Evaluation of the TyG, LAP, and VAI Indices as Markers of Glycemic Status in Patients with Atherosclerosis

Öz

Objective: This study aims to investigate the relationship between triglyceride-based indices (lipid accumulation product (LAP), triglyceride-glucose (TyG) index, and visceral adiposity index (VAI)) and glycated hemoglobin A (HbA1c) levels in atherosclerosis patients. Materials and Methods: The retrospective cross-sectional analysis was performed using recorded demographic, anthropometric, and laboratory data of 113 patients diagnosed with atherosclerosis. The TyG, LAP, and VAI indices were computed using standard formulas derived from available anthropometric and biochemical measurements. Participants were classified considering HbA1c levels as normoglycemic (<5.7%), prediabetic (5.7-6.4%), or diabetic (≥6.5%). Correlation analyses, group comparisons (ANOVA or Kruskal-Wallis tests), and multivariable logistic regression models adjusted for body mass index (BMI), waist-to-height ratio (WHtR), high-density lipoprotein cholesterol (HDL-C), sex, and age were applied. Results: HbA1c levels showed significant positive correlations with TyG (r = 0.32, p = 0.009), LAP (r = 0.47, p < 0.001), and VAI (r = 0.36, p = 0.004). All indices increased significantly across HbA1c categories (p < 0.001). In multivariable analysis, only the TyG index remained independently related with elevated HbA1c levels (OR = 21.57, 95% CI: 6.53-71.24, p < 0.001). Receiver operating characteristic (ROC) analysis yielded good discriminatory performance for the TyG index (AUC = 0.83), and the optimal cut-off value was 9.0. Conclusion: Among triglyceride-based metabolic indices, the TyG index demonstrated the strongest independent relationship with elevated HbA1c levels, highlighting its potential clinical utility as a simple marker of glycemic dysregulation in patients with atherosclerosis.

Anahtar Kelimeler

• Atherosclerosis
• glycated hemoglobin A
• lipid accumulation product
• triglyceride-glucose index
• visceral adiposity index

Destekleyen Kurum

None

Etik Beyan

This study was approved by the Ethics Committee of Tokat Gaziosmanpasa University (Date: 01/18/2024, decision no: 83116987-446). All procedures were conducted in line with international ethical standards and the principles outlined in the Declaration of Helsinki.

Teşekkür

None

Aterosklerozlu Hastalarda Glisemik Durumun Belirteçleri Olarak TyG, LAP ve VAI İndekslerinin Değerlendirilmesi

Öz

Amaç: Bu çalışma, ateroskleroz hastalarında trigliserid-glikoz (TyG) indeksi, lipit birikim ürünü (LAP) ve viseral adipozite indeksi (VAI) dahil olmak üzere trigliserid bazlı indeksler ile glikozillenmiş hemoglobin A (HbA1c) düzeyleri arasındaki bağımsız ilişkileri incelemek amacıyla yapılmıştır. Materyal ve Metot: Bu retrospektif kesitsel analiz, ateroskleroz hastalarının kaydedilmiş demografik, antropometrik ve laboratuvar verileri kullanılarak 113 hasta üzerinde gerçekleştirilmiştir. TyG, LAP ve VAI indeksleri, mevcut antropometrik ve biyokimyasal ölçümlerden standart formüller kullanılarak hesaplanmıştır. Katılımcılar HbA1c düzeylerine göre normal (<%5,7), prediyabet (%5,7-6,4) ve diyabet (%≥6,5) olarak sınıflandırıldı. Korelasyon analizleri, grup karşılaştırmaları (ANOVA veya Kruskal-Wallis) ve vücut kitle indeksi (VKI), bel-boy oranı (WHtR), yüksek yoğunluklu lipoprotein kolesterol (HDL-C), yaş ve cinsiyete göre ayarlanmış çok değişkenli lojistik regresyon modelleri uygulandı. Bulgular: HbA1c düzeyleri, TyG (r = 0,32, p = 0,009), LAP (r = 0,47, p < 0,001) ve VAI (r = 0,36, p = 0,004) ile anlamlı pozitif korelasyon gösterdi. Tüm indeksler HbA1c kategorileri arasında anlamlı şekilde artış gösterdi (p < 0,001). Çok değişkenli analizde yalnızca TyG indeksinin yüksek HbA1c düzeyleri ile bağımsız olarak ilişkili olduğu saptandı (OR = 21,57, %95 GA: 6,53–71,24, p < 0,001). Alıcı işletim karakteristiği (ROC) analizi, TyG indeksinin iyi ayırt edici performansa sahip olduğunu gösterdi (EAA = 0,83) ve optimal kesim değeri 9,0 olarak belirlendi. Sonuç: Trigliserid bazlı metabolik indeksler arasında, TyG indeksi yüksek HbA1c ile en güçlü bağımsız ilişkiyi gösterdi, bu da aterosklerozlu hastalarda glisemik dengesizliğin basit bir belirteci olarak klinik yararını ortaya koydu.

Anahtar Kelimeler

• Ateroskleroz
• glikozillenmiş hemoglobin A
• lipid birikim ürünü
• trigliserit-glukoz indeksi
• visseral adipozite indeks

Destekleyen Kurum

Yoktur

Etik Beyan

Bu çalışma, Tokat Gaziosmanpasa Üniversitesi Etik Komitesi tarafından onaylandı (Tarih: 18.01.2024, karar no: 83116987-446). Tüm prosedürler, uluslararası etik standartlara ve Helsinki Bildirgesi'nde belirtilen ilkelere uygun şekilde yürütülmüştür.

Teşekkür

Yoktur

Kaynakça

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