Triglyceride-Glucose Index in the Prediction of Prediabetes
DOI:
https://doi.org/10.37135/ee.04.25.02Palabras clave:
Triglycerides, Blood Glucose, Diabetes Mellitus, Prediabetic State, Insulin ResistanceResumen
Prediabetes is a metabolic disorder characterized by insulin resistance long before the diagnosis of type 2 diabetes mellitus (T2DM) and represents a key opportunity for intervention and prevention of T2DM. The triglyceride-glucose index (TGI) has been identified as an accessible marker of insulin resistance with potential diagnostic value. This study aimed to evaluate the diagnostic accuracy of the TGI in predicting prediabetic status in nondiabetic adults. A case-control study was conducted using retrospective data from 663 nondiabetic adults treated at an outpatient care center in Guayaquil between 2019 and 2023. 221 cases with Prediabetes and 442 controls matched for age and sex were selected. Nonparametric tests, binary logistic regression, and ROC curve analysis were applied. TGI was significantly associated with OR: 2.83 [95 % CI 1.94–4.14]. A TGI cutoff point ≥8.54 had a sensitivity of 75.1%, specificity of 58.1%, and negative predictive value of 0.82. The combination of TGI with overweight/obesity and albumin levels <4.15 g/dL improved specificity to 86.7%. Low albumin and being overweight were also independently associated with an increased risk of Prediabetes. The TGI demonstrated adequate diagnostic capacity in detecting Prediabetes, making it a valuable and cost-effective marker for T2DM screening. Its combination with other variables improves diagnostic accuracy, and future validations were planned to expand its clinical application
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Lahsen M. Rodolfo. Sindrome metabólico y diabetes. Revista Médica Clínica Las Condes. 2014; [cited May 15, 2025]; 25(1): 47–52. Available at: https://doi.org/10.1016/S0716-8640(14)70010-0
Civeira-Murillo F, Pérez-Ruiz MR, Baila-Rueda L. Síndrome metabólico: concepto, epidemiología, etiopatogenia y complicaciones. Medicine. 2013; [cited May 15, 2025];11(40): 2402–2409. Available at: https://doi.org/10.1016/S0304-5412(13)70637-1
Puchulu FM. Definition, Diagnosis and Classification of Diabetes Mellitus. In: Cohen Sabban EN, Puchulu FM, Cusi K (eds) Dermatology and Diabetes. Cham: Springer International Publishing; 2018; [cited May 15, 2025]; p. 7–18. Available at: https://doi.org/10.1007/978-3-319-72475-1_2 [Accessed 17th June 2024].
Organización Mundial de la Salud (OMS). Las diez causas principales de defunción. Available at: https://www.who.int/es/news-room/fact-sheets/detail/the-top-10-causes-of-death [Accessed 9th April 2025].
Instituto Nacional de Estadística y Censos. Registro Estadístico de Defunciones Generales. Instituto nacional de estadística y censos (INEC), 2024 Sept. Available at: https://www.ecuadorencifras.gob.ec/defunciones-generales/
Zavala Calahorrano AM, Fernández E. Diabetes mellitus tipo 2 en el Ecuador: revisión epidemiológica. Mediciencias UTA. 2018; [cited May 18, 2025]; 2(4): 3–3. Available at: https://doi.org/10.31243/mdc.uta.v2i4.132.2018
Flores JXD, Morán EEM, Gaytán ÁMM, Martinez JLT. La diabetes mellitus y diabetes gestacional, en adolescente, en el mundo y en el Ecuador, manejo, prevención, tratamiento y mortalidad. Recimundo. 2023; [cited May 18, 2025]; 7(2): 33–48. Available at: https://doi.org/10.26820/recimundo/7.(2).jun.2023.33-48
García Matamoros WF. Sedentarismo en niños y adolescentes: Factor de riesgo en aumento. Recimundo. 2019; [cited May 20, 2025]; 3(1): 1602–1624. Available at: https://doi.org/10.26820/recimundo/3.(1).enero.2019.1602-1624
Vasconcellos MB, Matta IEA da MP, Santana DD, Veiga GV da. Mudanças na obesidade, comportamento sedentário e inatividade física, entre 2010 e 2017, em adolescentes. Journal of Physical Education. 2021; [cited May 20, 2025]; 32(1): e-3280. Available at: https://doi.org/10.4025/jphyseduc.v32i1.3280
Guthold R, Stevens GA, Riley LM, Bull FC. Global trends in insufficient physical activity among adolescents: a pooled analysis of 298 population-based surveys with 1·6 million participants. The Lancet Child & Adolescent Health. 2020; [cited May 23, 2025]; 4(1): 23–35. Available at: https://doi.org/10.1016/S2352-4642(19)30323-2
Galicia-Garcia U, Benito-Vicente A, Jebari S, Larrea-Sebal A, Siddiqi H, Uribe KB, et al. Pathophysiology of Type 2 Diabetes Mellitus. International Journal of Molecular Sciences. 2020; [cited May 23, 2054]; 21(17): 6275. Available at: https://doi.org/10.3390/ijms21176275
Lee SH, Park SY, Choi CS. Insulin Resistance: From Mechanisms to Therapeutic Strategies. Diabetes & Metabolism Journal. 2021; [cited May 26, 2025]; 46(1): 15–37. Available at: https://doi.org/10.4093/dmj.2021.0280
American Diabetes Association Professional Practice Committee. 2. Diagnosis and Classification of Diabetes: Standards of Care in Diabetes—2024. Diabetes Care. 2023; [cited May 30, 2025]; 47(Supplement_1): S20–S42. Available at: https://doi.org/10.2337/dc24-S002
Pan American Health Organization (PAHO/WHO). Prevalence of diabetes and diabetes treatment coverage. Available at: https://www.paho.org/en/enlace/prevalence-diabetes-and-diabetes-treatment-coverage [Accessed 14th April 2025].
