SAT-268 - Association of Triglyceride-Glucose Index with Heart Failure Among Patients with Type 2 Diabetes

Background and Purpose
The Triglyceride-Glucose Index is a readily available surrogate marker of insulin resistance that has been associated with cardiovascular disease in multiple populations. However, its relationship with heart failure among patients with type 2 diabetes in the Middle East remains poorly defined. We therefore investigated the association between the Triglyceride-Glucose Index and prevalent heart failure in a large cohort of individuals with type 2 diabetes.
Methods
We retrospectively analyzed adult patients with established type 2 diabetes who attended a tertiary-care center between January 2022 and June 2025. Data on demographics, anthropometric measurements, laboratory values, comorbidities, and medication use were extracted from medical records. The Triglyceride-Glucose Index was calculated as the natural logarithm of fasting triglycerides (mg/dL) multiplied by fasting plasma glucose (mg/dL), divided by two. Heart failure was identified based on physician documentation and echocardiographic reports. Mean Triglyceride-Glucose Index values were compared between patients with and without heart failure using unpaired t-tests. Multivariable logistic regression was performed to evaluate the association between the Triglyceride-Glucose Index and heart failure after adjustment for age, sex, body mass index, and diabetes duration. Results are reported as adjusted odds ratios with 95% confidence intervals.
Results
Among 1,373 patients (mean age 59 ± 10 years, 49% women), 134 (9.8%) had heart failure. The mean Triglyceride-Glucose Index was significantly higher in patients with heart failure compared with those without heart failure (9.58 ± 0.76 vs 9.32 ± 0.70; p < 0.001). In multivariable analysis, each one-unit increase in the Triglyceride-Glucose Index was associated with a 75% higher odds of heart failure (adjusted odds ratio 1.75, 95% confidence interval 1.34–2.28; p < 0.001), independent of age, sex, body mass index, and diabetes duration. Older age and higher body mass index were also independently associated with heart failure, whereas diabetes duration showed a borderline association.
Conclusions
In this large cohort of patients with type 2 diabetes, a higher Triglyceride-Glucose Index was independently associated with prevalent heart failure after adjustment for traditional risk factors. These findings suggest that the Triglyceride-Glucose Index may serve as a simple and clinically useful marker to identify diabetic patients at increased risk of heart failure in Middle Eastern populations. Prospective studies are needed to confirm these associations and to determine whether incorporating the Triglyceride-Glucose Index into risk stratification improves early detection and preventive strategies.

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