Prognostic value of triglyceride‐derived metabolic parameters for micro‐ and macrovascular complications and mortality in individuals with type 2 diabetes: The Rio de Janeiro type 2 diabetes cohort study

TL;DR

This study found that triglyceride-based metabolic parameters are not reliable predictors of health risks in people with type 2 diabetes outside of Asian populations.

Contribution

The study evaluates the prognostic value of triglyceride-derived parameters in non-Asian type 2 diabetes patients, revealing their lack of predictive power.

Findings

Triglyceride-derived parameters showed no significant association with cardiovascular or microvascular outcomes.

TyG in the first year had a weak link to retinopathy, but it became non-significant after adjusting for LDL-cholesterol.

The results suggest these parameters should not be used for risk stratification in non-Asian type 2 diabetes populations.

Abstract

Triglyceride‐derived metabolic parameters have been proposed as indirect measures of insulin resistance and also as predictors of worse prognosis, mainly in Asian populations. However, their value as risk predictors of micro‐ and macrovascular complications in non‐Asian individuals with type 2 diabetes is uncertain.

Triglyceride‐derived parameters, the atherogenic index of plasma (AIP, the triglyceride/HDL‐cholesterol ratio), the triglyceride‐glucose index (TyG, the triglyceride‐fasting glucose product) and the TyG*BMI were calculated at baseline and during the 1st year of follow‐up in a prospective cohort of 667 individuals with type 2 diabetes. Multivariable Cox analyses assessed the associations between triglyceride‐derived parameters (as continuous and categorical tertile variables) and cardiovascular (total and major cardiovascular events) and microvascular (renal, retinopathy and peripheral neuropathy events) outcomes and mortality.

Over a median 10.6 years of follow‐up, there were 212 total cardiovascular events (172 major ones), 263 all‐cause deaths and 124 new microalbuminuria developments, 98 advanced renal function deteriorations, 154 retinopathy and 173 peripheral neuropathy development/progression events. None of the triglyceride‐derived metabolic parameters, either analysed as continuous or categorical variables, were associated with significantly higher risks for any of the adverse outcomes. The best predictive performance was the 1st year TyG for retinopathy development/progression (HR: 1.24; 95%CI: 1.01–1.53, for increments of 1‐SD), which attenuated to non‐significant (HR: 1.16; 95%CI: 0.92–1.45) after further adjustment for serum LDL‐cholesterol levels.

No triglyceride‐derived metabolic parameter was predictive of any adverse outcome, either micro‐ or macrovascular events or mortality, suggesting that they should not be used for risk stratification in individuals with type 2 diabetes.

Prognostic value of triglyceride‐derived metabolic parameters for micro‐ and macrovascular complications and mortality in individuals with type 2 diabetes.

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