The Predictive Value of Insulin Resistance Surrogates for Diabetic Kidney Disease in Type 2 Diabetes Mellitus.

Background: Insulin resistance (IR) is a major feature of type 2 diabetes mellitus (T2DM) and plays a crucial role in the accelerated progression of diabetic kidney disease (DKD). It has been found that surrogates of IR are of high value in assessing IR status. This study aims to evaluate the associations between surrogates of IR and DKD in T2DM.

Methods: A total of 1026 patients with T2DM from January 2021 to February 2022 were selected in our final analysis. Logistic regression analysis and the receiver operating characteristic (ROC) curve analysis were performed to assess the correlation between IR surrogates and DKD.

Results: The levels of triglyceride glucose-waist circumference (TyG-WC), triglyceride glucose-waist to height ratio (TyG-WHtR), visceral adiposity index (VAI), and lipid accumulation product (LAP) were significantly higher in the microalbuminuria group and macroalbuminuria group compared with the normoalbuminuria group (P < 0.05). The results of multivariate logistic regression analysis showed that the highest quartile of triglyceride/high-density lipoprotein cholesterol ratio (TG/HDL-C), triglyceride glucose (TyG) index, TyG-WHtR, TyG-WC, LAP, and VAI were significantly correlated with DKD (all P < 0.05). The ROC curves and results showed that TyG area under the curve (AUC) > VAI AUC > TG/HDL-C AUC > TyG-WHtR AUC > LAP AUC > 0.7 > TyG-WC AUC > metabolic index of insulin resistance (METS-IR) AUC > 0.6 > triglyceride glucose-body mass index (TyG-BMI) AUC > 0.5.

Conclusions: The predictive value of IR surrogates for DKD in T2DM varies. TG/HDL-C, TyG, TyG-WHtR, LAP, and VAI can effectively predict DKD and are expected to be simple and economic biological indicators of DKD risk.