Triglyceride-Glucose Index as a Surrogate Marker for Insulin Resistance in Predicting Diabetic Nephropathy

Ruqia Jamali; Muhammad Nouman; Gotam Kumar Jeswani; Gotam Kumar Jeswani; Mustafa Aatif; Saifullah; Hidayatullah Memon

doi:10.31838/ijprt.1000

Authors

Ruqia Jamali Senior Medical Officer, Social Security Hospital Hyderabad Pakistan.
Muhammad Nouman Associate Professor Medicine, Indus Medical College Tando Muhammad Khan Pakistan.
Gotam Kumar Jeswani Associate Professor Community Medicine, Peoples University of Medical and Health Sciences University Nawabshah Pakistan.
Gotam Kumar Jeswani Associate Professor Community Medicine, Peoples University of Medical and Health Sciences University Nawabshah Pakistan.
Mustafa Aatif Final Year Student, Royal college of Surgeons in Ireland, Bahrain Campus.
Saifullah Assistant Professor Medicine, Mekran medical college Turbat Balochistan Pakistan.
Hidayatullah Memon Lecturer Pathology, Ghulam Muhammad Mahar Medical College Sukkur, SMBBMU Larkana Pakistan.

DOI:

https://doi.org/10.31838/ijprt.1000

Keywords:

Triglyceride-glucose index, HOMA-IR, diabetic nephropathy, type 2 diabetes mellitus, insulin resistance.

Abstract

Objective: To determine the relationship between the triglyceride-glucose (TyG) index and the homeostasis model assessment of insulin resistance (HOMA-IR) in type 2 diabetes mellitus (T2DM) patients, and to determine whether the index of TyG can predict diabetic nephropathy by correlating it with urinary albumin-to-creatinine ratio (UACR).

Study design: Cross-sectional study

Duration and place of study: This study was conducted in Social Security Hospital Hyderabad Pakistan from May 2024 to May 2025

Methods: This cross-sectional study involved 150 patients who have just been diagnosed with type 2 diabetes. Demographic and clinical data, vital signs, age, gender and body mass index were all recorded. Triglycerides, total cholesterol, UACR, serum creatinine, fasting plasma glucose, fasting serum insulin, glycated haemoglobin (HbA1c), triglycerides, and high- and low-density lipoprotein cholesterol were all lab results. The patients were ranked into quartile groups according to their TyG index scores after computing the HOMA-IR and TyG index. Level I: The statistical analysis was conducted to determine the relationship between the estimated glomerular filtration rate (eGFR) and the TyG index, HOMA-IR, HbA1c and UACR.

Results: The mean age of the 150 participants was 48.7 ± 10.9 years, with 98 (65.3%) being female and 52 (34.7%) being male. According to BMI, 68 (45.3%) were normal weight, 24 (16%) were obese, and 58 (38.7%) were overweight. In addition to lower HDL-C and eGFR values (p < 0.05), higher TyG index quartiles were linked to significantly higher fasting plasma glucose, HbA1c, triglycerides, total cholesterol, LDL-C, HOMA-IR, and UACR. The TyG index showed a negative connection with eGFR (r = –0.34, p = 0.01) and a high positive correlation with HbA1c (r = 0.72, p < 0.001), HOMA-IR (r = 0.46, p < 0.001), and UACR (r = 0.29, p = 0.04). In contrast to the TyG index, HOMAIR shown a lesser connection with UACR.

Conclusion: The TyG index showed a strong association with insulin resistance and demonstrated superior predictive ability for diabetic nephropathy compared to HOMA-IR in patients with T2DM. It may serve as a practical and cost-effective marker for early risk assessment of diabetic kidney disease.