Utility of the Triglyceride Glucose Index and Atherogenic Lipid Indices in Differentiating Type 2 Diabetic Patients with and Without Coronary Heart Disease

Original Article

Abstract

Objectives: To assess the use of the Triglyceride-Glucose Index and atherogenic lipid indices to distinguish between T2DM with and without CHD.

Methodology: This comparative cross-sectional study was conducted in the Department of Biochemistry, Khyber Medical College, Peshawar, from July 2025 to Dec 2025 six months and included 200 patients with T2DM, comprising 100 with CHD and 100 without CHD. We assessed demographic, clinical, glycaemic, lipid, and inflammatory parameters. We calculated TG, AIP, Castelli risk indices I and II, non-HDL-C, and TG/HDL-C.

Results: Fasting Blood Glucose (FBG), HbA1c, triglycerides, CRP, and fibrinogen levels were significantly higher in cardiac diabetic patients than in diabetic patients without CHD. The TG index was significantly higher in patients with CHD (10.237 ± 0.703 vs. 9.849 ± 0.802, p<0.001), as were AIP (0.537 ± 0.309 vs. 0.387 ± 0.312, p=0.001) and median TG/HDL-C ratio [8.220 (IQR 8.84) vs. 5.779 (IQR 5.79), p=0.002]. TG demonstrated the highest discriminatory performance, with an AUC of 0.644 (95% CI: 0.567–0.721, p<0.001) and a sensitivity of 85.0% at a cut-off of 9.494. Both AIP and TG/HDL-C had an AUC of 0.629. TG was also weakly positive and significantly associated with CRP (ρ=0.190, p=0.007).

Conclusion: The TG index, AIP, and TG/HDL-C ratio was significantly higher in T2DM patients with CHD. TG had the highest discriminatory power among the indices evaluated, but with only moderate overall diagnostic power. TG could therefore be a simple screening metabolic marker for cardiovascular risk assessment in T2DM patients.