Abstract
BACKGROUND: Early vascular aging (EVA) is a key contributor to the elevated risk of cardiovascular disease, which remains a leading cause of mortality and disability in patients with type 2 diabetes mellitus (T2DM). This study aims to investigate the association between the triglyceride-glucose (TyG) index and EVA in T2DM patients. METHODS: T2DM patients were enrolled, and their clinical data were collected. Bilateral brachial-ankle pulse wave velocity (baPWV) was measured and used to determine the presence of EVA. Binary logistic regression analysis was conducted to evaluate the effect of the TyG index and identify factors associated with EVA. A predictive model was constructed using a nomogram, and its performance was assessed using receiver operating characteristic (ROC) curve analysis. RESULTS: A total of 380 patients were included in the study, among whom 144 (37.89%) were identified as having EVA. After adjusting for all relevant covariates, the TyG index remained independently and positively associated with EVA (odds ratio [OR] = 2.76, 95% confidence interval [CI]: 1.57-4.85), patients in the highest TyG tertile had a 4.30-fold increased risk of developing EVA compared to those in the lowest tertile (95% CI: 1.97-9.42). Elevated TyG index (OR = 2.53, 95% CI: 1.79-3.57) and systolic blood pressure (OR = 1.04, 95% CI: 1.02-1.06) were positively associated with EVA in T2DM patients, while male sex (OR = 0.50, 95% CI: 0.30-0.83) and absence of T2DM complications (OR = 0.56, 95% CI: 0.34-0.92) were negatively associated with EVA. Based on these findings, a predictive model was developed, which demonstrated good discrimination with an area under the ROC curve (AUC) of 0.776 (95% CI: 0.728-0.824). CONCLUSIONS: A higher TyG index and elevated systolic blood pressure were independently associated with the presence of EVA, whereas male sex and the absence of T2DM complications were associated with a lower likelihood of its occurrence. These findings provide valuable insights for the early identification of high-risk individuals.