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

Abstract

Background: Insulin resistance (IR) evaluation is a fundamental goal in clinical 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. Methods: This is a sub-study of Maracaibo City Metabolic Syndrome 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. Results: The TGI in the general population was 4.6±0.3 (male: 4.66±0.34 vs. female: 4.56±0.33, p=8.93x10 -10). 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). Conclusions: The TGI is a measure of interest to identify IR in the general 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.

Assessment of preferred methods to measure insulin resistance in Asian patients with hypertension

“…Although the first use of the TyG index in evaluating IR is not yet known, it is known to be introduced by South American experts. 21,24,26,28,40 28 Vasques et al (2011) have also showed that the TyG index is more valuable than the HOMA-IR index in assessing IR in Brazil. 25 Er et al (2016) concluded that the triglyceride-glucose-body mass index is a simple and effective method for early assessment of IR.…”

The effect of oral glucose administration before surgery based on Enhanced Recovery After Surgery (ERAS) protocol on preventing insulin resistance and patient's quality of life

“…The measurement results are categorized as insulin resistance if the value is more than 4.49 and is categorized as not insulin resistance if the value is less than/equal to 4.49 according to the study by Salazat et al in 2017. 25,26 In this study, a statistical relationship was found between the administration of glucose orally with the prevention of insulin resistance with a significance of p<0.001. This result is suitable with research conducted by Kobayashi et al…”

Association between the triglyceride-glucose index and arterial stiffness: A meta-analysis

“…In 2 other studies, the sensitivity of the TyG index was 82.6% and 75.9%, and the specificity was 82.1% and 71.9%, respectively. [4,38] These studies suggest that the application of this indicator is useful for assessing IR.…”

“…Previous research has confirmed the validity of the TyG index as a valuable indicator for assessing IR. [38,39] Moreover, the indicator is converted from TG and FBG by formula calculation, whereas the latter 2 indices are routine biochemical tests used in clinical work. The TyG index has considerable cost advantages over conventional IR evaluation models, and biomarkers are Table 2 Results of the sensitivity analysis when the TyG index was applied as a categorical variable.…”