Association of the Triglyceride Glucose Index and Epicardial Adipose Tissue with Type 2 Diabetes Mellitus Complicated by Coronary Atherosclerotic Heart Disease

Binbin Liu,1 Juan Du,2 Ziru Niu,3 Qiang Lu3 1Department of Functional Examination, First Hospital of Qinhuangdao, Hebei, Qinhuangdao, 066000, People’s Republic of China; 2Department of Imaging, First Hospital of Qinhuangdao, Hebei, Qinhuangdao, 066000, People’s Republic of China; 3Department of Endocrinology, First Hospital of Qinhuangdao, Hebei, Qinhuangdao, 066000, People’s Republic of ChinaCorrespondence: Qiang Lu, Department of Endocrinology, First Hospital of Qinhuangdao, Hebei, Qinhuangdao, 066000, People’s Republic of China, Tel +86 13933909066, Email [email protected]: To examine the role of the triglyceride glucose(TyG) index and epicardial adipose tissue(EAT) in the progression of type 2 diabetes mellitus (T2DM) with concurrent coronary atherosclerotic heart disease(CHD), thereby establishing a theoretical foundation for early clinical intervention in CHD among T2DM patients.Methods: This retrospective study analysed 96 patients with T2DM who underwent Coronary CT angiography at the Department of Endocrinology, Qinhuangdao First Hospital, between January 2020 and June 2023. Participants were categorised into two groups: those with T2DM and CHD (n=48) and those with T2DM alone (n=48). Clinical indicators were compared between the groups. Logistic regression analysis assessed the association between T2DM with CHD and both the TyG index and EAT. Receiver operating characteristic (ROC) curve analysis evaluated the predictive value of these parameters.Results: Significant differences (P < 0.05) were found between the two groups in weight, uric acid(UA), triglycerides(TG), high-density lipoprotein cholesterol (HDL-C), epicardial adipose tissue volume (EATV) and the TyG index. Multivariate analysis identified both EATV and the TyG index as independent risk factors for T2DM complicated by CHD (P < 0.05). ROC curve analysis demonstrated that both EATV and TyG index showed statistically significant predictive power for CHD development in T2DM patients (P< 0.05). The EATV exhibited an AUC of 0.739 with a predictive cut-off value of 128.45 mL (sensitivity 66.7%, specificity 72.9%). The TyG index demonstrated an AUC of 0.724 with a predictive cut-off value of 9.47 (sensitivity 58.3%, specificity 81.2%).Conclusion: The TyG index and EAT are significant risk factors for CHD in T2DM patients. These findings provide a theoretical basis for early screening, monitoring, and clinical intervention in this population.Keywords: triglyceride glucose index, epicardial adipose tissue, type 2 diabetes mellitus, coronary atherosclerotic heart disease