Clinical Ophthalmology (Feb 2023)

Association of Triglyceride Glucose Index with Prevalence and Incidence of Diabetic Retinopathy in a Singaporean Population

  • Neelam K,
  • Aung KCY,
  • Ang K,
  • Tavintharan S,
  • Sum CF,
  • Lim SC

Journal volume & issue
Vol. Volume 17
pp. 445 – 454

Abstract

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Kumari Neelam,1,2,* Khin Chaw Yu Aung,3,* Keven Ang,3 Subramaniam Tavintharan,3,4 Chee Fang Sum,4 Su Chi Lim3– 6 1Department of Ophthalmology and Visual Sciences, Khoo Teck Puat Hospital, Singapore; 2Singapore Eye Research Institute, Singapore; 3Clinical Research Unit, Khoo Teck Puat Hospital, Singapore; 4Diabetes Centre, Admiralty Medical Centre, Singapore; 5Saw Swee Hock School of Public Health, National University of Singapore, Singapore; 6Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore*These authors contributed equally to this workCorrespondence: Su Chi Lim, Clinical Research Unit, Khoo Teck Puat Hospital, 90 Yishun Central, 728828, Singapore, Email [email protected]: To examine the association of triglyceride glucose (TyG) index (product of fasting triglyceride and glucose) with prevalence and incidence of diabetic retinopathy (DR) in type 2 diabetes.Methods: 1339 patients from an ongoing Singapore Study of Macro-angiopathy and Micro-Vascular Reactivity in Type 2 Diabetes (SMART2D) were included in this study. Fasting triglyceride and glucose levels were quantified and color fundus photographs were assessed for DR presence and severity. Logistic regression models were used to evaluate associations of TyG index with DR prevalence and incidence (median follow-up period = 3.2 years).Results: Mean TyG index was higher in patients with DR than no DR (9.24± 0.7 versus 9.04± 0.6, p< 0.001). TyG index was significantly associated with DR prevalence (OR=1.4, CI 1.1– 1.7, p=0.002) and incidence (OR=1.8, CI 1.04– 2.9, p=0.03), after adjusting for confounders. In a stratified analysis, the association between TyG index and DR prevalence reached significance only in the subgroup with HbA1c levels < 7.0% (OR=2, CI 1.1– 3.8, p=0.03). TyG index significantly predicted DR prevalence and incidence with area under receiver operating curve as 0.77 (CI 0.74– 0.80, p < 0.001) and 0.66 (CI 0.57– 0.76, p value < 0.01), respectively.Conclusion: TyG index is a good predictor for DR prevalence and incidence. It can also be a secondary treatment target for patients with optimally controlled levels of HbA1c.Keywords: triglyceride glucose index, diabetic retinopathy, insulin resistance, prevalence, incidence

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