To investigate the relationship between triglyceride glucose index (TyG) and retinal arteriosclerosis grading in a community-based population.

764 subjects with fundus photograph and TyG data were included from December 2019 to January 2021 from an atherosclerosis cohort of Peking University First Hospital in Shijingshan District, Beijing. There were 301 male and 463 female with an average of (62.3±7.3) years-old (ranging from 33 to 86 years-old). General information was collected by questionnaire, blood pressure, height, weight, body mass index (BMI), fasting blood glucose, triglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) and creatinine were measured. Glomerular filtration rate (eGFR) and TyG index were calculated. Color fundus images were collected, and retinal arteriosclerosis was graded by experienced ophthalmologist according to Scheie′s classification. Subjects were divided into two groups according to TyG index (<9.272 and ≥9.272). Age, BMI, systolic blood pressure, blood glucose, HDL-C, LDL-C and eGFR were described by ±s, and t test was used to compare the differences between groups. Smoking status, concomitant diseases and medication were described by frequency and percentage, and Chi-square test was used to compare differences between groups. Multivariate logistic regression was used to analyze the correlation between TyG index and retinal arteriosclerosis grading, adjusted for factors including gender, age, BMI, smoking status, systolic blood pressure, HLD-C, LDL-C, eGFR, cardiovascular diseases history, use of lipid-lowering drugs, hypoglycemic drugs and antihypertensive drugs. The generalized additive model was used to fit the grading of retinal arteriosclerosis and the smooth curve of TYG index.

Among of 764 subjects, 416 (54.5%), 598 (78.3%) and 247 (32.3%) had hypertension, dyslipidemia and diabetes mellitus, respectively. 129 (16.9%) were current smokers, the fasting blood glucose were (6.4±1.9)mmol/L, and the TyG index was 8.9±0.6. Compared with subjects with TyG<9.272, subjects with TyG≥9.272 had higher BMI, systolic blood pressure, LDL-C, fasting blood glucose, lower levels of HDL-C, a higher fasting blood glucose, and lower HDL-C with the significant difference (t=-3.855, -3.345, -5.928, -15.768, 7.266; P<0.05); hypertension, dyslipidemia and diabetes mellitus with the significant difference (χ²=6.333, 57.723, 119.71; P<0.05). The retinal arteriosclerosis grade (0—1 and 2—4) had the positive correlation with TyG index (r=0.11, P<0.05). Multivariate logistic regression analysis showed that retinal arteriosclerosis grade 3—4 increased 59% compared to grade 0—1 for every 1 increase of TyG (OR=1.59, 95%CI: 1.02 to 2.49, P<0.05). Compared with TyG groups (TyG<9.3), the incidence of retinal arteriosclerosis grade 3—4 increased by 183% (TyG≥9.3) (OR=2.83, 95%CI: 1.31 to 6.11, P<0.05).

High TyG index is associated with grade 3—4 severe retinal arteriosclerosis.