Mediating effect of TyG index on the association between glucose-lipid metabolism-related dietary pattern and T2DM: a propensity score-matched analysis

Abstract Objective This study aimed to investigate the association of dietary patterns (DPs) with risk of T2DM, emphasizing the intermediary role of HOMA or TyG indices among a Chinese adult population. Research design and methods Directed acyclic graphs combined with propensity score matching were...

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Main Authors: ShuShu Li, Rong Xia, Xing Gong, Chao Wang, Hechun Liu, Huibin Dong, Zhangyao Su, Yucheng Liang, Shoulin Wang, Tao Yang
Format: Article
Language:English
Published: BMC 2025-04-01
Series:BMC Endocrine Disorders
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Online Access:https://doi.org/10.1186/s12902-025-01892-6
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author ShuShu Li
Rong Xia
Xing Gong
Chao Wang
Hechun Liu
Huibin Dong
Zhangyao Su
Yucheng Liang
Shoulin Wang
Tao Yang
author_facet ShuShu Li
Rong Xia
Xing Gong
Chao Wang
Hechun Liu
Huibin Dong
Zhangyao Su
Yucheng Liang
Shoulin Wang
Tao Yang
author_sort ShuShu Li
collection DOAJ
description Abstract Objective This study aimed to investigate the association of dietary patterns (DPs) with risk of T2DM, emphasizing the intermediary role of HOMA or TyG indices among a Chinese adult population. Research design and methods Directed acyclic graphs combined with propensity score matching were used to minimize confounding, resulting in 1330 subjects for final analysis. Principal component analysis and reduced rank regression, applied to eleven food groups. Multivariable logistic regression and restricted cubic spline regression models were used to assess associations between there DPs with prevalent T2DM, as well as insulin resistance and β-cell function (HOMA-TyG). Mediation analyses were conducted to evaluate whether the HOMA-TyG index mediated the relationship between DPs and T2DM. Results The DP1, characterized by high intakes of poultry, meat, and preserved foods, was associated with elevated body mass index, triglycerides, and hemoglobin A1c. Both PCA-DP1(OR Q4VsQ1 = 2.15, 95% CI: 1.53–3.03) and RRR-DP1 (OR Q4VsQ1 = 1.69, 95% CI: 1.82–3.58) were significantly positively correlated with T2DM. RRR-DP1 additionally demonstrated a dose-dependent relationship with HOMA-insulin resistance and TyG. Furthermore, the TyG index mediated approximately 19.51% of the relationship between RRR-DP1 and T2DM. Conclusions These findings indicate that glucose-lipid metabolism-related dietary pattern, notably high in animal fat, exacerbates insulin resistance and heightens T2DM risk. Tailoring dietary interventions to modify this pattern may be an effective strategy for preventing and managing T2DM.
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spelling doaj-art-7e16dba5adbb48caa4a38b009178a4d82025-08-20T03:13:54ZengBMCBMC Endocrine Disorders1472-68232025-04-0125111310.1186/s12902-025-01892-6Mediating effect of TyG index on the association between glucose-lipid metabolism-related dietary pattern and T2DM: a propensity score-matched analysisShuShu Li0Rong Xia1Xing Gong2Chao Wang3Hechun Liu4Huibin Dong5Zhangyao Su6Yucheng Liang7Shoulin Wang8Tao Yang9Department of Endocrinology and Metabolism, The First Affiliated Hospital of Nanjing Medical UniversityKey Lab of Modern Toxicology of Ministry of Education, Center for Global Health, School of Public Health, Nanjing Medical UniversityKey Lab of Modern Toxicology of Ministry of Education, Center for Global Health, School of Public Health, Nanjing Medical UniversityKey Lab of Modern Toxicology of Ministry of Education, Center for Global Health, School of Public Health, Nanjing Medical UniversityDepartment of Endocrinology and Metabolism, The First Affiliated Hospital of Nanjing Medical UniversityChangzhou Center for Disease Control and PreventionDepartment of Endocrinology and Metabolism, The First Affiliated Hospital of Nanjing Medical UniversityDepartment of Endocrinology and Metabolism, The First Affiliated Hospital of Nanjing Medical UniversityKey Lab of Modern Toxicology of Ministry of Education, Center for Global Health, School of Public Health, Nanjing Medical UniversityDepartment of Endocrinology and Metabolism, The First Affiliated Hospital of Nanjing Medical UniversityAbstract Objective This study aimed to investigate the association of dietary patterns (DPs) with risk of T2DM, emphasizing the intermediary role of HOMA or TyG indices among a Chinese adult population. Research design and methods Directed acyclic graphs combined with propensity score matching were used to minimize confounding, resulting in 1330 subjects for final analysis. Principal component analysis and reduced rank regression, applied to eleven food groups. Multivariable logistic regression and restricted cubic spline regression models were used to assess associations between there DPs with prevalent T2DM, as well as insulin resistance and β-cell function (HOMA-TyG). Mediation analyses were conducted to evaluate whether the HOMA-TyG index mediated the relationship between DPs and T2DM. Results The DP1, characterized by high intakes of poultry, meat, and preserved foods, was associated with elevated body mass index, triglycerides, and hemoglobin A1c. Both PCA-DP1(OR Q4VsQ1 = 2.15, 95% CI: 1.53–3.03) and RRR-DP1 (OR Q4VsQ1 = 1.69, 95% CI: 1.82–3.58) were significantly positively correlated with T2DM. RRR-DP1 additionally demonstrated a dose-dependent relationship with HOMA-insulin resistance and TyG. Furthermore, the TyG index mediated approximately 19.51% of the relationship between RRR-DP1 and T2DM. Conclusions These findings indicate that glucose-lipid metabolism-related dietary pattern, notably high in animal fat, exacerbates insulin resistance and heightens T2DM risk. Tailoring dietary interventions to modify this pattern may be an effective strategy for preventing and managing T2DM.https://doi.org/10.1186/s12902-025-01892-6Dietary patternsReduced rank regressionPSMType 2 diabetes mellitus
spellingShingle ShuShu Li
Rong Xia
Xing Gong
Chao Wang
Hechun Liu
Huibin Dong
Zhangyao Su
Yucheng Liang
Shoulin Wang
Tao Yang
Mediating effect of TyG index on the association between glucose-lipid metabolism-related dietary pattern and T2DM: a propensity score-matched analysis
BMC Endocrine Disorders
Dietary patterns
Reduced rank regression
PSM
Type 2 diabetes mellitus
title Mediating effect of TyG index on the association between glucose-lipid metabolism-related dietary pattern and T2DM: a propensity score-matched analysis
title_full Mediating effect of TyG index on the association between glucose-lipid metabolism-related dietary pattern and T2DM: a propensity score-matched analysis
title_fullStr Mediating effect of TyG index on the association between glucose-lipid metabolism-related dietary pattern and T2DM: a propensity score-matched analysis
title_full_unstemmed Mediating effect of TyG index on the association between glucose-lipid metabolism-related dietary pattern and T2DM: a propensity score-matched analysis
title_short Mediating effect of TyG index on the association between glucose-lipid metabolism-related dietary pattern and T2DM: a propensity score-matched analysis
title_sort mediating effect of tyg index on the association between glucose lipid metabolism related dietary pattern and t2dm a propensity score matched analysis
topic Dietary patterns
Reduced rank regression
PSM
Type 2 diabetes mellitus
url https://doi.org/10.1186/s12902-025-01892-6
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