Abstract
Triglyceride-glucose index (TyG index) is associated with type 2 diabetes mellitus (T2DM), but research on this relationship is limited in Japan. The purpose of this study was to evaluate the correlation between TyG index and the risk of T2DM in the Japanese population. Here, 12732 participants were selected from the NAGALA study (NAfld in the Gifu Area, Longitudinal Analysis) conducted between 2004 and 2015 for a retrospective cohort analysis. The association between TyG index and T2DM was assessed using the Cox proportional-hazard model. Subgroup analyses were conducted according to age, sex, smoking status, alcohol consumption, waist circumference, BMI, and follow-up duration. The formula for TyG index was expressed as ln [fasting triglyceride level (mg/dL) × fasting plasma glucose level (mg/dL)/2]. After follow-up, 150 (1.18%) patients developed T2DM. After adjusting for potential confounders, a linear relationship was observed between TyG and the risk of T2DM. After adjusting for age, sex, BMI, waist circumference, HDL-cholesterol, total cholesterol, systolic blood pressure, regular exercise, smoking status, and alcohol consumption, TyG index, as a continuous variable, was associated with an increased risk of T2DM (adjusted hazard ratio (aHR), 1.79; 95% confidence interval (95% CI), 1.25-2.57). Compared with the first quartile of TyG index, subjects in the fourth quartile were 2.33-fold more likely to develop T2DM (aHR 2.33, 95% CI 1.09-4.96; P for trend 0.0224). Subgroup analyses showed that the association between TyG index and incident T2DM stably existed in different subgroups according to the variables tested. Therefore, TyG index was linearly related to the risk of incident T2DM in the Japanese population and may be used as a monitoring tool.
Highlights
At present, epidemiological reports suggest 463 million people have diabetes worldwide, and this number is projected to increase to 700 million people by 2045 [1]
Using the univariate Cox proportional hazard model, we discovered that regular exercise, light alcohol consumption, and past smoking were not associated with Type 2 diabetes mellitus (T2DM)
We found that T2DM was associated with lower high-density lipoprotein cholesterol (HDL-C)
Summary
Epidemiological reports suggest 463 million people have diabetes worldwide, and this number is projected to increase to 700 million people by 2045 [1]. Type 2 diabetes mellitus (T2DM) and its associated complications impose an enormous economic burden on individuals, societies, and nations. Major risk factors for T2DM include an unhealthy diet, obesity, and a sedentary lifestyle [2, 3]. Large epidemiological investigations require noninvasive and inexpensive tests to identify those with a greater risk of developing T2DM and to prevent its development. Simental-Mendía et al [6] proposed that triglycerideglucose (TyG) index, which is estimated using the formula ln ðfasting triglycerides ðmg/dlÞ × fasting blood glucose ðmg/dlÞ/ 2Þ, is associated with diabetes. TyG index showed a BioMed Research International remarkable relationship with commonly used surrogate indicators of IR, such as hyperglycemic clamp and the homeostasis model assessment of IR (HOMA-IR) [6,7,8,9]
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