Insulin resistance and central obesity contribute to vascular complications in type 2 diabetes mellitus (T2DM), although the clinical utility of triglyceride-glucose (TyG)-related obesity indices for peripheral artery disease (PAD) remains uncertain. A cross-sectional study published in Diabetes, Metabolic Syndrome and Obesity evaluated associations between TyG-related indices and lower extremity PAD in adults with T2DM.
The single-center retrospective study included 2,224 adults with T2DM treated at a university-affiliated hospital between August 2020 and December 2024. PAD was defined using ankle-brachial index criteria, postexercise ankle-brachial index decline, or imaging-confirmed lower extremity arterial stenosis or thrombosis. Multivariable logistic regression, subgroup analyses, and receiver operating characteristic analyses were performed to assess associations and discriminative performance.
Findings
- The TyG index and central obesity derivatives including TyG-waist-to-height ratio (TyG-WHtR), TyG-waist-to-hip ratio (TyG-WHR), and TyG-waist circumference (TyG-WC) demonstrated significant positive relationships with PAD after multivariable adjustment (all P < 0.05).
- TyG-body mass index (TyG-BMI) lost statistical significance after adjustment, although subgroup analyses identified persistent significance among patients with well-controlled glycemia.
- Participants in the highest quartiles of significant TyG indices demonstrated 1.787-fold to 2.128-fold higher odds of PAD than those in the lowest quartiles.
- Subgroup analyses identified stronger associations among women and non-smokers.
- Receiver operating characteristic analyses showed that TyG-WHtR demonstrated the highest discriminative ability among evaluated indices with an area under the curve of 0.622.
The findings demonstrated independent relationships between TyG-related central obesity indices and PAD in adults with T2DM, while TyG-BMI showed weaker overall relevance. TyG-WHtR demonstrated relatively stronger discriminative performance, although its overall screening accuracy remained limited.
