Association of Triglyceride–Glucose Index with Heart Failure with Preserved Ejection Fraction and Diastolic Dysfunction in Patients with Type 2 Diabetes Mellitus: A Cross-Sectional Study

Abstract

Background: Heart failure with preserved ejection fraction (HFpEF) is increasingly recognized as a major cardiovascular
complication in patients with type 2 diabetes mellitus (T2DM). Insulin resistance plays a central role in the pathogenesis of
HFpEF, and the triglyceride–glucose (TyG) index has emerged as a simple surrogate marker of insulin resistance. This study
aimed to evaluate the association between the TyG index, HFpEF, and diastolic dysfunction among patients with T2DM.
Methods: This hospital-based cross-sectional study included 65 patients with T2DM aged between 18 and 70 years without
known hypertension or overt cardiovascular disease. Clinical, anthropometric, biochemical, and echocardiographic parameters
were assessed. The TyG index was calculated using fasting triglyceride and fasting blood glucose levels. HFpEF was evaluated
using the HFA-PEFF scoring system and echocardiographic parameters of diastolic dysfunction. Statistical analysis was
performed using SPSS version 26.
Results: The mean age of participants was 52.74 ± 8.69 years, and 18.5% had an HFA-PEFF score ≥5 suggestive of HFpEF.
Patients with a higher TyG index demonstrated significantly greater waist circumference, fasting blood glucose, fasting
triglyceride levels, and E/e′ ratio compared to those with a lower TyG index (p < 0.05). Participants with HFpEF had
significantly higher TyG index values, fasting triglyceride levels, E/e′ ratio, and left atrial volume index. Binary logistic
regression analysis demonstrated that an elevated TyG index was significantly associated with HFpEF (OR: 9.75; 95% CI:
1.98–47.94; p < 0.001).
Conclusion: An elevated TyG index was significantly associated with subclinical HFpEF and markers of diastolic dysfunction
in patients with T2DM. The TyG index may serve as a simple, inexpensive, and clinically useful marker for early cardiovascular
risk stratification in diabetic patients