PeerJ · 2026
Correlation between the triglyceride-glucose index and retinal vascular parameters in the fundus: a cross-sectional study.
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Wu Zhenyan, Xin Yu, Jiang Xue, Ling Saiguang, Guo Caixia
Аннотация
BACKGROUND: The triglyceride-glucose (TyG) index is a simple, cost-effective indicator of insulin resistance, strongly linked to cardiovascular/cerebrovascular risk. Advances in deep learning enable quantitative retinal microvascular analysis from non-invasive fundus photography. This study assessed correlations between retinal vascular characteristics and the TyG index to explore relationships between glucose-lipid metabolism and microvascular alterations.
METHODS: This cross-sectional study included 712 inpatients from Beijing Tongren Hospital Cardiovascular Center. Patients were stratified by TyG index quartiles (Q1-Q4). Retinal vascular parameters were automatically quantified from color fundus photographs (CFPs) using a deep learning segmentation model. Linear regression and subgroup analyses evaluated associations with TyG.
RESULTS: Significant intergroup differences existed in hypertension, diabetes, revascularization history, Gensini score, body mass index (BMI), fasting blood glucose (FBG), total cholesterol (TC), triglycerides (TG), low- density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and glycated hemoglobin (HbA1c) (P < 0.01). Higher TyG levels correlated with increased BMI, TC, HbA1c, FBG, LDL-C, and decreased HDL-C. Retinal parameters fractal dimension (FD), vessel density (VD), mean blood vessel diameter (MBVD), mean venous diameter (MVD), and arteriovenous ratio (AVR) significantly differed between groups (P < 0.01), particularly Q1 vs. Q4 and Q2 vs. Q4. After full adjustment (age, sex, medical/personal history, BMI, glucose/lipids), linear regression showed FD, VD, and AVR were negatively correlated with TyG, while MVD and MBVD were positively correlated. Restricted cubic spline (RCS) confirmed linearity (P-nonlinear >0.05). Subgroup analysis further demonstrated that these linear associations (specifically for FD and VD) remained significant within the non-diabetic population. Significant interactions with age were observed (P-interaction < 0.05), where elevated TyG was associated with decreased FD and VD, and increased MBVD and MVD specifically in participants aged ≥65 years.
CONCLUSION: TyG levels negatively correlate with retinal FD, VD, and AVR, and positively correlate with MBVD and MVD. Significant interactions exist in individuals ≥ 65 years, where TyG correlates strongly with FD, VD, MBVD, and MVD.
METHODS: This cross-sectional study included 712 inpatients from Beijing Tongren Hospital Cardiovascular Center. Patients were stratified by TyG index quartiles (Q1-Q4). Retinal vascular parameters were automatically quantified from color fundus photographs (CFPs) using a deep learning segmentation model. Linear regression and subgroup analyses evaluated associations with TyG.
RESULTS: Significant intergroup differences existed in hypertension, diabetes, revascularization history, Gensini score, body mass index (BMI), fasting blood glucose (FBG), total cholesterol (TC), triglycerides (TG), low- density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and glycated hemoglobin (HbA1c) (P < 0.01). Higher TyG levels correlated with increased BMI, TC, HbA1c, FBG, LDL-C, and decreased HDL-C. Retinal parameters fractal dimension (FD), vessel density (VD), mean blood vessel diameter (MBVD), mean venous diameter (MVD), and arteriovenous ratio (AVR) significantly differed between groups (P < 0.01), particularly Q1 vs. Q4 and Q2 vs. Q4. After full adjustment (age, sex, medical/personal history, BMI, glucose/lipids), linear regression showed FD, VD, and AVR were negatively correlated with TyG, while MVD and MBVD were positively correlated. Restricted cubic spline (RCS) confirmed linearity (P-nonlinear >0.05). Subgroup analysis further demonstrated that these linear associations (specifically for FD and VD) remained significant within the non-diabetic population. Significant interactions with age were observed (P-interaction < 0.05), where elevated TyG was associated with decreased FD and VD, and increased MBVD and MVD specifically in participants aged ≥65 years.
CONCLUSION: TyG levels negatively correlate with retinal FD, VD, and AVR, and positively correlate with MBVD and MVD. Significant interactions exist in individuals ≥ 65 years, where TyG correlates strongly with FD, VD, MBVD, and MVD.