Jul 2026· Obesity and Metabolism· 0 citations· 21 references
TL;DR
In patients with T2DM, UCPCR could be used as a simple, noninvasive and available biomarker for IR and it also could be used as a marker of glycemic control.
Abstract
Background
Insulin resistance (IR) is considered the main mechanism of type 2 diabetes (T2DM). Diabetic vascular complications (DVC) are main causes of morbidity and mortality. Urinary c-peptide to creatinine ratio (UCPCR) is a novel promising biomarker that may be of value in assessment of IR and DVC.
Aim
The present work aimed at studying the relation between UCPCR, IR and DVC in subjects with T2DM.
Materials And Methods
This was a cross-sectional study performed on a group of subjects with T2DM. Insulin resistance was assessed by measuring homeostasis model assessment for insulin resistance (HOMA-IR). Laboratory investigations included glycemic parameters and renal functions. Human C-peptide ELISA kit was used to asses c-peptide level in a spot urine sample after processing.
Results
The study included 90 subjects with T2DM. There was highly statistically significant positive correlations between UCPCR and HOMA-IR, FPG and HbA1c with P values of <0.001, 0.006 and 0.005 respectively. FPG, HbA1c, and UCPCR were the independent risk factors for IR in the univariate regression analysis. However, UCPCR was the only independent risk factor for IR in multivariate analysis (OR 16.431(1.401–192.706). UCPCR cut-off value (>0.19) nmol/mmol was able to differentiate significantly (p<0.001) between patients with IR and those without IR with good sensitivity, specificity and AUC (85.11%, 60.47% and 0.716 respectively).
Conclusion
In patients with T2DM, UCPCR could be used as a simple, noninvasive and available biomarker for IR. It also could be used as a marker of glycemic control. However, UCPCR is not related to DVC.
C-peptide can be used as an appropriate index for identifying IR in T2DM patients with complications and illustrated the clinical utility of C-peptide in microvascular complications such as diabetic nephropathy and diabetic retinopathy.
K. Siddiqui, S. Joy, S. Nawaz et al.· Medicine· 0 citations
Early diabetic kidney disease in type 2 diabetes is characterized by increased urinary albumin excretion despite preserved estimated glomerular filtration rate (eGFR). The roles of systemic inflammation and insulin resistance at this stage remain incompletely defined. This study evaluated the associations of high-sensitivity C-reactive protein (hs-CRP) and insulin resistance (HOMA-IR) with early renal impairment. In this single-center retrospective cross-sectional study, 126 patients with type 2 diabetes and eGFR ≥60 mL/min/1.73 m2 were included; patients not using exogenous insulin formed a subgroup (n=97). The primary outcome was natural log-transformed urine albumin-to-creatinine ratio (ln-UACR). Associations were assessed using Spearman correlation and multivariable linear regression adjusted for age, sex, diabetes duration, systolic blood pressure, and glycated hemoglobin (HbA1c). Dose-response relationships, joint exposure effects, surrogate outcomes, and sensitivity analyses were also examined. Statistical analyses were performed using R (version 4.3.2). ln-UACR was positively correlated with hs-CRP in the overall sample (ρ=0.28, p=0.001) and with HOMA-IR in the subgroup (ρ=0.26, p=0.009). After adjustment, hs-CRP remained associated with ln-UACR in both the overall sample (βstd=0.23) and subgroup (βstd=0.22), and HOMA-IR remained associated in the subgroup (βstd=0.17, p=0.018). ln-UACR increased across tertiles of both exposures (p for trend <0.01). The high hs-CRP/high HOMA-IR group showed higher ln-UACR compared with the low/low group (mean difference 0.64, 95% CI 0.37-0.88), without significant interaction (p=0.173). Associations were consistent across surrogate outcomes and sensitivity analyses. In patients with type 2 diabetes and preserved eGFR, hs-CRP and HOMA-IR were independently associated with markers of early renal impairment. These findings suggest potential relevance for early risk characterization, although prospective studies are required to confirm clinical utility.
Xiaowen Guo, Wei Wei, Xiao Yahe et al.· Journal of Visualized Experi...· 0 citations
BACKGROUND
Patients with early-onset type 2 diabetes mellitus (T2DM) face a significantly elevated risk of developing diabetic kidney disease (DKD) in the early stages, attributable to their prolonged disease duration. The urinary albumin-to-creatinine ratio (UACR) serves as a critical marker for screening incipient renal injury. While insulin resistance (IR) is a pivotal driver of this pathological progression, the triglyceride-glucose (TyG) index, a simple and effective surrogate marker for IR, has not been thoroughly investigated in this specific population. The association between TyG index and UACR, along with its potential discriminatory ability for early renal damage in patients with early-onset T2DM, remained unclear.
