First-Trimester Triglyceride-Glucose Index and Risk of Pregnancy-Related Complications: A Prospective Birth Cohort Study in Southeast China

Abstract

To evaluate the relationships of the triglyceride-glucose (TyG) index with pregnancy-related complications (PRCs) and to clarify the predictability of the TyG index for PRCs. Patients and Methods: Totally of 11,387 women with a singleton pregnancy were prospectively followed until after delivery. Maternal fasting lipids and glucose concentration were measured in the first trimester (11 weeks gestation on average). The TyG index was calculated as ln [triglyceride (mg/dL) × fasting plasma glucose (mg/dL)/2]. We used generalized linear models to calculate the relative risks and 95% confidence intervals. Receiver-operating characteristic curve analysis was employed to assess the ability of the TyG index to predict the risks of PRCs. Results: Smooth spline reveals that the probability of gestational diabetes mellitus (GDM) is intensified with the increasing TyG index. Multivariate logistic regression adjusted for risk factors demonstrates a 1-unit and a 1-SD increment in the TyG index raises the risk of GDM by 3.63 and 1.57 times, respectively. Identically, the risk of GDM maximizes in the TyG quintile 5 (OR: 3.14; 95% CI: 2.55~3.85) relative to the lowest TyG index group. However, no association between TyG index and the risk of other PRCs was observed after full adjustment. The area under receiver operating characteristic curves is 0.647 (95% CI: 0.632-0.66) for GDM, and the optimal predictive cut-off is 8.55, with a specificity of 0.679 and sensitivity of 0.535. Conclusion:The first-trimester TyG index is significantly associated with the risk of incident GDM, while the relationships between the TyG index and other PRCs need further exploration.

Association of triglyceride-glucose index levels with gestational diabetes mellitus in the US pregnant women: a cross-sectional study

“…The TyG index, calculated from fasting plasma glucose (FPG) and serum triglycerides (TG), is considered a straightforward, economical, replicable, and reliable surrogate for IR ( 10 , 11 ). While many studies have investigated the relationship between the TyG index and GDM, suggesting its potential as an early GDM risk indicator ( 12 , 13 ), there may be variations between ethnic groups. For instance, Sánchez-García et al.…”

Triglyceride-glucose index in early pregnancy predicts the risk of gestational diabetes: a prospective cohort study

“…Determining the optimal cutoff value for the TyG index to predict GDM during early pregnancy varies across studies. Li et al [ 15 ] proposed a cutoff value of 8.55 for the TyG index in early pregnancy, with a specificity of 67.9% and a sensitivity of 53.5%. Kim et al [ 17 ] identified an optimal cutoff value of 8.15 for the TyG index 2 years preceding the first delivery, demonstrating a sensitivity of 47.0% and specificity of 68.2%.…”

“…It is widely utilized in clinical settings to assess GDM risk. Various TyG indices have been established to identify women vulnerable to GDM in different regions, including southeastern and northern China [ 15 ], Mexico [ 16 ], Korea [ 17 ], Hungary [ 18 ], and Iran [ 19 ]. However, current studies on pregnant women have several methodological shortcomings, such as reliance on a single sample source, small sample sizes and subgroups, insufficient control of confounding variables, and the absence of universally accepted cutoff values for the TyG index in expectant mothers.…”

Association between lipid profile in early pregnancy and the risk of congenital heart disease in offspring: a prospective cohort study

“…This prospective population-based cohort study was conducted based on the Fujian Birth Cohort Study (FJBCS), which was commenced in 2019 at Fujian Maternal and Child Health Hospital in Fujian, China for exploring the relationship between perinatal exposure and adverse pregnancy outcomes. The method and design details of the FJBCS study have been previously described 13 . Briefly, pregnant women of gestational age ≤ 14 weeks were invited to complete the registration during their first prenatal visit at our hospital.…”

“…In this study, the confounders were collected from self-reported questionnaires (Table S1 ) or physical examination 13 , 17 and defined as follows: (1) Sociodemographic factors: maternal age, ethnicity (Han and ethnic minorities), residence (urban and rural), educational level (12, 12–16 and > 16 years), and monthly income in CNY (4500, 4500–9000 and > 9000 yuan); (2) Obstetric characteristics of this pregnancy: gravidity (0, 1, ≥ 2), assisted reproduction; (3) Health status: body mass index (BMI) and BMI categories (underweight, normal weight, overweight, and obesity), hypertension, medication history (any medication other than non-nutritive substances); (4) Environmental pollution: exposure to air pollution; (5) Lifestyle characteristics: smoking, passive smoking, alcohol consumption; (6) Nutritional supplements: vitamin supplementation, folic acid supplementation, DHA supplementation, cod-liver oil supplementation, and calcium supplementation. For environmental pollution, lifestyle characteristics, and nutritional supplements, the time window of exposure is from the preconception period (within 3 months before conception) to the first trimester of pregnancy (conception to 12 weeks).…”