Elevated TyG Index tied to Diabetic Retinopathy Risk especially in Poor Glycemic Control: Study
Researchers have found in a new study that elevated triglyceride-glucose (TyG) index, a marker of insulin resistance, was strongly related to diabetic retinopathy (DR) risk in type 2 diabetes mellitus (T2DM) patients. A recent study was conducted by Xiaohua Wan and fellow researchers published in the journal Diabetes, Metabolic Syndrome and Obesity. The findings indicated that a high TyG index and risk of DR were highest among patients with poor glycemic control (HbA1c > 9%), emphasizing the need to use the TyG index as a risk stratification tool in the management of T2DM.
Diabetic retinopathy is a microvascular DM complication and an important cause of acquired blindness among the working-aged population. Insulin resistance (IR) or diminished cellular sensitivity to insulin is the core mechanism for developing T2DM and vascular complications associated with it. Glycated hemoglobin A1c (HbA1c) is universally accepted as a reliable marker for the assessment of long-term glycemic control, and has been invariably proven to be related to the development of both microvascular and macrovascular complications of DM
This retrospective analysis divided patients into four quartiles (Q1-Q4) according to their TyG index. Glycemic control was also evaluated based on HbA1c levels, with patients divided into three groups: < 7%, 7–9%, and > 9%. Statistical analyses such as restricted cubic spline (RCS) modeling, logistic regression, and subgroup analyses were conducted to investigate the correlation between the TyG index, glycemic control, and risk of DR.
Key Findings
• Patients in Q4 were at significantly higher risk of DR than those in Q1 (Odds Ratio [OR]: 1.289; 95% Confidence Interval [CI]: 1.008–1.648, p< 0.05).
• There was a significant interaction between the TyG index and glycemic control status (p< 0.05).
• The highest correlation between high TyG index and risk of DR was observed in patients with poor glycemic control (HbA1c > 9%).
The current research highlights the strong correlation of elevated TyG index with heightened DR risk, particularly the peak risk among the patient population whose HbA1c concentration exceeded 9%. These data propose that an awareness of TyG index surveillance can further streamline risk stratification and contribute toward refining glycemic control in the management of patients with T2DM. However, additional work would be desirable to understand mechanisms involved and assess use of TyG index for routine clinical use.
Reference:
Wan, X., Zhang, R., Abudukeranmu, A., Wei, W., Zhu, H., Zhang, L., & Hu, Y. (2025). Elevated triglyceride-glucose index as a risk stratification marker for diabetic retinopathy in type 2 diabetes mellitus: The influence of glycemic control. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 18, 743–759. https://doi.org/10.2147/dmso.s503672
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