Hubungan Triglyceride Glucose Index (Tyg Index) dengan Neuropati Diabetik Perifer (NDP) Berdasarkan Skor Michigan Neuropathy Screening Instrument (Mnsi) pada Diabetes Melitus Tipe 2

Abstract

Background: Type 2 diabetes mellitus (T2DM) is one of the most common metabolic disorders worldwide and a major cause of morbidity and mortality due to chronic complications, including peripheral diabetic neuropathy (PDN). Peripheral diabetic neuropathy results from chronic hyperglycemia and metabolic abnormalities that trigger oxidative stress, inflammation, and endothelial dysfunction. One of the practical indicators of insulin resistance is the Triglyceride Glucose Index (TyG Index), a mathematical combination of fasting glucose and triglyceride levels. However, the relationship between the TyG Index and PDN remains controversial and has not been studied in Indonesia, particularly in Medan. Objective: To analyze the relationship between the Triglyceride Glucose Index (TyG Index) and peripheral diabetic neuropathy based on the Michigan Neuropathy Screening Instrument (MNSI) score among patients with type 2 diabetes mellitus. Methods: This was a descriptive analytic study with a cross-sectional design. A total of 90 patients with T2DM who met the inclusion criteria were recruited from the inpatient and outpatient units of the Endocrine, Metabolic, and Diabetes Clinic, Adam Malik Hospital, Medan. Data were obtained through structured interviews, anthropometric measurements, laboratory tests (fasting glucose, triglycerides, HbA1C), and neuropathy assessment using the MNSI. Statistical analysis included independent t-test, Mann–Whitney U test, and Pearson/Spearman correlation tests, with a significance level of p<0.05. Results: The mean TyG Index was higher in T2DM patients with PDN compared to those without PDN. There was a significant positive correlation between TyG Index and MNSI score (p<0.05). Receiver Operating Characteristic (ROC) analysis demonstrated that the TyG Index had predictive value for PDN occurrence in T2DM patients. Conclusion: This study found that the Triglyceride Glucose Index (TyG Index) was not significantly associated with peripheral diabetic neuropathy (PDN) in patients with type 2 diabetes mellitus. The factors most strongly associated with PDN were longer diabetes duration and higher HbA1C levels, while anthropometric parameters, lipid profiles, and TyG Index showed no significant relationships. Thus, the TyG Index cannot be used as a single predictor for assessing PDN risk, whereas HbA1C and diabetes duration remain more reliable clinical indicators for predicting the occurrence of peripheral diabetic neuropathy in patients with type 2 diabetes mellitus. x Keywords: Type 2 Diabetes Mellitus, Triglyceride Glucose Index, Peripheral Diabetic Neuropathy, Michigan Neuropathy Screening Instrument (MNSI)