Impacts of Triglyceride Glucose-Waist to Height Ratio on Diabetes Incidence: A Secondary Analysis of A Population-Based Longitudinal Data

Abstract

BackgroundThe anthropometric indices (body mass index [BMI], waist circumference [WC] and waist-to-height ratio [WHtR]), triglyceride-glucose (TyG) index and TyG-related indicators (TyG-WHtR, TyG-BMI, TyG-WC) have been well documented to be highly correlated with insulin resistance (IR) and type 2 diabetes mellitus (T2DM). However, it was not immediately obvious which indicator would be optimal for screening people at risk of T2DM. Hence, this study intended to compare the predictive effects of the aforementioned markers on T2DM and to investigate the relation between baseline TyG-WHtR and incident T2DM.MethodsThis longitudinal study included 15464 study population who were involved in the NAGALA (NAfld in the Gifu Area Longitudinal Analysis) study from 2004 to 2015. The TyG index was defined as ln [FPG (mg/dL) ×fasting TG (mg/dL)/2]. And the TyG-WHtR was calculated as TyG index ×WHtR. We divided the participants into four groups according to the TyG-WHtR quartiles. The primary endpoint was the incidence of diabetes.ResultsAfter a median follow-up of 5.4 years, 2.4% (373/15464) participants developed diabetes. The incidence of diabetes increased with ascending TyG-WHtR quartiles (P for trend<0.001). Multivariable Cox proportional hazard analysis showed that a one-unit increase in TyG-WHtR was independently correlated with a 2.714-fold higher risk of diabetes [hazard ratio (HR) 2.714, 95% confidence interval (CI) 1.942-3.793; P<0.001). Stratification analysis revealed that increased TyG-WHtR (per 1-unit) was consistently correlated with diabetes incidence in different subgroups. Moreover, TyG-WHtR outperformed the other parameters by presenting the biggest area under the ROC curve (AUC) in men (AUC 0.746, 95% CI 0.716-0.776, P<0.001). However, all pairwise comparisons of AUC between TyG-WHtR and other indicators were not statistically different except TyG-WHtR vs. WHtR in women.ConclusionsA high TyG-WHtR is an important predictor of the increased cumulative risk of diabetes development. TyG-WHtR outperforms TyG, WHtR, TyG-WC and TyG-BMI in screening individuals who are susceptible to T2DM, especially in men.

High triglyceride glucose-body mass index correlates with prehypertension and hypertension in east Asian populations: A population-based retrospective study

“…Therefore, a number of simple, inexpensive and reproducible alternative parameters have emerged, which have been shown to replace HEC for IR. These parameters include the ratios of triglycerides and specific components of cholesterol, TyG and TyG-related parameters, metabolic score for insulin resistance (METS-IR), visceral adiposity index (VAI) and lipid accumulation product (LAP), whose association with IR has been explored (16, 30, 31) and compared in the prediction of some specific diseases (32)(33)(34)(35)(36).…”

The triglyceride glucose-waist-to-height ratio outperforms obesity and other triglyceride-related parameters in detecting prediabetes in normal-weight Qatari adults: A cross-sectional study

“…However, no evidence has been published regarding the relationship between TyG-WHTR and prediabetes in normal-weight individuals. However, in recently published studies, TyG-WHTR exceeded the commonly used anthropometric markers in predicting diabetes ( 45 , 46 ).…”

“…However, no evidence has been published regarding the relationship between TyG-WHTR and prediabetes in normal-weight individuals. However, in recently published studies, TyG-WHTR exceeded the commonly used anthropometric markers in predicting diabetes (45,46). The TyG-WHTR index's capacity to detect prediabetes was contrasted with FPG's to determine whether it could be a useful screening tool.…”

The U-Shape Relationship between Triglyceride-Glucose Index and the Risk of Diabetic Retinopathy among the US Population

“…What is more, obesity is commonly acknowledged to trigger or worsen the presence of insulin resistance [ 12 ]. Several studies have evaluated that TyG-related parameters are more effective than the isolated TyG index [ 13 ], such as TyG combined with body mass index (TyG-BMI), TyG combined with waist circumference (TyG-WC) and TyG combined with waist-height ratio (TyG-WHtR). However, the effect of applying the TyG index and TyG-related parameters to predict the risk of diabetic retinopathy in diabetes patients is still unclear.…”