INS and diabetes mellitus: With further adjustment for confounders of age, gender, diabetes duration, systolic pressure, HbA1c, BMI, hypertension, heart rate, logarithmic microalbuminuria, LVEF and insulin therapy, the higher quartile of the TyG index remained an independent risk indicator related to GLS < 18% (Q3 vs Q1: OR 4.52, 95% CI 1.12 to 18.27, P = 0.034; Q4 vs Q1: OR 5.23, 95% CI 1.12 to 24.51, P = 0.036).