OBJECTIVE
This study aimed to explore the correlation between the TyG index and UACR in patients with early-onset type 2 diabetes.
RESEARCH DESIGN AND METHODS
A dual-center, retrospective cross-sectional study was conducted. Clinical data from a total of 596 adult patients (aged 18-40 years) with early-onset type 2 diabetes mellitus, admitted to the First Medical Center of the Chinese PLA General Hospital and Hainan Hospital of the Chinese PLA General Hospital between January 2012 and December 2022, were collected and retrospectively analyzed. Participants were stratified into three groups based on the tertiles of the TyG index: Q1 (< 7.67), Q2 (7.67-8.33), and Q3 (> 8.33). They were also categorized into two groups according to UACR levels: <30 mg/g and ≥ 30 mg/g. The association between TyG index, traditional glucose/lipid parameters, and elevated UACR (≥ 30 mg/g) was assessed using correlation analysis and binary logistic regression models. Receiver operating characteristic (ROC) curves were plotted to evaluate the discriminatory ability of these indicators for elevated UACR. Subgroup analyses were further performed based on gender, blood pressure status, and estimated glomerular filtration rate (eGFR).
RESULTS
The mean age of the 596 participants was 31.78 ± 9.99 years. A significant positive correlation was observed between the TyG index and UACR (r = 0.250, P < 0.001). Binary logistic regression analysis revealed that after adjustment for multiple confounding factors, patients in the highest TyG tertile (Q3) had a 1.366-fold increased risk of elevated UACR (≥ 30 mg/g) compared to those in the lowest tertile (Q1) (OR: 1.366, 95% CI: 1.015-1.838, P = 0.039). The discriminatory ability of TyG index for elevated UACR was evaluated using the receiver operating characteristic curve, yielding an area under the curve of 0.649 (95% CI: 0.609-0.687). At the optimal cut-off value of 8.18, the sensitivity and specificity were 69.47% and 61.08%, respectively. Notably, the TyG index demonstrated superior discriminatory efficacy compared to traditional lipid parameters, including triglycerides, total cholesterol, LDL-C, and HDL-C.
CONCLUSION
In patients with early-onset type 2 diabetes, an elevated TyG index was independently associated with increased UACR levels and served as a potential indicator for early diabetic kidney injury. Specifically, for individuals aged 18-40 years, a TyG index exceeding 8.18 was associated with an elevated association of developing diabetic kidney disease.
CLINICAL TRIAL REGISTRATION
Not applicable.
Wei Wang, Wenjing Dong, Shiju Yan et al.· BMC Endocrine Disorders· 0 citations
Higher levels and strong positive correlation between HbA1c and C-peptide-especially in diabetics-suggests increased insulin secretion in response to poor glycemic control and insulin resistance.
N. Sridevi, N. Chowdeswari, A. Navaneeta Lakshmi et al.· International Journal of Res...· 0 citations
Background: Type 2 diabetes mellitus (T2DM) is one of the most common chronic metabolic diseases worldwide, and insulin resistance is the core pathophysiological basis for its development. This study aims to explore the relationship between various metabolic-related indicators and insulin resistance in patients with T2DM, and to analyze the correlation between obesity indicators, glucose and lipid metabolism indicators, and serum uric acid with insulin resistance, providing a reference for clinical identification of insulin resistance.Methods: This was a single-center retrospective study, consecutively enrolling 263 patients with type 2 diabetes who received treatment at our center between August 2022 and August 2025. Patients were divided into a non-insulin-resistant group (n = 211) and an insulin-resistant group (n = 52) based on the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR). Baseline clinical data and laboratory parameters were collected, including body mass index, waist-to-hip ratio, fasting blood glucose, 2-hour postprandial blood glucose, lipid profile, glycated hemoglobin, fasting C-peptide, and serum uric acid. The triglyceride-glucose (TyG) index was also calculated. Logistic regression analysis was performed to screen for metabolic indicators associated with insulin resistance, and receiver operating characteristic (ROC) curve analysis was then conducted to evaluate the discriminative ability of these indicators for insulin resistance.Results: Patients in the insulin resistance group had significantly higher levels of body mass index (BMI), waist-to-hip ratio (WHR), triglycerides, fasting blood glucose, TyG index, fasting C-peptide, glycated hemoglobin (HbA1c), systolic blood pressure, diastolic blood pressure, and serum uric acid than the non-insulin resistance group (all p < 0.05), and a higher proportion of patients with hypertension (65.38% vs. 46.45%, p = 0.014). Multivariate logistic regression analysis showed that WHR, TyG index, fasting C-peptide, and serum uric acid were independently associated with insulin resistance. The area under the curve (AUC) for assessing insulin resistance using the combined indicators was 0.81 (95% CI: 0.74–0.88), with a sensitivity of 79.0% and a specificity of 71.0%.Conclusion: In patients with type 2 diabetes, WHR and serum uric acid levels are significantly correlated with insulin resistance status. These indicators reflect various metabolic characteristics from different perspectives, including obesity, glucose and lipid metabolism, and pancreatic β-cell function, and may provide preliminary insights into the metabolic abnormalities associated with insulin resistance in patients with type 2 diabetes.
