The changes of triglyceride-glucose index in elderly patients with Type 2 diabetes mellitus complicated with cerebral small vessel disease and its clinical significance
Zhao Lei
Xuan Qi
Yang Wei
Ren Yi
Sun Lina
Abstract：Objective To explore the changes of triglyceride-glucose(TyG)index and its clinical significance in eld-erly patients with type 2 diabetes mellitus(T2DM)complicated with cerebral small vessel disease(CSVD).Methods A total of 317 elderly T2DM patients admitted to Xuanwu Hospital Capital Medical University from January 2021 to October 2023 were enrolled.Patients were divided into CSVD group(n=149)and non-CSVD group(n=168)based on CSVD comorbidity.The CSVD group was further stratified into mild(n=72),moderate(n=50),and severe(n=27)subgroups according to disease severity.Spearman's correlation analysis was used to analyze the relationship between TyG index and disease severity.Multivariate logistic regression analysis was conducted to identify influencing factors for CSVD in elderly T2DM patients.Receiver operating characteristic(ROC)curve analysis was performed to evaluate the predictive value of TyG index for CSVD in elderly T2DM patients.Results The TyG index in the CSVD group was significantly higher than that in the non-CSVD group(t/P=16.531/＜0.001).Among CSVD patients,the TyG index showed a severity-dependent increase:se-vere subgroup＞moderate subgroup＞mild subgroup(F/P=22.610/＜0.001).Spearman's correlation analysis revealed signifi-cant positive correlations between TyG index and CSVD severity,Fazekas score,cerebral microbleeds grade,number of lacu-nar infarcts,and basal ganglia perivascular space grade(r/P=0.723/＜0.001,0.685/＜0.001,0.652/＜0.001,0.701/＜0.001,0.668/＜0.001).Multivariate logistic regression identified long T2DM duration,high FPG,high HbA1c,high SCr,high UA,high BUN,high Cys-C,high UACR,and high TyG index as independent risk factors for CSVD[OR(95％CI)=1.526(1.298-1.795),1.265(1.118-1.433),1.366(1.187-1.569),1.035(1.019-1.051),1.108(1.010-1.027),1.412(1.191-1.669),2.776(2.013-3.817),1.028(1.017-1.039),1.722(1.375-2.156)],while high eGFR was a protective factor[OR(95％CI)=0.969(0.958-0.980)].ROC curve analysis showed that the AUC of TyG index for predicting CSVD was 0.838,with sensitivity of 0.685,specificity of 0.929,maximum Youden index of 0.614,optimal cutoff value of 8.245,and 95％CI of 0.790-0.886.Conclusion The TyG index is closely associated with the occurrence and severity of CSVD in elderly T2DM patients and may serve as a potential predictive indicator.Long-term abnormalities in glucose,lipid,and renal function are important risk factors for CSVD.
Keywords：Type 2 diabetes mellitusCerebral small vessel diseaseTriglyceride-glucose indexElderly
Publication Date：2025-10-18
Online Publishing Date：2025-11-10(First online date of this platform, not the publication date of the document)
Pages：5( 1210-1214 )