The triglyceride-glucose index as an indicator of insulin resistance and cardiometabolic risk in Brazilian adolescents

Abstract

Objective: To set cutoff points for the triglyceride and glucose index (TyG) as a marker of insulin resistance (IR) for the pediatric population. Subjects and methods: This was a cross-sectional study with schoolchildren population-based data using data of 377 schoolchildren age 10 to 17 years of both sexes. We studied metabolic variables associated with IR indicators, such as fasting insulin and blood glucose, to calculate the homeostatic model assessment (HOMA-IR), and we studied triglycerides (TG) to determine the TyG index. We obtained TyG cutoff values for IR using the receiver operation characteristic (ROC), with definitions of sensitivity (Sen), specificity (Spe), and area under the ROC curve (AUC), with the HOMA-IR as reference. Results: The cutoff points of the TyG index for IR in adolescents are 7.94 for both sexes, 7.91 for boys, and 7.94 for girls, indicating moderate discriminatory power. When we also considered anthropometric variables of excess weight [TyG-BMI (body mass index)] and visceral fat [TyG-WC (waist circumference)], these indexes reached AUC values higher than 0.72, enhancing their potential use for a good diagnosis. Conclusion: TyG has proven to be a useful instrument for identifying IR in adolescent health screening, with high discrimination capacity when added to anthropometric variables, making it a feasible and inexpensive option.

Cardiometabolic Risk Assessment in a Cohort of Children and Adolescents Diagnosed with Hyperinsulinemia

“…The exclusion criteria of our study were as follows: Diagnosis of diabetes mellitus, defined as glycated hemoglobin ≥ 6.5% OR fasting plasma glucose ≥ 126 mg/dL OR glucose ≥ 200 mg/dL during an OGTT, OR random glucose ≥ 200 mg/dL in a patient with classic diabetic symptoms, like polyuria and/or polydipsia [ 7 ]. Coded diagnosis of metabolic syndrome (obesity with waist circumference > 90th percentile and two risk factors among blood pressure ≥ 130/85 mm Hg , HDL ≤ 40 mg/dL, triglycerides ≥ 150 mg/dL, or fasting glucose ≥ 100 mg/dL [ 4 ].…”

“…Diagnosis of diabetes mellitus, defined as glycated hemoglobin ≥ 6.5% OR fasting plasma glucose ≥ 126 mg/dL OR glucose ≥ 200 mg/dL during an OGTT, OR random glucose ≥ 200 mg/dL in a patient with classic diabetic symptoms, like polyuria and/or polydipsia [ 7 ].…”

“…Over time, cardiovascular risk indices have therefore been developed based on the combination of multiple auxological parameters, laboratory markers, or a combination of both. An alteration of these indirect indices has been statistically associated with both hyperinsulinemia and risk of developing metabolic syndrome [ 7 ]. However, the majority of studies pertains to adult patients, while there are limited data referred to the pediatric population.…”