ASSOCIATIONS OF TYG INDEX WITH HOMA-IR AND UACR FOR PREDICTING DIABETIC NEPHROPATHY IN T2DM PATIENTS

Main Article Content

Muhammad Muddasser khan Panezai
Naeema Asghar
Muhammad Rashid Qureshi
Mehwish Abrar
Saleem Shahzad
Kamran Ali Qureshi

Keywords

diabetic nephropathy, type 2 diabetes, TyG index, HOMA-IR

Abstract

Background: Diabetes mellitus (DM) damages blood vessels, kidneys, eyes, nerves, and the heart by increasing blood sugar levels and changing metabolism. A total of 10.5% of people worldwide suffered from diabetes in 2021; by 2030, that number is projected to increase to 643 million, and by 2045, it will reach 783 million. Pakistan has over 33 million people with a diabetes prevalence of 26.7%. Due to the slow course of type 2 diabetes mellitus (T2DM), patients should be screened for diabetic nephropathy (DN) at diagnosis and then once a year thereafter. Insulin-resistant kidneys exhibit hyper filtration, which is associated with the progression of diabetic nephropathy (DN) and severe illness. Microalbuminuria, which indicates endothelial dysfunction, can be treated early.


Objective: To determine the association of TyG index with HOMA-IR in T2DM patients, and to determine the association of TyG index with UACR for predicting DN.


Study design: A cross-sectional study


Place and Duration: This study was conducted in Sandeman Provincial Hospital Quetta from March 2023 to March 2024.


Methodology: The sample was acquired from Diabetic Clinic patients using a non-probability consecutive sampling technique. The study comprised T2DM patients with fasting plasma glucose (FPG) values of ≥126 mg/dl and a diagnosis of 1-5 years. Data was collected after patients provided informed consent and ensured their confidentiality. The demographic and clinical data gathered were gender, age, height, diabetes duration, blood pressure (BP), waist circumference (WC), weight, and body mass index (BMI).


Results: In all, 250 patients were included in this investigation. There were 88 (35.2%) male participants and 162 (64.8%) female participants, making up the majority of the participants. Overall 49.2 years of age was the average. Overall 3.46 was the mean fasting serum insulin. The mean HOMA-IR was 1.79. The mean glycated hemoglobin was 6.65. The mean TyG index levels were 5.39. 46% of the participants were overweight while 15% were obese and 39% were normal weighted.


Conclusion: The TyG index showed a strong connection with HOMA-IR and was superior in predicting diabetic nephropathy (DN) in type 2 diabetes patients.

