Association of Triglyceride–Glucose Index with Heart Failure with Preserved Ejection Fraction and Diastolic Dysfunction in Patients with Type 2 Diabetes Mellitus: A Cross-Sectional Study
Abstract
Background: Heart failure with preserved ejection fraction (HFpEF) is increasingly recognized as a major cardiovascularcomplication in patients with type 2 diabetes mellitus (T2DM). Insulin resistance plays a central role in the pathogenesis ofHFpEF, and the triglyceride–glucose (TyG) index has emerged as a simple surrogate marker of insulin resistance. This studyaimed to evaluate the association between the TyG index, HFpEF, and diastolic dysfunction among patients with T2DM.Methods: This hospital-based cross-sectional study included 65 patients with T2DM aged between 18 and 70 years withoutknown hypertension or overt cardiovascular disease. Clinical, anthropometric, biochemical, and echocardiographic parameterswere assessed. The TyG index was calculated using fasting triglyceride and fasting blood glucose levels. HFpEF was evaluatedusing the HFA-PEFF scoring system and echocardiographic parameters of diastolic dysfunction. Statistical analysis wasperformed using SPSS version 26.Results: The mean age of participants was 52.74 ± 8.69 years, and 18.5% had an HFA-PEFF score ≥5 suggestive of HFpEF.Patients with a higher TyG index demonstrated significantly greater waist circumference, fasting blood glucose, fastingtriglyceride levels, and E/e′ ratio compared to those with a lower TyG index (p < 0.05). Participants with HFpEF hadsignificantly higher TyG index values, fasting triglyceride levels, E/e′ ratio, and left atrial volume index. Binary logisticregression analysis demonstrated that an elevated TyG index was significantly associated with HFpEF (OR: 9.75; 95% CI:1.98–47.94; p < 0.001).Conclusion: An elevated TyG index was significantly associated with subclinical HFpEF and markers of diastolic dysfunctionin patients with T2DM. The TyG index may serve as a simple, inexpensive, and clinically useful marker for early cardiovascularrisk stratification in diabetic patients