Predictive performance of triglyceride glucose index (TyG index) to identify glucose status conversion: a 5-year longitudinal cohort study in Chinese pre-diabetes people

Abstract

Objective Triglyceride glucose index (TyG index) has been recommended as an alternative indicator of insulin resistance. However, the association between TyG and regression from prediabetes to normoglycemia remains to be elucidated. Methods This retrospective cohort study involved 25,248 subjects with prediabetes at baseline conducted from 2010 to 2016. A Cox proportional hazard regression model was designed to evaluate the role of TyG in identifying people at converting from prediabetes to normoglycemia. Cox proportional hazards regression with cubic spline functions and smooth curve fitting was used to dig out the nonlinear relationship between them. Detailed evaluations for TyG were also performed using sensitivity and subgroup analyse. Results Among the included prediabetes subjects (n = 25,248), the mean age was 49.27 ± 13.84 years old, and 16,701 (66.15%) were male. The mean TyG was 8.83 ± 0.60. The median follow-up time was 2.96 ± 0.90 years. 11,499 (45.54%) individuals had a final diagnosis of normoglycemia. After adjusting for covariates, TyG was negatively affecting the results of glucose status conversion in prediabetes people (HR 0.895, 95% CI 0.863, 0.928). There was a nonlinear connection between TyG and normoglycemia in prediabetes people, and the inflection point was 8.88. The effect sizes (HR) on the left and right sides of the inflection point were 0.99 (0.93, 1.05) and 0.79 (0.74, 0.85), respectively. Sensitivity analysis confirmed the robustness of these results. Subgroup analysis showed that TyG was more strongly associated with incident glucose status conversion in male, BMI ≥ 25. In contrast, there was a weaker relationship in those with female, BMI < 25. Conclusion Based on sample of subjects evaluated between 2010 and 2016, TyG index appears to be a promising marker for predicting normoglycemic conversion among prediabetes people in China. This study demonstrates a negative and non-linear association between TyG and glucose status conversion from prediabetes to normoglycemia. TyG is strongly related to glucose status conversion when TyG is above 8.88. From a therapeutic point of view, it is meaningful to maintain TyG levels within the inflection point to 8.88.

Normal triglyceride concentration and the risk of diabetes mellitus type 2 in the general population of China

“…Increasing evidence suggests that triglycerides, when combined with other indicators, serve as independent predictive factors for the risk of developing T2DM. A longitudinal study spanning 5 years and comprising 25,248 participants from China discovered that the triglyceride-glucose index (TyG index) shows potential as a reliable marker for forecasting the transition from normal blood sugar levels to prediabetes among the Chinese population ( 16 ). In a 13-year cohort study conducted in Japan with a participant pool of 15,464 individuals, multivariate Cox regression analysis revealed the triglyceride-glucose BMI index (TyG-BMI) as an autonomous prognosticator for the initiation of T2DM ( 10 ).…”

Association between triglyceride glucose-waist to height ratio and coronary heart disease: a population-based study

“…It is substantially correlated with carotid atherosclerosis, even after controlling for conventional cardiovascular risk factors [ 11 ]. In individuals with type 2 diabetes, Chen et al recently noted an independent correlation between the TyG index and severe coronary artery stenosis [ 12 ]. The TyG index is linked to an increased risk of cardiovascular disease, atherosclerosis, and coronary artery calcification [ 10 , 13 ].…”