Publication:

Exploring the relationship between triglyceride-glucose index and peripheral neuropathy in Nigerian patients with type 2 diabetes: a comparison with other metabolic markers

Background Diabetic peripheral neuropathy (DPN) is a common and disabling complication of type 2 diabetes mellitus (T2DM). The triglyceride–glucose (TyG) index, a surrogate marker of insulin resistance, has been associated with several diabetes-related complications, but its role in identifying DPN remains unclear. This study evaluated the relationship between the TyG index and DPN among Nigerian patients with T2DM and compared its performance with other metabolic markers.

Methods This hospital-based cross-sectional study was conducted among adults with T2DM attending diabetes clinics in two tertiary hospitals in North-Central Nigeria. DPN was assessed using the Michigan Neuropathy Screening Instrument, 10-g monofilament and 128-Hz tuning fork. The TyG index, albumin–creatinine ratio (ACR), glycated haemoglobin (HbA1c), serum uric acid and apolipoprotein A-I (Apo A-I) were measured.

Results The prevalence of DPN was 61.8% (n=63). DPN was associated with longer diabetes duration, higher hypertension prevalence, lower physical activity and worse renal indices. Participants with DPN had lower Apo A-I (p=0.013), higher urine albumin (p<0.001) and higher ACR (p<0.001). The TyG index did not differ significantly between groups (p=0.218) and showed poor diagnostic performance (AUC 0.427, p=0.218). By contrast, ACR (AUC 0.757, p<0.001) and Apo A-I (AUC 0.647, p=0.013) demonstrated better discriminatory ability.

Conclusions TyG index showed poor diagnostic utility for DPN, whereas ACR and Apo A-I were significantly associated with neuropathy and provided superior discrimination. These findings support the use of renal and lipid-related markers alongside routine neuropathy screening.