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Investigation of the effect of SGLT-2 inhibitors on the triglyceride/glucose index in diabetic patients: a cross-sectional study

Year 2025, EARLY ONLINE, 1 - 7
https://doi.org/10.18621/eurj.1561505

Abstract

Objectives: The aim of this study is to estimate the change in the Triglyceride Glucose Index (TyG index), in patients with type 2 Diabetes Mellitus who are using a sodium-glucose cotransporter-2 (SGLT2) inhibitor, and to evaluate the effect of these drugs on triglyceride glucose index.

Methods: This is a cross-sectional study of 55 diabetic patients in our internal medicine clinic in Turkey. Triglyceride, glucose, and glycosylated hemoglobin (HbA1c) values were measured at the beginning of the treatment and the 3rd-month follow-up. The TyG index of the patients before starting SGLT-2 inhibitor treatment and at the end of 3 months of treatment was calculated by the researchers using the data in the hospital digital records.

Results: The mean age of 55 patients (56.4% male) was 62.7±10.2 years. The number of patients using dapagliflozin 10 mg was 15 (27.3%) and the number of patients using empagliflozin was 41 (72.8%). It was determined that fasting plasma glucose, TyG index, and HbA1c values before starting SGLT-2 inhibitor treatment and in the 3rd month of treatment decreased significantly (P<0.001, P=0.002 and P<0.001, respectively). According to the correlation analysis results between TyG index and HbA1c, it was determined that the values both before treatment and in the 3rd month of treatment showed a correlation (r=0.516, P<0.001 and r=0.448, P=0.001, respectively).

Conclusions: SGLT-2 inhibitor usage significantly reduces TyG index in diabetic patients, and new studies are needed to investigate the effect of these drugs on triglyceride index among pre-diabetic patients.

Ethical Statement

The study adhered to the Declaration of Helsinki and was approved by the Samsun University Clinical Research Ethics Committee (Decision no: SUKAEK-2023 7/20 and date: 12.04.2023).

