182-OR: The Triglyceride-Glucose Index and the Presence of Coronary Artery Disease are Mutually Independent Predictors for the Development of Type 2 Diabetes Mellitus

The Triglyceride-Glucose-Index (TyG-Index) is a predictor of cardiovascular event risk and is associated with the metabolic syndrome as well as with type 2 diabetes (T2DM). Whether this parameter also predicts incident diabetes in subjects who do not yet have diabetes is less clear; this issue is adressed in the present study. We prospectively recorded incident diabetes over 4 years in 1296 consecutive nondiabetic Caucasian patients who underwent coronary angiography for the evaluation of established or suspected stable coronary artery disease (CAD). Diabetes was diagnosed according to ADA criteria. At baseline, 701 (54.1%) of our patients had significant CAD with lumen narrowing ≥50% at angiography; the TyG-Index was significantly higher in patients with than in those without significant CAD (8.7 [8.3-9.1] vs 8.6 [8.2-8.9] p=0.003). During follow-up, diabetes was newly diagnosed in 204 patients, i.e. in 15.7% of the study population. The TyG-Index strongly predicted diabetes both univariately (OR 1.72 [1.47-2.00]; p<0.001) and after multivariate adjustment including age, sex, smoking, BMI and HbA1c (OR 1.57 [1.33-1.86]; p<0.001). When we further adjusted for the presence of significant CAD, the TyG-Index remained predictive of incident diabetes (OR 1.54 [1.30-1.83]; p<0.001), while CAD predicted incident diabetes in this model independently of TyG-Index (OR 1.61 [1.14-2.28]; p=0.007). We conclude that the TyG-Index and the presence of CAD are mutually independent predictors for the development of T2DM.