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Triglyceride-Glucose Index and Atherogenic Index as Alternative Biomarkers for Glycemic Control in Type 2 Diabetes Mellitus

Cureus. 2025 Mar 31;17(3):e81550. doi: 10.7759/cureus.81550. eCollection 2025 Mar.

ABSTRACT

BACKGROUND: The triglyceride-glucose (TyG) index and the atherogenic index (AI) are emerging biomarkers that have been gaining attention in diabetes management as alternatives for assessing glycemic control in clinical settings. Since direct measurement of insulin resistance is impractical in routine care, it offers a more accessible alternative with potential broad clinical application. The TyG index and AI can serve as useful substitute biomarkers and could help in the management of glycemic control in type 2 diabetes mellitus (T2DM).

METHODOLOGY: A cross-sectional study was conducted with 200 T2DM participants, divided into two groups: 100 with good glycemic control (<7.0%) and 100 with poor control (≥7.0%), based on HbA1c levels. Lipid profile and HbA1c were measured using Chem-7 (Erba Mannheim, India) and Insta Check semi-auto analyzers. TyG index, TyG-body mass index (BMI), and TyG-waist circumference (WC) were calculated using standard formulas. Statistical analysis was performed by using SPSS 20.0 (IBM Corp., Armonk, New York, US), with p < 0.05 considered statistically significant.

RESULTS: Among 200 subjects, 63% were men and 37% were women. The mean age for type 2 diabetes subjects is 61.24 ± 7.25 years. The mean level of the TyG index in poor glycemic control is significantly higher (30.36 ± 5.51, p < 0.001) than that of good glycemic control (4.06 ± 0.05, p < 0.001). A significant positive correlation was observed between the TyG index and poor glycemic control. The TyG index has good predictive ability in poor glycemic control (area under the curve (AUC): 0.88; 95% confidence interval (CI): 0.83-0.92). The TyG optimal cutoff is ≥5.22 with 78.22% sensitivity and 94.06% specificity.

CONCLUSION: The TyG index shows a significant correlation with glycemic control and could serve as a valuable supportive marker for T2DM, particularly in smaller clinical settings.

PMID:40314056 | PMC:PMC12045142 | DOI:10.7759/cureus.81550

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