Association of the triglyceride-glucose index with subclinical left ventricular dysfunction in type 2 diabetes mellitus: mediation by myocardial energetic efficiency and resting perfusion
Authors' conclusion
In patients with T2DM, a higher TyG index is independently associated with decreased LV global strain, and this relationship is statistically mediated by reduced MEEi and impaired resting perfusion upslope.
Study context
- Population
- T2D patients who underwent cardiac magnetic resonance (CMR) examination
- Participants
- 235 patients
- Exposure
- High vs moderate vs low triglyceride-glucose (TyG) index tertiles
- Lown = 78reference
- Moderaten = 79
- Highn = 78
- Outcome
- Association of TyG index with LV global peak strain (GRPS, GCPS, GLPS) and mediation by imaging indicators
Methodological detailsCMR-based, exploratory mediation analysis
- CMR-based
- Exploratory mediation analysis
Main finding
As reported in the abstract
LV global peak strain, multivariate analysis adjusted for confounders
Β (GRPS)
−0.261
all p < 0.001
TyG index
Β (GCPS)
0.271
all p < 0.001
TyG index
Β (GLPS)
0.381
all p < 0.001
TyG index
Observational data: associations, not effects.
Further findings
Myocardial energetic efficiency index (MEEi) and upslope associated with left ventricular (LV) GRPS and GLPS
- MEEi and upslope independently associated with reduced LV GRPS and GLPS (all p < 0.05)
Mediated proportion of TyG–LV global strain association
- Mediated by MEEi
- 8.2-8.6%
- Mediated by upslope
- 4.3% to 12.5%
- Exploratory mediation analysis
Model fit: TyG index vs either component alone
- TyG index substantially better model fit across all strain directions (all Akaike Information Criterion difference)
- > 150
Original publication
Association of the triglyceride-glucose index with subclinical left ventricular dysfunction in type 2 diabetes mellitus: mediation by myocardial energetic efficiency and resting perfusion. Cardiovasc Diabetol. Published 26 July 2026. doi:10.
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