Introduction: Insulin resistance, dyslipidemia, and increased risk of developing cardiovascular diseases have been identified in patients with type 2 diabetes mellitus (T2DM). Triglyceride – Glucose (TyG) index has been identified as the surrogate marker for insulin resistance and vitamin D deficiency is known to contribute to poor metabolic profile. This study aimed at exploring the relation between TyG index and vitamin D and their association with cardiovascular disease risk factors in patients with T2DM.
Materials and Methods: Hospital-based cross-sectional study was carried out on 156 patients with T2DM presenting in tertiary care hospital. Anthropometry, fasting blood glucose, HbA1c, lipid profile, and serum vitamin D were determined. TyG index, Cardiac Risk Ratio (CRR), Atherogenic Coefficient (AC) and Atherogenic Index of Plasma (AIP) were calculated. Group comparisons based on vitamin D deficiency and correlations were carried out using one-way ANOVA, Chi square and Spearman’s rank correlation.
Results: The mean age of participants was 52.1 ± 10.4 years, mean BMI was 27.3 ± 3.2 kg/m², mean TyG index was 9.85 ± 0.24, and mean serum vitamin D concentration was 18.0 ± 7.3 ng/mL. Vitamin D deficiency was observed in 94 (60.3%) participants. Patients with vitamin D deficiency had higher BMI (28.6 ± 4.3 vs. 25.1 ± 3.2 kg/m²), TyG index (10.01 ± 0.25 vs. 9.63 ± 0.21), HbA1c (8.1 ± 1.6% vs. 7.5 ± 1.3%), Cardiac Risk Ratio (5.4 ± 1.7 vs. 4.5 ± 1.3), and Atherogenic Index of Plasma (0.32 ± 0.26 vs. 0.18 ± 0.20) than vitamin D-sufficient participants. One-way ANOVA demonstrated significant differences in BMI (F (2,153) = 7.58, p < 0.001), TyG index (F (2,153) = 13.42, p < 0.001), Cardiac Risk Ratio (F (2,153) = 3.40, p = 0.036), and Atherogenic Index of Plasma (F (2,153) = 3.27, p = 0.040), whereas differences in HbA1c were not statistically significant (F (2,153) = 1.55, p = 0.216). Vitamin D status showed significant associations with gender (χ² = 10.03, df = 2, p = 0.007) and BMI category (χ² = 15.44, df = 4, p = 0.004), whereas no significant association was observed with age group (χ² = 1.23, df = 4, p = 0.873). Spearman correlation analysis demonstrated that the TyG index was positively correlated with HbA1c (ρ = 0.46), Cardiac Risk Ratio (ρ = 0.52), and Atherogenic Index of Plasma (ρ = 0.61), and negatively correlated with vitamin D (ρ = −0.41) (all p < 0.001).
Conclusions: The TyG index was significantly associated with adverse glycemic and atherogenic markers and inversely associated with vitamin D levels in patients with type 2 diabetes mellitus. These findings suggest that the TyG index and vitamin D status are associated with cardiometabolic risk factors; however, the cross-sectional design precludes causal inference, and prospective studies are needed to confirm these associations.
Key words: TyG index, Vitamin D, Insulin resistance, Type 2 diabetes mellitus, Cardiovascular risk
Sweety Kumari, A. Batta, Manju Sharma et al.· International Journal of Hea...· 0 citations