TyG-BRI demonstrated an independent, non-linear dose-response association with CAS risk in type 2 diabetes, and its integration into cardiovascular risk stratification holds promise for enabling earlier identification of carotid atherosclerosis.
Key Findings
Results
Patients with carotid atherosclerosis had significantly higher TyG-BRI levels than non-CAS controls in a sample of 1060 adults with type 2 diabetes mellitus.
Cross-sectional observational study consecutively enrolled 1060 adults with type 2 diabetes mellitus in Fujian, China
CAS was ascertained using high-resolution B-mode ultrasound
Anthropometric measurements and fasting venous blood biochemical data were collected to calculate TyG-BRI
Difference in TyG-BRI between CAS and non-CAS groups was statistically significant
Results
TyG-BRI was positively correlated with multiple metabolic and cardiovascular risk indicators.
TyG-BRI was positively correlated with carotid intima-media thickness
Positive correlations were found with glycated hemoglobin (HbA1c), blood pressure, total cholesterol, low-density lipoprotein cholesterol, and uric acid
Correlations were assessed using Spearman correlation analysis
Results
Elevated TyG-BRI was non-linearly associated with higher carotid atherosclerosis risk in fully adjusted models.
P for overall association < 0.001; P for non-linearity < 0.01
Hierarchical binary logistic regression and restricted cubic spline curves were used to evaluate the association
The non-linear dose-response relationship persisted after stepwise adjustment for confounding variables
Results
Per 1-standard-deviation increment in TyG-BRI, odds ratios for carotid intima-media thickening, carotid plaque, and CAS were each statistically significant and elevated.
OR for carotid intima-media thickening: 1.503 (95% CI 1.281–1.763, P < 0.001)
OR for carotid plaque: 1.453 (95% CI 1.236–1.709, P < 0.001)
OR for CAS overall: 2.247 (95% CI 1.820–2.773, P < 0.001)
Results
The association between TyG-BRI and carotid atherosclerosis was consistent across subgroups but was stronger in participants with BMI < 24 kg/m².
Subgroups were stratified by age, sex, BMI, HbA1c, and hypertension status
In participants with BMI < 24 kg/m², the OR was 4.838 (95% CI 3.007–7.784, P < 0.001)
Associations remained consistent across all other subgroups examined
AUC for TyG-BRI = 0.698 (95% CI 0.664–0.731, P < 0.001)
TyG-BRI outperformed both TyG alone and TyG-BMI in discriminating CAS
TyG-BRI matched the performance of composite indices combining TyG with waist circumference or waist-to-height ratio
What This Means
This research suggests that a measurement called the triglyceride-glucose body roundness index (TyG-BRI) — which combines blood fat levels, blood sugar levels, and a measure of body shape — is meaningfully linked to carotid atherosclerosis (hardening and narrowing of the arteries in the neck) in people with type 2 diabetes. Among 1,060 diabetic adults in China, those with carotid atherosclerosis had notably higher TyG-BRI scores, and each standard-deviation increase in TyG-BRI more than doubled the odds of having carotid atherosclerosis. The relationship was not a simple straight line — it followed a non-linear pattern — suggesting that risk may accelerate at higher TyG-BRI values.
The study also found that TyG-BRI performed better at identifying carotid atherosclerosis than some other commonly used composite metabolic indices (TyG alone and TyG-BMI), achieving an area under the ROC curve of about 0.70. Interestingly, the association appeared even stronger in people with a lower BMI (under 24 kg/m²), suggesting TyG-BRI may capture cardiovascular risk in leaner diabetic individuals who might otherwise be considered lower risk based on body weight alone.
This research suggests that TyG-BRI could be a useful, relatively simple tool for identifying type 2 diabetes patients who may be at higher risk for carotid artery disease before symptoms appear. Because TyG-BRI can be calculated from routine blood tests and basic body measurements, it may have practical value in clinical settings for earlier cardiovascular risk screening — though its role alongside or compared to established clinical tools would need further study in different populations.
Huang C, Tong Y, Luo Y, Xie C. (2026). The association of triglyceride-glucose body roundness index with carotid atherosclerosis in type 2 diabetes: a cross-sectional study.. Frontiers in endocrinology. https://doi.org/10.3389/fendo.2026.1952432