Index Identifies Subclinical Heart Failure Risk in Type 2 Diabetes

The study covered in this summary was published in Research Square as a preprint and has not yet been peer reviewed.

Key Takeaways

The triglyceride-glucose (TyG) index — fasting triglycerides (mg/dL) x fasting glucose (mg/dL)/2 — correlated significantly with increased risk for heart failure with preserved ejection fraction (HFpEF) in asymptomatic patients with type 2 diabetes.

Why This Matters

Early stages of diabetes-induced HF are characterized by asymptomatic cardiac dysfunction.
Identification of asymptomatic patients with diabetes who are at risk for cardiac dysfunction could help improve outcomes.

Study Design

Cross-sectional study of 180 individuals with type 2 diabetes without cardiac symptoms.
HFpEF was defined as Heart Failure Association (HFA)-PEFF score ≥ 5 points.
Patients were separated into low-TyG (TyG index < 9.47, n = 88) and high-TyG (TyG index ≥ 9.47, n = 92) groups.

Key Results

Compared with the low-TyG group, patients in the high-TyG group had higher levels of metabolic syndrome-related risk factors, including elevated body mass index (BMI), A1c, triglycerides, total cholesterol, non-HDL-C, and fasting blood glucose (FBG), and lower high-density lipoprotein-cholesterol (HDL-C) levels (all P < .05).
The TyG index showed significant associations with all of those factors (P < .05 for the positive associations and P < .001 for the negative association with HDL-C) after adjustment for age, sex, and diabetes duration.
In the correlation analysis, the TyG index was positively associated with parameters of diastolic dysfunction (P < .001).
In the receiver operating characteristic (ROC) analysis, the TyG index was found to be significantly better at predicting the risk of suspected HFpEF than other indicators (AUC, 0.706), including TG/HDL-C ratio, FBG, and A1c.
A TyG index cutoff of 0.0067 had 72.8% sensitivity and 60.6% specificity for detecting suspicious/positive HFpEF.
In the multivariate analysis, the TyG index was independently correlated with HFpEF risk after adjustment for age, sex, BMI, diabetes duration, and A1c (odds ratio, 0.883; P < .001).

Limitations

Incomplete parameters for evaluating cardiac diastolic function and HFA-PEFF score, potentially reducing statistical power and causing selection bias.
Use of single TyG index score rather than cumulative scores.
Small study sample.

Disclosures

Study funding: National Natural Science Foundation of China, China Postdoctoral Science Foundation, Post-Doctoral Foundation of Jiangsu Province, Six Talent Peaks Project of Jiangsu Province, and Changzhou Science & Technology Program.
Author disclosures: None.

This is a summary of a preprint research study, “Triglyceride-glucose index for the detection of subclinical heart failure with preserved ejection fraction in patients with type 2 diabetes,” written by Tingting Wang of the Third Affiliated Hospital of Soochow University, China, and colleagues. Published on Research Square and provided to you by Medscape. The study has not yet been peer reviewed.

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