Triglyceride–cholesterol–body weight index and microvascular complications in Tibetan adults with type 2 diabetes: A cross-sectional study
Zhining Zhang, Qing Tian, Lihui YangObjective
To examine the associations of the triglyceride–cholesterol–body weight index with microvascular complications and assess its incremental value beyond conventional variables and its components.
Methods
This cross-sectional study included Tibetan adults with type 2 diabetes from the China National Diabetic Chronic Complications Study. Logistic regression and restricted cubic spline analyses were used to evaluate the associations of triglyceride–cholesterol–body weight index with albuminuria, reduced estimated glomerular filtration rate, and diabetic retinopathy. Triglyceride–cholesterol–body weight index was compared with triglycerides, total cholesterol, body weight, body mass index, and the Castelli risk indices. The incremental predictive value of albuminuria was assessed using the 10-fold cross-validated area under the receiver operating characteristic curve, Brier score, and calibration slope. A sensitivity analysis excluded patients receiving lipid-lowering medications.
Results
Among 662 participants, 657 contributed to the renal analyses and 575 to the retinopathy analyses. The prevalence of albuminuria increased from 40.0% in the lowest quartile to 54.9% in the highest quartile. After full adjustment, triglyceride–cholesterol–body weight index was not associated with albuminuria (odds ratio per 1-standard deviation increase, 1.09; 95% confidence interval: 0.91–1.32; p = 0.355), reduced estimated glomerular filtration rate, or diabetic retinopathy. Spline analyses showed no evidence of nonlinearity. Adding triglyceride–cholesterol–body weight index changed the cross-validated area under the receiver operating characteristic curve from 0.728 to 0.725 and did not improve the Brier score or calibration slope. Triglyceride–cholesterol–body weight index provided no improvement beyond its components. Excluding patients receiving lipid-lowering medications yielded a similar estimate for albuminuria (odds ratio = 1.10; 95% confidence interval: 0.91–1.34).
Conclusions
Triglyceride–cholesterol–body weight index reflected a metabolic profile but was not independently associated with microvascular outcomes. No incremental value beyond conventional clinical variables and its components was demonstrated.