ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Clinical Diabetes
This article is part of the Research TopicAddressing insulin resistance and hyperinsulinemia for cardiovascular disease preventionView all 16 articles
Association between the triglyceride-glucose index and carotid plaque progression in patients with type 2 diabetes mellitus: a retrospective cohort study
Provisionally accepted
Zhangxiang Zhu1,2
Xuan Xu3Guojuan Wang2Qianqian Zhang2
Ying Li2Ying Li4
Li Chen2Qibao Ye2
Mingwei Chen1*- 1The First Affiliated Hospital of Anhui Medical University, Hefei, China
- 2The first people's Hospital of Hefei, Hefei, China
- 3Hefei Eighth People's Hospital, Hefei, China
- 4Wannan Medical College, Wuhu, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Background: The triglyceride-glucose (TyG) index is a novel marker of insulin resistance associated with carotid vascular disease, but its role in type 2 diabetes Mellitus(T2DM) remains unclear.Methods: This retrospective study enrolled patients with T2DM who underwent repeated hospitalization in our hospital between 2014-2024. Participants were stratified into tertiles based on TyG index values. Multivariable regression analyses were subsequently performed to assess the association between TyG index levels and carotid plaque progression.Results:A total of 548 patients with T2DM(55.93±12.26years,60.4% males)were enrolled in this study, with a median follow-up time of 4 (2-7) years. The prevalence of carotid plaque progression increased stepwise with the increasing tertile of the TyG index (45.9% vs. 62.6% vs. 57.4%; p=0.004), and the growth rates of bilateral plaque length and width also increased (all p < 0.05).The positive association between the TyG index and the growth rates of left carotid plaque length, left width, and right width was also determined in the fully adjusted model(TyG,per 1-unit increase:0.197 mm vs.0.196 mm vs.0.189 mm;tertile of TyG:0.156 mm vs.0.162 mm vs.0.164 mm,all p < 0.05) .In addition,After multivariable adjustment, Cox regression models showed that higher TyG index levels were associated with 1.261-fold, 1.244-fold, and 1.378-fold increased risks of carotid plaque progression in T2DM patients, respectively ( all p<0.05).ROC curve analysis indicated that the TyG index exhibits modest predictive value for carotid plaque progression in T2DM patients, with an AUC of 0.556 (p=0.024) . Adding the TyG index to the predictive model for carotid plaque progression in patients with T2DM could contribute to an increase in C-statistics (0.624 vs 0.649, p<0.001), NRI:0.211(p = 0.015), and IDI:0.020 (p < 0.001).Conclusion:In patients with T2DM, a higher TyG index is an independent risk factor for carotid plaque progression.
Keywords: T2DM, carotid plaque, TyG, Insulin Resistance, hyperinsulinemia
Received: 19 Sep 2025; Accepted: 05 Nov 2025.
Copyright: © 2025 Zhu, Xu, Wang, Zhang, Li, Li, Chen, Ye and Chen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Mingwei Chen, chmw1@163.com
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.