References

  • 1. Simental-Mendía LE, Rodríguez-Morán M, Guerrero-Romero F. The product of fasting glucose and triglycerides as surrogate for identifying insulin resistance in apparently healthy subjects. Metab Syndr Relat Disord. 2008;6(4):299-304. doi: 10.1089/met.2008.0034.
  • 2. Guerrero-Romero F, Simental-Mendía LE, González-Ortiz M, et al. The product of triglycerides and glucose, a simple measure of insulin sensitivity. Comparison with the euglycemic-hyperinsulinemic clamp. J Clin Endocrinol Metab. 2010;95(7):3347-3351. doi: 10.1210/jc.2010-0288.
  • 3. Son DH, Lee HS, Lee YJ, Lee JH, Han JH. Comparison of triglyceride-glucose index and HOMA-IR for predicting prevalence and incidence of metabolic syndrome. Nutr Metab Cardiovasc Dis. 2022;32(3):596-604. doi: 10.1016/j.numecd.2021.11.017.
  • 4. Li X, Chan JSK, Guan B, et al. Triglyceride-glucose index and the risk of heart failure: Evidence from two large cohorts and a mendelian randomization analysis. Cardiovasc Diabetol. 2022;21(1):229. doi:10.1186/s12933-022-01658-7.
  • 5. Wang X, Xu W, Song Q, et al. Association between the triglyceride-glucose index and severity of coronary artery disease. Cardiovasc Diabetol. 2022;21(1):168. doi:10.1186/s12933-022-01606-5.
  • 6. Chen S, Mei Q, Guo L, et al. Association between triglyceride-glucose index and atrial fibrillation: A retrospective observational study. Front Endocrinol (Lausanne). 2022;13:1047927. doi: 10.3389/fendo.2022.1047927.
  • 7. Lee EY, Yang HK, Lee J, et al. Triglyceride glucose index, a marker of insulin resistance, is associated with coronary artery stenosis in asymptomatic subjects with type 2 diabetes. Lipids Health Dis. 2016;15(1):155. doi: 10.1186/s12944-016-0324-2
  • 8. Sánchez-Íñigo L, Navarro-González D, Fernández-Montero A, Pastrana-Delgado J, Martínez JA. The TyG index may predict the development of cardiovascular events. Eur J Clin Invest. 2016;46(2):189-197. doi: 10.1111/eci.12583.
  • 9. Zinman B, Wanner C, Lachin JM, et al. Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes. N Engl J Med. 2015;373(22):2117-2128. doi: 10.1056/NEJMoa1504720.
  • 10. Fitchett D, Inzucchi SE, Cannon CP, et al. Empagliflozin Reduced Mortality and Hospitalization for Heart Failure Across the Spectrum of Cardiovascular Risk in the EMPA-REG OUTCOME Trial. Circulation. 2019;139(11):1384-1395. doi: 10.1161/CIRCULATIONAHA.118.037778.
  • 11. Wanner C, Inzucchi SE, Lachin JM, et al. Empagliflozin and Progression of Kidney Disease in Type 2 Diabetes. N Engl J Med. 2016;375(4):323-334. doi: 10.1056/NEJMoa1515920 12.
  • 12. Mosenzon O, Wiviott SD, Cahn A, et al. Effects of dapagliflozin on development and progression of kidney disease in patients with type 2 diabetes: an analysis from the DECLARE-TIMI 58 randomised trial. Lancet Diabetes Endocrinol. 2019;7(8):606-617. doi: 10.1016/S2213-8587(19)30180-9.
  • 13. Preda A, Montecucco F, Carbone F, et al. SGLT2 inhibitors: from glucose-lowering to cardiovascular benefits. Cardiovasc Res. 2024;120(5):443-460. doi: 10.1093/cvr/cvae047.
  • 14. Wang A, Tian X, Zuo Y, et al. Change in triglyceride-glucose index predicts the risk of cardiovascular disease in the general population: a prospective cohort study. Cardiovasc Diabetol. 2021;20(1):113. doi: 10.1186/s12933-021-01305-7.
  • 15. Miao M, Zhou G, Bao A, et al. Triglyceride-glucose index and common carotid artery intima-media thickness in patients with ischemic stroke. Cardiovasc Diabetol. 2022;21(1):43. doi: 10.1186/s12933-022-01472-1.
  • 16. Xu L, Wu M, Chen S, et al. Triglyceride-glucose index associates with incident heart failure: A cohort study. Diabetes Metab. 2022;48(6):101365. doi: 10.1016/j.diabet.2022.101365.
  • 17. Wu Z, Liu L, Wang W, et al. Triglyceride-glucose index in the prediction of adverse cardiovascular events in patients with premature coronary artery disease: a retrospective cohort study. Cardiovasc Diabetol. 2022;21(1):142. doi: 10.1186/s12933-02201576-8.
  • 18. Yan F, Yan S, Wang J, et al. Association between triglyceride glucose index and risk of cerebrovascular disease: systematic review and meta-analysis. Cardiovasc Diabetol. 2022;21(1):226. doi: 10.1186/s12933-022-01664-9.
  • 19. Bilgin S, Kurtkulagi O, Duman TT, et al. Sodium glucose co-transporter-2 inhibitor, Empagliflozin, is associated with significant reduction in weight, body mass index, fasting glucose, and A1c levels in Type 2 diabetic patients with established coronary heart disease: the SUPER GATE study. Ir J Med Sci. 2022;191(4):1647-1652. doi: 10.1007/s11845-021-02761-6.
  • 20. Şahin S, Haliloğlu Ö, Polat Korkmaz Ö, et al. Does treatment with sodium-glucose cotransporter-2 inhibitors have an effect on sleep quality, quality of life, and anxiety levels in people with Type 2 diabetes mellitus?. Turk J Med Sci. 2020;51(2):735-742. doi: 10.3906/sag-2008-37.
Year 2025, EARLY ONLINE, 1 - 7
https://doi.org/10.18621/eurj.1561505

