Association of Triglyceride-Glucose Index with the Incidence of Ketoacidosis in Chinese Children with Type 1 Diabetes

Abstract

Objective: The relationship between triglyceride-glucose index (TyG index) and the prevalence of type 2 diabetes mellitus (T2DM) has been confirmed by former studies. However, it remains uncertain whether TyG index has a predictive value in T1DM patients with diabetic ketoacidosis (DKA).Methods: The study retrospectively enrolled 143 patients ((boys/girls = 60/83) with T1DM in the Endocrine inpatient wards of Tianjin Children’s Hospital from June 2017 to May 2019.TyG index was calculated as follows: ln[fasting triglycerides (mg/dL)×fasting plasma glucose (mg/dL)/2]. These patients stratifed by the optimal cut-off point of TyG index were divided into the lower TyG index group (n=73) and higher TyG index group (n=70).Results: TyG index and related lipid parameters were significantly higher in patients with DKA compared with those without. Compared with patients in lower TyG index group, those with higher TyG index seemed to be younger. Multiple linear regression analysis showed that increase of TC (95%CI: 0.018~0.568, p=0.037) level and decrease of T3(95%CI:-2.314~-0.668,p=0.001) level were associated with the risk of higher TyG index. A linear equation was obtained between TC, T3 and TyG index (TyG index=10.226+0.299*TC-1.384*T3, R2=0.481). Conclusions: Increased TyG index is a significant predictor of DKA in children with T1DM. Higher TC and lower T3 levels were associated with higher TyG index. Further studies need to be conducted to determine whether interventions for TyG index have a positive impact on improving clinical prognosis.