Abstract
OBJECTIVE: To explore and compare the correlation between triglyceride-glucose (TyG) index, triglyceride-glucose body mass index (TyG-BMI) and plasma atherogenic (AIP) index and early onset type 2 diabetic nephropathy. METHODS: 179 patients with early-onset type 2 diabetes admitted to the Department of Endocrinology, The Second Hospital of Lanzhou University from January 2024 to June 2025 were selected retrospectively. According to the ratio of urinary microalbumin to creatinine (UACR), they were divided into early-onset T2DM group (UACR<30mg/g) and DKD group (UACR≥30mg/g). Spearman correlation was performed to analyze the correlation between insulin resistance parameters and UACR, Logistic regression was used to analyze the risk factors of DKD, and the curve of ROC was drawn to evaluate the predictive efficacy of TyG index, TyG-BMI index and AIP index. RESULTS: There were 129 cases (72.07%) in T2DM group and 50 cases (27.93%) in DKD group. The levels of age, course of disease, TG, UTP, UACR, HOMA-IR, TyG, TyG-BMI, AIP and TC/HDL-C in early-onset T2DM with DKD were significantly compared to that of early-onset T2DM (P < 0.05). TyG, TyG-BMI, AIP, and TC/HDL-C were positively correlated with UACR (P<0.05). TyG, TyG-BMI and AIP were independent risk factors for early-onset T2DM complicated with DKD (P<0.05). Additionally, TyG, TyG-BMI and AIP are all effective indicators for predicting DKD in patients with early-onset T2DM. The order according to the area under the curve (AUC) is: TyG index (AUC 0.690, 95%CI 0.606-0.773), TyG-BMI index (AUC 0.600, 95%CI 0.506-0.695), AIP index (AUC 0.678, 95%CI 0.595-0.761). Among the three indices, the TyG index showed a relatively stronger association with DKD (AUC 0.690), though its discriminative ability remains modest. These indices may serve as adjunctive screening tools rather than standalone diagnostic tests for early-onset DKD, and its optimal critical value for predicting DKD is 10.0013. CONCLUSION: The increase of TyG, TyG-BMI and AIP index are associated factors for patients with early-onset type 2 diabetic nephropathy. TyG index has the strongest diagnostic value, the best sensitivity and the strongest correlation with UACR, and can be used as the most valuable IR substitute index for DKD risk prediction in early-onset T2DM patients.