Abstract 57 | pdf Downloads 16

References

1. Khan S, Qayyum S, Khan MN. Triglyceride-glucose index: A surrogate marker of homeostasis model assessment of insulin resistance to predict diabetic nephropathy. JPMA. The Journal of the Pakistan Medical Association. 2024 May 1;74(5):862-7.
2. Al-Bayati AA, Al-Khateeb SM. The association between glycaemic level and lipid profile with Albuminuria in Iraqi type 2 diabetes patients—A cross sectional study. JPMA. The Journal of the Pakistan Medical Association. 2021 Dec 1;71(12):S57-62.
3. Liu L, Xia R, Song X, Zhang B, He W, Zhou X, Li S, Yuan G. Association between the triglyceride–glucose index and diabetic nephropathy in patients with type 2 diabetes: A cross‐sectional study. Journal of diabetes investigation. 2021 Apr;12(4):557-65.
4. Satirapoj B, Supasyndh O, Boonyavarakul A, Luesutthiviboon L, Choovichian P. The correlation of insulin resistance and renal function in non diabetic chronic kidney disease patients. JOURNAL-MEDICAL ASSOCIATION OF THAILAND. 2005 Nov 1;88:S97.
5. Al-Fartosy AJ, Awad NA, Alsalimi SA. Insulin resistance and specific biomarkers in blood and urine of type 2 diabetic patients with or without nephropathy in Basrah, Iraq. African Journal of Biochemistry Research. 2020 Oct 31;14(4):125-34.
6. Mohan V, Vishwanath VN. The Association between Serum Lipid Profile and Nephropathy in Type 2 Diabetes Mellitus Patients. Academia Journal of Medicine. 2019 Jul 1;2(1):18-21.
7. Borisa KD. Nephropathy and serum lipid profile in type 2 diabetes patients: A retrospective study in central India.
8. Wanyama FM, Kigondu CS, Mburu DN, Ngugi NN, Kiboi NG. Evaluation of high density lipoprotein cholesterol as a predictor of diabetic nephropathy in type 1 diabetic patients.
9. Jabeen WM, Jahangir B, Khilji S, Aslam A. Association of triglyceride glucose index and triglyceride HDL ratio with glucose levels, microvascular and macrovascular complications in Diabetes Mellitus Type-2. Pakistan Journal of Medical Sciences. 2023 Sep;39(5):1255.
10. Agarwal AK, Singla S, Garg U, Yadav R, Miglani S, Jain AK. Glomerular filtration rate and total kidney volume in cases of recent onset type-2 diabetes mellitus. J Indian Acad Clin Med. 2005 Oct;6:285-90.
11. Saeedi P, Petersohn I, Salpea P, Malanda B, Karuranga S, Unwin N, et al. Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas, 9th edition. Diabetes Res Clin Pract 2019;157:107843. doi: 10.1016/j.diabres.2019.107843
12. Abro M, Zafar AB, Fawwad A, Mustafa N, Bilal Tahir B, Riaz M, et al. Prevalence of diabetic micro vascular complications at a tertiary care unit of Karachi, Pakistan. Int J Diabetes Dev Ctries 2019;39:325-30. doi: 10.1007/s13410-018-0683-5
13. Rossing P. Diabetic nephropathy: worldwide epidemic and effects of current treatment on natural history. Curr Diab Rep 2006;6:479-83. doi: 10.1007/s11892-006-0083-y.
14. Faselis C, Katsimardou A, Imprialos K, Deligkaris P, Kallistratos M, Dimitriadis K. Microvascular Complications of Type 2 Diabetes Mellitus. Curr Vasc Pharmacol 2020;18:117-24. doi: 10.2174/1570161117666190502103733
15. Chiu H, Tsai HJ, Huang JC, Wu PY, Hsu WH, Lee MY, et al. Associations between Triglyceride-Glucose Index and Micro- and MacroangiopathiesinType 2 Diabetes Mellitus. Nutrients 2020;12:328. doi: 10.3390/nu12020328
16. Wang J, Wang Y, Li Y, Hu Y, Jin L, Wang W, et al. High Normal Urinary Albumin-Creatinine Ratio Is Associated With Hypertension, Type 2 Diabetes Mellitus, HTNWithT2DM, Dyslipidemia, and Cardiovascular Diseases in the Chinese Population: A Report From the REACTION Study. Front Endocrinol (Lausanne) 2022;13:864562. doi: 10.3389/fendo.2022.864562
17. Sasson AN, Cherney DZ. Renal hyperfiltration related to diabetes mellitus and obesity in human disease. World J Diabetes 2012;3:1-6. doi: 10.4239/wjd.v3.i1.1
18. Malik AR, Sultan S, Turner ST, Kullo IJ. Urinary albumin excretion is associated with impaired flow- and nitroglycerin-mediated brachial artery dilatation in hypertensive adults. J Hum Hypertens 2007;21:231-8. doi: 10.1038/sj.jhh.1002143
19. Liu L, Xia R, Song X, Zhang B, He W, Zhou X, et al. Association between the triglyceride-glucose index and diabetic nephropathy in patients with type 2 diabetes: A cross-sectional study. J Diabetes Investig 2021;12:557-65. doi: 10.1111/jdi.13371
20. Srinivasan S, Singh P, Kulothungan V, Sharma T, Raman R. Relationship between triglyceride glucose index, retinopathy and nephropathy in Type 2 diabetes. Endocrinol Diabetes Metab 2020;4:e00151. doi: 10.1002/edm2.151