Ying Miao,1– 6 Yu Wang,7 Yi Wang,8 Pijun Yan,1– 6 Zhuang Chen,9 Qin Wan1– 6 

1Department of Endocrinology and Metabolism, Affiliated Hospital of Southwest Medical University, Luzhou, People’s Republic of China; 2Southwest Medical University, Luzhou, People’s Republic of China; 3Metabolic Vascular Disease Key Laboratory of Sichuan Province, Luzhou, People’s Republic of China; 4Sichuan Clinical Research Center for Diabetes and Metabolism, Luzhou, People’s Republic of China; 5Sichuan Clinical Research Center for Nephropathy, Luzhou, People’s Republic of China; 6Cardiovascular and Metabolic Diseases Key Laboratory of Luzhou, Luzhou, People’s Republic of China; 7Department of Cardiology, Luzhou People’s Hospital, Luzhou, People’s Republic of China; 8Department of Pharmacy, Luzhou People’s Hospital, Luzhou, People’s Republic of China; 9Experimental Medicine Center, the Affiliated Hospital of Southwest Medical University, Luzhou, People’s Republic of China

Correspondence: Qin Wan, Email wanqin3@126.com

Background: Lower extremity peripheral artery disease (LEAD) is a significant chronic complication of type 2 diabetes mellitus (T2DM) that significantly contributes to disability and mortality. The subtle presentation of LEAD symptoms often leads to underrecognition and misdiagnosis. Therefore, identifying simple and effective evaluation indicators is essential for the early detection and management of LEAD. Insulin resistance is closely associated with diabetes and its complications. However, the specific relationship between insulin resistance—measured by the triglyceride-glucose (TyG) index—and obesity indicators in relation to LEAD remains unclear.
Objective: This study aims to investigate the association between the TyG index and its combination with obesity indicators in participants with T2DM and LEAD.
Methods: We performed a univariate analysis on 3176 T2DM patients to identify risk factors for LEAD. Patients were then divided into quartiles based on the TyG index combined with various obesity indicators. The chi-square test was used to compare the prevalence of LEAD across these groups. Logistic regression analysis was conducted to examine the association between the TyG index, in combination with different obesity indicators, and the occurrence of LEAD. Finally, we assessed the predictive ability of the TyG index combined with obesity indicators for LEAD by comparing the area under the ROC curve (AUC).
Results: The study included 3176 T2DM patients (1691 males and 1485 females) with a mean age of 56.16± 10.60 years. Among them, 106 individuals had LEAD. The prevalence of LEAD varied significantly across quartiles of the TyG index, TyG-WC, and TyG-WHR (Q4 > Q3 > Q2 > Q1; P < 0.05). Multiple logistic regression analysis showed that the TyG index, TyG-WC, and TyG-WHR were positively associated with the risk of LEAD in T2DM patients. ROC curve analysis identified the best cutoff values for predicting LEAD: 9.8059 for the TyG index (sensitivity: 49.1%, specificity: 67.9%, AUC: 0.583), 808.8397 for TyG-WC (sensitivity: 70.8%, specificity: 47.8%, AUC: 0.603), and 8.8543 for TyG-WHR (sensitivity: 75.5%, specificity: 44.6%, AUC: 0.607).
Conclusion: In T2DM patients, the TyG index, TyG-WHR, and TyG-WC are positively associated with the occurrence of LEAD. TyG-WHR and TyG-WC exhibit a stronger correlation with LEAD compared to the TyG index alone, indicating their superior diagnostic value.

Keywords: type 2 diabetes mellitus, lower extremity peripheral artery disease, TyG-WC, TyG-WHR, insulin resistance