Association between triglyceride glucose-body mass index and incident diabetes mellitus in Chinese population: a secondary retrospective analysis

Author(s): Fan Yang, Xiaohan Ding, Peisheng Chen, Zhuangsen Chen, Yan Liao, Ziqi Luo, Miaoling Chen, Weili Yao, Qian Liang, Haofei Hu, Xinyu Wang

Background: TyG-BMI is one of the insulin resistance markers. However, few studies have investigated the relationship between TyG-BMI and diabetes. The aim of this study is to investigate the relationship between TyG-BMI and diabetes occurrence in Chinese individuals.

Methods: This retrospective study is a population-based cohort of 204978 non-diabetic individuals using healthy screening program data in China between 2010 and 2016. Cox proportional hazards regression analysis evaluated the Hazard Ratio (HR) and 95% Confidence Interval (95% CI) of the relationship between TyG-BMI and diabetes events. Then the association between TyG-BMI and incident diabetes was further explored by generalized additive models and subgroup analyses.

Results: Our study indicated that a increase in diabetes incidence occurred with the rise of TyG-BMI (HR=1.023, 95% CI (1.022, 1.024) after the adjustment of potential confounders. TyG- BMI has a non-linear relationship with the incidence of diabetes, and the inflection point is 232.416. Subgroup analysis showed that the correlation was stronger in the population aged 20-30 (P for interaction<0.0001, HR 1.029, 95%CI:1.024 to 1.035), and the same trend was found in the following populations: age 30-40(HR=1.032), age 40-50(HR=1.029), HDL (high group) (HR=1.024 ), SBP<140(HR=1.025), DBP<90(HR=1.024), current drinker(HR=1.031), and ever drinker(HR=1.032).

Conclusion: TyG-BMI and incident diabetes had a non-linear positive relationship. Before and after TyG-BMI equals 232.416, the risk of diabetes increased by 2.9% and 1.6%, respectively, when TyG-BMI increased one unit. The findings emphasise the importance of baseline TyG-BMI as a measure for identification of patients at risk of diabetes early and improve their outcomes.