Triglyceride and glucose index and the risk of gestational diabetes mellitus: A nationwide population-based cohort study

Kim, Jung A; Kim, Jinsil; Roh, Eun; Hong, Seunghun; Lee, You-Bin; Baik, Sei Hyun; Choi, Kyung Mook; Noh, Eunjin; Hwang, Soon Young; Cho, Geum Joon; Yoo, Hye Jin

doi:10.1016/j.diabres.2020.108533

Cited by 28 publications

(27 citation statements)

References 32 publications

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“…TG/HDL-C and TyG have been proposed as simple clinical indicators of insulin resistance and previous studies found its potential clinical utility for predicting GDM. 18 , 36 To further investigate the clinical value of HSI, we examined the predictive ability of HSI for GDM and compared it with the above indices. In this cohort study, HSI in first trimester appeared relatively higher predictive ability for GDM compared with other indices, although there was no statistical significance.…”

Section: Discussionmentioning

confidence: 99%

The Predictive Ability of Hepatic Steatosis Index for Gestational Diabetes Mellitus and Large for Gestational Age Infant Compared with Other Noninvasive Indices Among Chinese Pregnancies: A Preliminary Double-center Cohort Study

Song¹,

Duo²,

Zhang³

et al. 2021

DMSO

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Objective To evaluate the association of hepatic steatosis index (HSI) in the first trimester and the risk of gestational diabetes mellitus (GDM) as well as large for gestational age (LGA) infant in Chinese women. Methods A total of 1082 pregnant women were included in this study. Maternal basic laboratory data, including ALT, AST, FBG, insulin, TG, and HDL-C, were tested during 6–12 weeks of gestation and anthropometric characteristics were monitored during gestation. A 75-g oral glucose tolerance test (OGTT) was conducted at 24–28 weeks of gestation. HSI, nonalcoholic fatty liver disease (NAFLD) liver fat score, triglyceride/high-density lipoprotein cholesterol (TG/HDL-C) and triglyceride-glucose (TyG) index were calculated. Odds ratio with 95% confidence interval for subsequent risk of GDM and LGA by HSI quartiles were assessed by binary logistic regression model. The predictive ability of HSI for GDM and LGA was evaluated by the receiver operating characteristic (ROC) curve analysis and was compared with other indices. Results The incidence of GDM and LGA were 22.09% (239/1082) and 10.53% (87/826). HSI was higher in GDM group than in NGT group (median, interquartile range: 30.67, 27.20–35.10 vs 27.98, 25.70–30.82, P <0.001). Incidence of GDM was gradually increased with increasing HSI values. Women in the highest HSI quartile had significantly higher risk of LGA delivery than those in the lowest HSI quartile ( P <0.05). The area under the ROC curves of HSI for GDM and LGA were higher than other indices, reaching 0.646 (95%CI: 0.605–0.686) and 0.600 (95%CI: 0.541–0.660), respectively. Conclusion Higher HSI was independently associated with higher risk of GDM and LGA in Chinese women. HSI in the first trimester can predict the risk of GDM and LGA.

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Section: Discussionmentioning

confidence: 99%

The Predictive Ability of Hepatic Steatosis Index for Gestational Diabetes Mellitus and Large for Gestational Age Infant Compared with Other Noninvasive Indices Among Chinese Pregnancies: A Preliminary Double-center Cohort Study

Song¹,

Duo²,

Zhang³

et al. 2021

DMSO

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“…However, results from existing studies on the performance of TyG index in predicting GDM are inconsistent. Some studies showed a correlation between TyG index and GDM ( 19 , 20 , 21 , 22 ), whereas others suggested there was no such correlation ( 23 ). These studies are limited in statistical power because of small study samples.…”

Section: Introductionmentioning

confidence: 99%

Triglyceride glycemic index as a biomarker for gestational diabetes mellitus: a systemic review and meta-analysis

Liu

Chi

Jiang

et al. 2021

Endocrine Connections

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Background: Triglyceride glycemic (TyG) index is a novel tool for assessing insulin resistance (IR). Recently, TyG index as a potential biomarker for gestational diabetes mellitus (GDM) has been studied, but its performance is yet inconclusive. Thus, we performed this systemic review and meta-analysis to evaluate the performance of TyG index in predicting GDM. Methods: Studies published before March 1st, 2021 with comparison of TyG index between GDM patients and healthy controls were retrieved from multiple databases (PubMed, Web of Science, The Cochrane Library and Embase). The mean difference (MD) of TyG index in GDM patients and healthy controls were pooled using random-effect models. Results: Differentiation of TyG index between patients with GDM and controls showed significant results. Overall, there is a four-fold increase in TyG index in GDM patients compared with controls (MD: 0.22, 95%CI: 0.07 - 0.36, p = 0.003; I2 = 71%, p = 0.009). In subgroup analyses according to gestational time, TyG index in the second trimester predicted GDM with low heterogeneity (MD: 0.26, 95%CI: 0.15 - 0.37, p < 0.001; I2 = 0%, p = 0.54), while no such correlation was found in the first trimester. Conclusion: TyG index, especially in the second trimester, could be a promising biomarker for predicting GDM.

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“…The TyG index, which can be easily obtained and calculated in clinical practice or large-scale epidemiologic investigations, 12,17 may be used to assess the risks of PRCs. Indeed, several descriptions of the TyG index are available for recognizing women susceptible to GDM in China, 18,19 Korea, 20 Iran, 21 and Mexico. 22 However, the associations of the TyG index with PRCs beyond GDM have not yet been widely validated in China.…”

Section: Introductionmentioning

confidence: 99%

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

Li¹,

Miao²,

Liu³

et al. 2022

DMSO

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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.

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Triglyceride and glucose index and the risk of gestational diabetes mellitus: A nationwide population-based cohort study

Cited by 28 publications

References 32 publications

The Predictive Ability of Hepatic Steatosis Index for Gestational Diabetes Mellitus and Large for Gestational Age Infant Compared with Other Noninvasive Indices Among Chinese Pregnancies: A Preliminary Double-center Cohort Study

The Predictive Ability of Hepatic Steatosis Index for Gestational Diabetes Mellitus and Large for Gestational Age Infant Compared with Other Noninvasive Indices Among Chinese Pregnancies: A Preliminary Double-center Cohort Study

Triglyceride glycemic index as a biomarker for gestational diabetes mellitus: a systemic review and meta-analysis

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

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