Furthermore, after adjusting for sex, age of DM onset, duration of diabetes, hyperlipidemia, treatment of lipid-lowering drugs, smoking status, insulin treatment, HF, eGFR, MAP, BMI, anemia, urinary protein, LDL, and HbA1c, the HR for ESRD in participants with a baseline TyG index ≥ 9.5 was 2.03 (95% CI 1.31-3.14) compared to participants with a baseline TyG index < 9.5. Here, INS is linked to hyperlipidemia.