Abstract

References

  • 1. Simental-Mendía LE, Rodríguez-Morán M, Guerrero-Romero F. The product of fasting glucose and triglycerides as surrogate for identifying insulin resistance in apparently healthy subjects. Metab Syndr Relat Disord. 2008;6(4):299-304. doi: 10.1089/met.2008.0034.
  • 2. Guerrero-Romero F, Simental-Mendía LE, González-Ortiz M, et al. The product of triglycerides and glucose, a simple measure of insulin sensitivity. Comparison with the euglycemic-hyperinsulinemic clamp. J Clin Endocrinol Metab. 2010;95(7):3347-3351. doi: 10.1210/jc.2010-0288.
  • 3. Son DH, Lee HS, Lee YJ, Lee JH, Han JH. Comparison of triglyceride-glucose index and HOMA-IR for predicting prevalence and incidence of metabolic syndrome. Nutr Metab Cardiovasc Dis. 2022;32(3):596-604. doi: 10.1016/j.numecd.2021.11.017.
  • 4. Li X, Chan JSK, Guan B, et al. Triglyceride-glucose index and the risk of heart failure: Evidence from two large cohorts and a mendelian randomization analysis. Cardiovasc Diabetol. 2022;21(1):229. doi:10.1186/s12933-022-01658-7.
  • 5. Wang X, Xu W, Song Q, et al. Association between the triglyceride-glucose index and severity of coronary artery disease. Cardiovasc Diabetol. 2022;21(1):168. doi:10.1186/s12933-022-01606-5.
  • 6. Chen S, Mei Q, Guo L, et al. Association between triglyceride-glucose index and atrial fibrillation: A retrospective observational study. Front Endocrinol (Lausanne). 2022;13:1047927. doi: 10.3389/fendo.2022.1047927.
  • 7. Lee EY, Yang HK, Lee J, et al. Triglyceride glucose index, a marker of insulin resistance, is associated with coronary artery stenosis in asymptomatic subjects with type 2 diabetes. Lipids Health Dis. 2016;15(1):155. doi: 10.1186/s12944-016-0324-2
  • 8. Sánchez-Íñigo L, Navarro-González D, Fernández-Montero A, Pastrana-Delgado J, Martínez JA. The TyG index may predict the development of cardiovascular events. Eur J Clin Invest. 2016;46(2):189-197. doi: 10.1111/eci.12583.
  • 9. Zinman B, Wanner C, Lachin JM, et al. Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes. N Engl J Med. 2015;373(22):2117-2128. doi: 10.1056/NEJMoa1504720.
  • 10. Fitchett D, Inzucchi SE, Cannon CP, et al. Empagliflozin Reduced Mortality and Hospitalization for Heart Failure Across the Spectrum of Cardiovascular Risk in the EMPA-REG OUTCOME Trial. Circulation. 2019;139(11):1384-1395. doi: 10.1161/CIRCULATIONAHA.118.037778.
  • 11. Wanner C, Inzucchi SE, Lachin JM, et al. Empagliflozin and Progression of Kidney Disease in Type 2 Diabetes. N Engl J Med. 2016;375(4):323-334. doi: 10.1056/NEJMoa1515920 12.
  • 12. Mosenzon O, Wiviott SD, Cahn A, et al. Effects of dapagliflozin on development and progression of kidney disease in patients with type 2 diabetes: an analysis from the DECLARE-TIMI 58 randomised trial. Lancet Diabetes Endocrinol. 2019;7(8):606-617. doi: 10.1016/S2213-8587(19)30180-9.
  • 13. Preda A, Montecucco F, Carbone F, et al. SGLT2 inhibitors: from glucose-lowering to cardiovascular benefits. Cardiovasc Res. 2024;120(5):443-460. doi: 10.1093/cvr/cvae047.
  • 14. Wang A, Tian X, Zuo Y, et al. Change in triglyceride-glucose index predicts the risk of cardiovascular disease in the general population: a prospective cohort study. Cardiovasc Diabetol. 2021;20(1):113. doi: 10.1186/s12933-021-01305-7.
  • 15. Miao M, Zhou G, Bao A, et al. Triglyceride-glucose index and common carotid artery intima-media thickness in patients with ischemic stroke. Cardiovasc Diabetol. 2022;21(1):43. doi: 10.1186/s12933-022-01472-1.
  • 16. Xu L, Wu M, Chen S, et al. Triglyceride-glucose index associates with incident heart failure: A cohort study. Diabetes Metab. 2022;48(6):101365. doi: 10.1016/j.diabet.2022.101365.
  • 17. Wu Z, Liu L, Wang W, et al. Triglyceride-glucose index in the prediction of adverse cardiovascular events in patients with premature coronary artery disease: a retrospective cohort study. Cardiovasc Diabetol. 2022;21(1):142. doi: 10.1186/s12933-02201576-8.
  • 18. Yan F, Yan S, Wang J, et al. Association between triglyceride glucose index and risk of cerebrovascular disease: systematic review and meta-analysis. Cardiovasc Diabetol. 2022;21(1):226. doi: 10.1186/s12933-022-01664-9.
  • 19. Bilgin S, Kurtkulagi O, Duman TT, et al. Sodium glucose co-transporter-2 inhibitor, Empagliflozin, is associated with significant reduction in weight, body mass index, fasting glucose, and A1c levels in Type 2 diabetic patients with established coronary heart disease: the SUPER GATE study. Ir J Med Sci. 2022;191(4):1647-1652. doi: 10.1007/s11845-021-02761-6.
  • 20. Şahin S, Haliloğlu Ö, Polat Korkmaz Ö, et al. Does treatment with sodium-glucose cotransporter-2 inhibitors have an effect on sleep quality, quality of life, and anxiety levels in people with Type 2 diabetes mellitus?. Turk J Med Sci. 2020;51(2):735-742. doi: 10.3906/sag-2008-37.
There are 20 citations in total.

Details

Primary Language English
Subjects ​Internal Diseases
Journal Section Original Articles
Authors

Düriye Sıla Karagöz Özen 0000-0001-7852-2114

Abdulcelil Kayabaş 0000-0001-7387-9173

Rana İlhan Van 0009-0006-3545-7205

Mehmet Derya Demirağ 0000-0001-5667-1805

Early Pub Date February 14, 2025
Publication Date
Submission Date October 4, 2024
Acceptance Date January 13, 2025
Published in Issue Year 2025 EARLY ONLINE

Cite

AMA Karagöz Özen DS, Kayabaş A, İlhan Van R, Demirağ MD. Investigation of the effect of SGLT-2 inhibitors on the triglyceride/glucose index in diabetic patients: a cross-sectional study. Eur Res J. Published online February 1, 2025:1-7. doi:10.18621/eurj.1561505

e-ISSN: 2149-3189 


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