Association of the triglyceride-glucose index with carotid intima-media thickness in type 2 diabetes: effect modification by age and albuminuria—a retrospective cross-sectional study

Background: The Triglyceride-Glucose (TyG) index, a surrogate marker of insulin resistance, is associated with increased cardiovascular risk. However, its relationship with subclinical atherosclerosis in diabetic patients with early-stage kidney injury, characterized by an elevated urinary albumin-to-creatinine ratio (ACR), remains unclear. This study examined the association between carotid intima-media thickness (IMT) and the TyG index, specifically investigating how this association is modified by albuminuria status. Methods: This cross-sectional study included 507 patients with type 2 diabetes and preserved kidney function who had ACR values of 0-300 mg/g. Participants were stratified into quartiles based on ACR levels. IMT was measured using high-resolution B-mode ultrasonography. The relationship between the TyG index and IMT was evaluated using partial correlation and multivariate linear regression analyses, with emphasis on assessing this relationship across ACR-based strata. Result: = 0.015) and diminishing in older age groups. Conclusions: The association between the TyG index and IMT exhibits stage-specific and population-heterogeneous patterns. A significant, ACR-dependent positive correlation was observed, with the association being pronounced in patients with elevated ACR (>30 mg/g) and in those younger than 50 years. These findings suggest that the pro-atherogenic effect of insulin resistance is more pronounced in diabetic patients with early albuminuria or in younger individuals, underscoring the need for enhanced vascular management to reduce insulin resistance in these high-risk populations.