Triglyceride-cholesterol-body weight index and microvascular complications in Tibetan adults with type 2 diabetes: A cross-sectional study.

ObjectiveTo examine the associations of the triglyceride-cholesterol-body weight index with microvascular complications and assess its incremental value beyond conventional variables and its components.MethodsThis 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.ResultsAmong 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).ConclusionsTriglyceride-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.