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

Abstract

ObjectiveThis investigation aimed to assess the correlation between the triglyceride-glucose (TyG) index and gestational diabetes mellitus (GDM) in pregnant women in the United States.MethodsWe calculated the TyG index utilizing data from pregnant women who participated in the National Health and Nutrition Examination Survey (NHANES) through 1999 to March 2020, and then employed multivariate logistic regression, smoothed curve fitting, and subgroup analysis to investigate the association between the TyG index and gestational diabetes during pregnancy.ResultsLogistic regression models revealed a positive association between the TyG index and GDM, remaining significant even after adjusting for all confounding variables (OR=3.43, 95% CI: 1.20-9.85, P = 0.0216). Subgroup analysis demonstrated consistent correlations and showed that there is no difference in the TyG index among first trimester subgroup. The TyG index had limited diagnostic efficacy for GDM (AUC=0.57, 95% CI: 0.50-0.63).ConclusionThe TyG index correlates positively with the GDM, however its diagnostic efficacy is limited. Further research on the TyG index as an early predictor of GDM is required.

Relationships between triglyceride-glucose index and incident gestational diabetes mellitus: a prospective cohort study of a Korean population using publicly available data

“…Notably, a 12-fold increase in the likelihood of getting GDM is associated with each unit rise in the TyG index. Our findings revealed a higher diagnostic efficiency with an AUC of 0.807 (95%CI: 0.734–0.879) for the TyG index in predicting GDM, which is significantly superior to the AUC values reported in similar studies, ranging from 0.57 to 0.69 ( 25 , 26 , 35 ). These similar studies rely on FPG, a one-step 75 g OGTT, or self-reported diagnosis of GDM.…”

“…Compared to TG, HDL-C, TG/HDL-C ratio, TC, LDL-C, FPG, insulin, and HOMA-IR, the AUC of the TyG index for predicting DM was the highest. (35). In the current study, the TyG index demonstrated robust predictive capability for GDM, with an AUC of 80.7% and an optimal predictive cutoff value of around 8.632.…”

“…The predictive capacity of the TyG index for GDM or T2DM has been extensively investigated, with consistent threshold values found across various studies ( 24–26 , 35 , 38 , 39 ). Notably, Wang et al ( 38 ) conducted a 15-year prospective study in Chinese adults, revealing a threshold of around 8.51 for the TyG index’s impact on incident T2DM risk.…”

“…Similarly, Sanchez-Garcia et al ( 39 ) identified a relatively low cutoff value of 4.69 (specificity 50%, sensitivity 89.0%). In addition, Zeng Y et al found limited diagnostic efficacy of the TyG index for GDM (AUC = 0.57, 95% CI: 0.50–0.63) ( 35 ). In the current study, the TyG index demonstrated robust predictive capability for GDM, with an AUC of 80.7% and an optimal predictive cutoff value of around 8.632.…”

“…Secondly, high triglyceride levels, as part of the TyG index, suggest a disturbance in lipid metabolism as a consequence of hyperglycemia. This dyslipidemia can lead to an accumulation of fatty acids in tissues such as muscle and liver, which can interfere with insulin signaling and exacerbate insulin resistance, thereby increasing the risk of GDM ( 35 ). Furthermore, FPG levels reflect insulin sensitivity of the liver and insulin secretion by pancreatic β-cells, which are key factors in the pathogenesis of GDM ( 2 , 32 ).…”