Haixia Li,1 Mingxian Chen,2 Youhua Wang,3 Weilu Cui,1 Yuqing Lou,1 Dong Chen,4 Haiming Deng,5 Zican Shen6 

1Department of Cardiology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, People’s Republic of China; 2Department of Gastroenterology, Tongde Hospital of Zhejiang Province, Zhejiang, People’s Republic of China; 3Department of Cardiology, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China; 4Department of Oncology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, People’s Republic of China; 5Department of Cardiology, Pingxiang People’s Hospital, Pingxiang, Jiangxi, People’s Republic of China; 6Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, Hubei, People’s Republic of China

Correspondence: Zican Shen, Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, Hubei, 430000, People’s Republic of China, Email shenzc189@foxmail.com Haiming Deng, Department of Cardiology, Pingxiang People’s Hospital, Pingxiang, Jiangxi, 337000, People’s Republic of China, Email 18879487060@163.com

Background: There is a paucity of research examining the Triglyceride-glucose (TyG) index and Neutrophil-to-lymphocyte ratio (NLR) in relation to the onset and severity of coronary heart disease (CHD) in individuals with type 2 diabetes mellitus (T2DM). This study aims to explore the relationship between these biomarkers and the risk of CHD in T2DM patients and clarify their association with the CHD severity.
Methods: A total of 518 patients with T2DM who underwent coronary angiography (CAG) were included and categorized into either the T2DM group or the T2DM combined with CHD group based on the angiographic findings. The association of the TyG index and NLR with CHD and its severity were validated by logistic regression analyses. The predictive efficacy of both biomarkers, individually and in combination, for CHD was evaluated using receiver operating characteristic (ROC) curves.
Results: Among the 518 patients with T2DM, 396 individuals were identified as having a combination of CHD of varying severity. Multifactorial logistic regression analysis showed that after adjusting for age, sex, smoking, hypertension, and history use of glucose- and lipid-lowering medications, both TyG index and NLR were risk factors for CHD in T2DM patients (TyG index: OR:3.89, 95% CI:2.60– 5.82; NLR: OR:1.44, 95% CI:1.22– 1.71; all P< 0.05). The odds ratios(OR) for the highest tertile compared to the lowest tertile of TyG index and NLR were 3.61(95% CI:2.41– 5.40) and 1.62(95% CI:1.25– 2.09).The TyG index exhibited a significant correlation with CHD severity in T2DM patients (OR:2.96, 95% CI:1.19– 7.32; P=0.019). The areas under the curve for TyG index and NLR alone, and in combination, to predict CHD were 0.717, 0.692, and 0.761, respectively (all P< 0.001).
Conclusion: The TyG index and NLR were significantly associated with the occurrence of CHD in the T2DM population. The combined use of these two biomarkers enhances diagnostic accuracy, which is beneficial for the prevention of CHD.

Keywords: triglyceride-glucose index, neutrophil-to-lymphocyte ratio, type 2 diabetes, coronary heart disease, coronary heart disease severity