Optimal cutoff for the evaluation of insulin resistance through triglyceride-glucose index: A cross-sectional study in a Venezuelan population

Abstract

Insulin resistance (IR) evaluation is a fundamental goal in clinical Background: and epidemiological research. However, the most widely used methods are difficult to apply to populations with low incomes. The triglyceride-glucose index (TGI) emerges as an alternative to use in daily clinical practice. Therefore the objective of this study was to determine an optimal cutoff point for the TGI in an adult population from Maracaibo, Venezuela. This is a sub-study of Maracaibo City Metabolic Syndrome Methods: Prevalence Study, a descriptive, cross-sectional study with random and multi-stage sampling. For this analysis, 2004 individuals of both genders ≥18 years old with basal insulin determination and triglycerides < 500 mg/dl were evaluated.. A reference population was selected according to clinical and metabolic criteria to plot ROC Curves specific for gender and age groups to determine the optimal cutoff point according to sensitivity and specificity.The TGI was calculated according to the equation: ln [Fasting triglyceride (mg / dl) x Fasting glucose (mg / dl)] / 2.The TGI in the general population was 4.6±0.3 (male: 4.66±0.34 vs. Results: female: 4.56±0.33, p=8.93x10 ). The optimal cutoff point was 4.49, with a sensitivity of 82.6% and specificity of 82.1% (AUC=0.889, 95% CI: 0.854-0.924). There were no significant differences in the predictive capacity of the index when evaluated according to gender and age groups. Those individuals with TGI≥4.5 had higher HOMA2-IR averages than those with TGI <4.5 (2.48 vs 1.74, respectively, p<0.001).The TGI is a measure of interest to identify IR in the general Conclusions: population. We propose a single cutoff point of 4.5 to classify individuals with IR. Future studies should evaluate the predictive capacity of this index to determine atypical metabolic phenotypes, type 2 diabetes mellitus and even cardiovascular risk in our population.

Association of NAFLD and Insulin Resistance with Non Metastatic Bladder Cancer Patients: A Cross-Sectional Retrospective Study

“…First of all, HOMA-IR is a relatively extensive method (although there is hardly any consensus on the cut-off points) used in research, but the lack of standardised insulin assays has relatively hindered its development [ 32 ]. Anyway, some authors think that the TyG index is not preferable to HOMA-IR [ 33 ], while other authors disagree, considering the TyG a measure of interest to identify IR in the general population [ 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 ].…”

Association Between Triglyceride-Glucose Index (TyG Index) and Type 2 Diabetes Mellitus: A Systematic Review

“…The sensitivity and specificity of the TyG index were high for identifying insulin resistance in Mexico population [27]. A study in China that conducted at nine provinces (Liaoning, Heilongjiang, Jiangsu, Shandon, Henan, Hubei, Hunan, Guangxi, and Guizhou) reported TyG index was effective for predicting insulin resistance [21].…”

The Relationship Between Acne Vulgaris and Insulin Resistance

“…The triglyceride-glucose (TyG) index was calculated as the natural logarithm (Ln) of the product of plasma glucose and triglyceride (TG) using the formula: Ln (TG [mg/dL] × glucose [mg/dL] /2) [ 7 ]. Subjects with an index of 4.49 or greater are likely to suffer from insulin resistance [ 8 ]. C-peptide was measured using the CL-1000i Chemiluminescence Immunoassay System (Mindray, Shenzhen, China), and a value higher than 1.89 ng/ml was the cutoff used for the definition of insulin resistance [ 9 ].…”