Zhou B, Rayner AW, Gregg EW, Sheffer KE, Carrillo-Larco RM, Bennett JE, et al. Worldwide trends in diabetes prevalence and treatment from 1990 to 2022: a pooled analysis of 1108 population-representative studies with 141 million participants. The Lancet. 2024; [cited May 30, 2025]; 404(10467): 2077–2093. Available at: https://doi.org/10.1016/S0140-6736(24)02317-1
Park PH, Pastakia SD. Access to Hemoglobin A1c in Rural Africa: A Difficult Reality with Severe Consequences. Journal of Diabetes Research. 2018; [cited Jun 06, 2025]; 2018(1): 6093595. Available at: https://doi.org/10.1155/2018/6093595
Unger G, Benozzi SF, Perruzza F, Pennacchiotti GL. Índice triglicéridos y glucosa: Un indicador útil de insulinorresistencia. Endocrinologia y Nutricion. 2014; [cited Jun 06, 2025]; 61(10): 533–540. Available at: https://doi.org/10.1016/j.endonu.2014.06.009
Navarro-González D. El Índice Trigliceridos-Glucosa como predictor de Diabetes tipo 2 y su relación con el Estado Metabólico y la Obesidad. [Tesis doctoral] [Pamplona, España]: Universidad de Navarra; 2016. Available at: https://dialnet.unirioja.es/servlet/tesis?codigo=246480
Campos Muñiz C, León-García PE, Serrato Diaz A, Hernández-Pérez E. Diabetes mellitus prediction based on the triglyceride and glucose index. Medicina Clinica. 2022; [cited Jun 06, 2025]; 160(6): 231–236. Available at: https://doi.org/10.1016/j.medcli.2022.07.003
Guerrero-Romero F, Simental-Mendía LE, González-Ortiz M, Martínez-Abundis E, Ramos-Zavala MG, Hernández-González SO, et al. The Product of Triglycerides and Glucose, a Simple Measure of Insulin Sensitivity. Comparison with the Euglycemic-Hyperinsulinemic Clamp. The Journal of Clinical Endocrinology & Metabolism. 2010; [cited Jun 06, 2025]; 95(7): 3347–3351. Available at: https://doi.org/10.1210/jc.2010-0288
Calcaterra V, Montalbano C, De Silvestri A, Pelizzo G, Regalbuto C, Paganelli V, et al. Triglyceride Glucose Index as a Surrogate Measure of Insulin Sensitivity in a Caucasian Pediatric Population. Journal of clinical research in pediatric endocrinology. 2022; [cited July 06, 2025]; 0–0. Available at: https://doi.org/10.4274/jcrpe.galenos.2019.2019.0024
Babic N, Valjevac A, Zaciragic A, Avdagic N, Zukic S, Hasic S. The Triglyceride/HDL Ratio and Triglyceride Glucose Index as Predictors of Glycemic Control in Patients with Diabetes Mellitus Type 2. Medical archives (Sarajevo, Bosnia and Herzegovina). 2019; [cited July 06, 2025]; 73(3): 163–168. Available at: https://doi.org/10.5455/medarh.2019.73.163-168
Muhammad IF, Bao X, Nilsson PM, Zaigham S. Triglyceride-glucose (TyG) index is a predictor of arterial stiffness, incidence of diabetes, cardiovascular disease, and all-cause and cardiovascular mortality: A longitudinal two-cohort analysis. Frontiers in Cardiovascular Medicine. 2023; [cited July 06, 2025]; 9. Available at: https://doi.org/10.3389/fcvm.2022.1035105
Li HF, Miao X, Li Y. The Triglyceride Glucose (TyG) Index as a Sensible Marker for Identifying Insulin Resistance and Predicting Diabetic Kidney Disease. Medical Science Monitor. 2023; [cited July 06, 2025]; 29: 0–0. Available at: https://doi.org/10.12659/MSM.939482
Hameed EK, Al-Ameri LT, Hasan HS, Abdulqahar ZH. The Cut-off Values of Triglycerides - Glucose Index for Metabolic Syndrome Associated with Type 2 Diabetes Mellitus. Baghdad Science Journal. 2022; [cited July 08, 2025];19(2): 0340–0340. Available at: https://doi.org/10.21123/bsj.2022.19.2.0340
Yoon JS, Lee HJ, Jeong HR, Shim YS, Kang MJ, Hwang IT. Triglyceride glucose index is superior biomarker for predicting type 2 diabetes mellitus in children and adolescents. Endocrine Journal. 2022; [cited July 08, 2025]; 69(5): 559–565. Available at: https://doi.org/10.1507/endocrj.EJ21-0560
