TRIGLYCERIDE-GLUCOSE INDEX: A REPLACEMENT MEASURE OF HOMEOSTASIS TO ASSESS INSULIN ESISTANCE AND FORECAST OF DIABETIC NEPHROPATHY

Main Article Content

Muhammad Sohail Baig
Ravi Kumar
Sarfaraz Ahmed
Mahesh Kumar
Nasira Sohail
Saima Rafique

Keywords

Diabetic nephropathy, Homeostasis model assessment, Triglyceride-glucose index

Abstract

BACKGROUND: The World Health Organization estimates that diabetes killed almost 1.5 million people in 2019.  Diabetic nephropathy (DN) is the most common underlying cause of end-stage renal disease in people with diabetes. About 40% of people on Earth have DN. Albuminuria or a decrease in glomerular filtration rate (GFR) indicate chronic renal impairment, which accounts for 31% of all cases of diabetic kidney disease (DN) in Pakistan.


OBJECTIVE: In order to predict diabetic nephropathy, the current study sought to determine whether the TyG index is related to UACR or HOMA-IR in people with type 2 diabetes.


STUDY DESIGN: A cross-sectional study


PLACE AND DURATION: This study was conducted in Liaquat University of Medical and Health Sciences Jamshoro from January 2023 to January 2024


METHODOLOGY: The sample size was calculated using the formula Z2 (pq)/e2, with Z=1.96, p=prevalence of T2DM in Pakistan 17.1%, Using a non-probability sequential selection approach, a sample of patients visiting the diabetic clinic was selected. Included were known T2DM patients who had been diagnosed for one to five years and had a fasting plasma glucose (FPG) of 126 mg/dl or above. Venous blood samples (5 ml) were taken using special tubes for different parameters after a 10- to 12-hour overnight fast, and they were then refrigerated at -20°C. For HOMA-IR evaluation, the concentrations of insulin and FPG were measured. A spot urine sample was collected in order to calculate the ACR.


 


RESULTS: Among the 180 patients, 48.7±7.56 years was the average age. The average BMI for everyone was 28.63±4.56. When comparing Q4 to the other quartiles, there was a substantial increase in fasting plasma glucose, triglycerides, total cholesterol, low-density lipoprotein (LDL) cholesterol, and HOMA-IR (p<0.05

CONCLUSION: In T2DM patients, the TyG index outperformed HOMA-IR in predicting DN, exhibiting a substantial correlation with the latter. In T2DM patients, it accurately predicted the probability of micro-albuminuria and diabetic nephropathy at an early stage.

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