Triglyceride Glucose Index as A Promising Biomarker for Glycemic Control in Type 2 Diabetic Patients

Diabetes Mellitus (DM) is increasing at an alarming rate throughout the world, the assessment of glycemic control is of prime importance because of its key role in the management of type 2 DM. Diabetics with poor glycemic control have adverse effects on the life expectancy; however, laboratory determinations of plasma HbA1c are not yet widely available in addition to its high cost. Recently, the TyG index, a product from the fasting levels of triglycerides and glucose, presented promising results as a surrogate marker for the assessment of insulin resistance. Is to evaluate the potential of using TyG index and TyG derived indices (TyG-WC, TyG-BMI) to assess glycemic control and its correlation with HbA1c in patients with type 2 DM. This cross-sectional study was conducted on 50 type 2 diabetic patients recruited from Endocrinology and Metabolism department of Al-Zahraa University Hospital. They were divided into two groups according to HbA1c level Group 1: included 11 controlled type 2 diabetic patients with HbA1c less than 6.5% Group 2: included 39 uncontrolled type 2 diabetic patients with HbA1c more than 6.5%. Detailed history, clinical examination and anthropometric measurements were assessed for all selected patients. Fasting plasma glucose, glycosylated hemoglobin (HbA1c), total cholesterol, triglycerides, low density lipoprotein (LDL-C), high density lipoprotein HDL-C, and fasting insulin) were measured then insulin resistance index (IR) was calculated as follow: HOMA-IR =(FBI (uIU/ml) x FBG (mg/dl))/405 .TyG indices were calculated according to the following formula: triglyceride glucose index (TyG) is calculated as TyG index = ln (fasting TG [mg/dL] x fasting glucose [mg/dL]/2). Triglyceride waist circumference (TyG-WC) calculated asTyG-WC= TyG x waist circumference. Triglyceride BMI (TyG-BMI) calculated asTyG-BMI = TyG xBMI. The mean triglyceride glucose index in the uncontrolled cases was statistically significantly higher as compared to the cases with controlled diabetes, Significant positive correlation was found between triglyceride glucose index and fasting blood glucose, postprandial blood glucose, HbA1c, triglyceride and HOMA-IR. Triglyceride glucose index revealed the highest accuracy for detection of uncontrolled diabetic cases.