Q3, OR = 2.701 for TyG Q4), all
p
< 0.05]. A significant nonlinear relationship was also observed in this tertile (
p
nonlinear < 0.05), after adjusting for covariates. The indirect effect of TyG index on CAD by HDL-C was 0.1372 (95% bootstrap CI: 0.0702 to 0.2156), while LDL-C and aopB showed no mediation effect on this association (
p
> 0.05). The TyG index was independently associated with CAD risk. Mediation analysis confirmed that HDL-C exerted a significant mediating effect on the association. Comprehensive management of HDL-C for people with high TyG index facilitates primary prevention of cardiovascular diseases.
Li Li, G. Cai, Feng Li et al.· Scientific Reports· 0 citations
In patients with type 2 diabetes, WHR and serum uric acid levels are significantly correlated with insulin resistance status, and may provide preliminary insights into the metabolic abnormalities associated with insulin resistance in patients with type 2 diabetes.
Zinc plays an important role in glucose metabolism and lipid regulation, and its imbalance has been implicated in the development of type 2 diabetes, metabolic syndrome, and dyslipidemia. A case–control study was conducted on 100 patients with type 2 diabetes and 95 controls. Serum zinc levels, metabolic panel and Blood pressure, were measured. Demographic and treatment-related factors were assessed to evaluate their potential influence on trace element status. Moreover, dietary zinc consumption was estimated. Diabetic patients had significantly lower serum zinc levels compared to non-diabetic participants despite comparable intake. In addition, each unit (mcg/dL) increase in serum zinc was associated with 10% lower odds of diabetes prevalence (p = 0.003). Total TC, TG, and LDL were all significantly increased in patients with diabetes (p < 0.001), each 1 mg/dL increase in LDL-cholesterol increased the odds of zinc deficiency by 4% (p = 0.03). Individuals with diabetes had significantly lower diastolic blood pressure as compared to healthy participants (p = 0.01). People with diabetes display different blood pressure and lipid patterns, as well as lower serum zinc concentrations, despite having dietary zinc intake comparable to those without diabetes. Higher serum zinc levels are associated with reduced odds of having diabetes. However, because these findings are based on cross-sectional data, further longitudinal and intervention studies are needed to determine the most effective zinc formulations and dosing regimens.
Sara M. Eladawy, H. Salem, Gehan F. Balata et al.· Scientific Reports· 0 citations
Insulin resistance (IR) is a key factor in cardiometabolic diseases, but there are few practical ways to measure it in adolescents. The insulin sensitivity’s surrogate measure, the eGDR, has not been well validated in young populations.
eGDR was determined by the use of waist circumference (WC), HbA1c levels, and hypertension status in this cross-sectional study of Chinese adolescents. Restricted cubic spline models and multivariate logistic regression were utilized to estimate associations between eGDR and cardiometabolic risk factors (CMRFs), such as dyslipidemia, hyperuricemia, and high fasting plasma glucose (FPG). The eGDR’s discriminative performance was compared with traditional IR indices, such as HOMA-IR, TyG, AIP, TyG-BMI, and QUIKI.
After confounders’ adjustment, each SD raise in eGDR was linked with reduced odds of dyslipidemia (OR = 0.781, 95% CI: 0.703–0.866,
p
< 0.001) and hyperuricemia (OR = 0.884, 95% CI: 0.800–0.977,
p
= 0.016). eGDR showed negative correlations with atherogenic lipid subfractions, such as LDL-C, non-HDL-C, and triglycerides (TG), but not with total cholesterol (TC) or FPG. Subgroup analyses showed that the protective effect against dyslipidemia was stronger in participants with BMI in the ≥ 85th percentile, and sex-specific differences in the associations with TG and FPG. eGDR was found to be better than traditional IR indices in discriminating clustered CMRFs. Sex-specific cut-offs for IR were determined: eGDR <8.06 mg/kg/min and <8.46 mg/kg/min for males and females, respectively.
eGDR is a strong, non-invasive cardiometabolic risk indicator in adolescents, especially dyslipidemia and hyperuricemia. It can offer a feasible instrument of early risk stratification in this group.
Yi-Wen Wang, H. Yao, Ling Li et al.· Frontiers in Nutrition· 0 citations
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