Triglyceride Glucose-Body Mass Index Is a Simple and Clinically Useful Surrogate Marker for Insulin Resistance in Nondiabetic Individuals

Abstract

BackgroundInsulin resistance (IR) and the consequences of compensatory hyperinsulinemia are pathogenic factors for a set of metabolic abnormalities, which contribute to the development of diabetes mellitus and cardiovascular diseases. We compared traditional lipid levels and ratios and combined them with fasting plasma glucose (FPG) levels or adiposity status for determining their efficiency as independent risk factors for IR.MethodsWe enrolled 511 Taiwanese individuals for the analysis. The clinical usefulness of various parameters—such as traditional lipid levels and ratios; visceral adiposity indicators, visceral adiposity index (VAI), and lipid accumulation product (LAP); the product of triglyceride (TG) and FPG (the TyG index); TyG with adiposity status (TyG-body mass index [BMI]) and TyG-waist circumference index [WC]); and adipokine levels and ratios—was analyzed to identify IR.ResultsFor all lipid ratios, the TG/high-density lipoprotein cholesterol (HDL-C) ratio had the highest additional percentage of variation in the homeostasis model assessment of insulin resistance (HOMA-IR; 7.0% in total); for all variables of interest, TyG-BMI and leptin-adiponectin ratio (LAR) were strongly associated with HOMA-IR, with 16.6% and 23.2% of variability, respectively. A logistic regression analysis revealed similar patterns. A receiver operating characteristic (ROC) curve analysis indicated that TG/HDL-C was a more efficient IR discriminator than other lipid variables or ratios. The area under the ROC curve (AUC) for VAI (0.734) and TyG (0.708) was larger than that for TG/HDL-C (0.707). TyG-BMI and LAR had the largest AUC (0.801 and 0.801, respectively).ConclusionTyG-BMI is a simple, powerful, and clinically useful surrogate marker for early identification of IR.

Triglyceride glucose index is an independent predictor for the progression of coronary artery calcification in the absence of heavy coronary artery calcification at baseline

“…Considering that insulin levels are not usually achieved during general health check-up in South Korea, calculating the HOMA-IR to estimate IR is somewhat inconvenient for this population. A number of previous studies identified that the TyG index is closely correlated with the HOMA-IR [9,30]. Moreover, recent data reported that the value of the TyG index predicting IR was better than that of the HOMA-IR [8,31].…”

Adiposity indicators lipid accumulation product and triglyceride-glucose index as alternate criteria for the diagnosis of metabolic obesity in adult

“…This is also in favor of the results of our study. 20 Er et al (2016) found triglyceride-glucose index is simple and clinically useful surrogate marker for insulin resistance in non diabetic individuals. 21 The prevalence of metabolic obesity in total study …”

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

“…In developing countries with economic difficulties in health systems, such as Venezuela, routine measurements of plasma insulin are not easily accessible, which forces the use of other indices based on the role of glucolipotoxicity as a key element in the development of IR 29 . In this way, the TGI has recently been proposed and validated as a useful alternative in clinical settings, and has been well accepted due to the high predictive power observed with respect to other indices 30 .…”

“…Several studies have shown that the TGI better predicts HOMA-IR levels than variables, such as the TAG/HDL index, visceral adiposity index, leptin, Apo-B/Apo-AI, and lipid parameters 29, 30 , representing a very good correspondence with this index 31 , which constitutes an important tool with high validity for the clinician when facing limited access to lab work-ups. However, in view of the wide variability of TAG levels according to the ethnic, sociocultural and genetic characteristics of each population, the need arises to evaluate their epidemiological behavior and establish reference values specific to each region.…”