Sánchez-García A, Rodríguez-Gutiérrez R, Mancillas-Adame L, González-Nava V, Díaz González-Colmenero A, Solis RC, et al. Diagnostic Accuracy of the Triglyceride and Glucose Index for Insulin Resistance: A Systematic Review. International Journal of Endocrinology. 2020; [cited July 08, 2025]; 2020. Available at: https://doi.org/10.1155/2020/4678526
Chen X, Liu D, He W, Hu H, Wang W. Predictive performance of triglyceride glucose index (TyG index) to identify glucose status conversion: a 5-year longitudinal cohort study in Chinese pre-diabetes people. Journal of Translational Medicine. 2023; [cited July 08, 2025]; 21(1): 624. Available at: https://doi.org/10.1186/s12967-023-04402-1
Yang H, Kuang M, Qiu J, He S, Yu C, Sheng G, et al. Relative importance of triglyceride glucose index combined with body mass index in predicting recovery from prediabetic state to normal fasting glucose: a cohort analysis based on a Chinese physical examination population. Lipids in Health and Disease. 2024; [cited July 08, 2025]; 23(1): 71. Available at: https://doi.org/10.1186/s12944-024-02060-w
Suleiman RR, Salih SF, Abdullah BI, Ibrahim IH, Saeed ZA. Triglyceride Glucose Index, its Modified Indices, and Triglyceride HDL-C Ratio as Predictor Markers of Insulin Resistance in Prediabetic Individuals. Medical Journal of Babylon. 2023; [cited July 08, 2025]; 20(2): 268. Available at: https://doi.org/10.4103/MJBL.MJBL_269_22
Wen J, Wang A, Liu G, Wang M, Zuo Y, Li W, et al. Elevated triglyceride-glucose (TyG) index predicts incidence of Prediabetes: a prospective cohort study in China. Lipids in Health and Disease. 2020; [cited July 08, 2025]; 19: 226. Available at: https://doi.org/10.1186/s12944-020-01401-9
Cao C, Han Y, Deng H, Zhang X, Hu H, Zha F, et al. Non-linear connection between the triglyceride–glucose index and prediabetes risk among Chinese adults: a secondary retrospective cohort study. European Journal of Medical Research. 2024; [cited July 08, 2025]; 29(1): 529. Available at: https://doi.org/10.1186/s40001-024-02121-x
Shan Y, Liu Q, Gao T. Triglyceride-glucose index in predicting the risk of new-onset diabetes in the general population aged 45 years and older: a national prospective cohort study. BMC Endocrine Disorders. 2025; [cited July 08, 2025]; 25(1): 25. Available at: https://doi.org/10.1186/s12902-025-01848-w
Rothberg A, Lean M, Laferrère B. Remission of type 2 diabetes: always more questions, but enough answers for action. Diabetologia. 2024; [cited July 08, 2025]; 67(4): 602–610. Available at: https://doi.org/10.1007/s00125-023-06069-1
Lima LMTR. Insulin resistance underlying type 2 diabetes. The Lancet Diabetes & Endocrinology. 2019; [cited July 08, 2025]; 7(6): 424. Available at: https://doi.org/10.1016/S2213-8587(19)30147-0
Zhang J, Zhang Z, Zhang K, Ge X, Sun R, Zhai X. Early detection of type 2 diabetes risk: limitations of current diagnostic criteria. Frontiers in Endocrinology. 2023; [cited July 08, 2025]; 14. Available at: https://doi.org/10.3389/fendo.2023.1260623
Katki HA, Berndt SI, Machiela MJ, Stewart DR, Garcia-Closas M, Kim J, et al. Increase in power by obtaining 10 or more controls per case when type-1 error is small in large-scale association studies. BMC Medical Research Methodology. 2023; [cited July 08, 2025]; 23(1): 153. Available at: https://doi.org/10.1186/s12874-023-01973-x
Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults: Executive Summary123. The American Journal of Clinical Nutrition. 1998; [cited July 15, 2025]; 68(4): 899–917. [cited July 08, 2025]; Available at: https://doi.org/10.1093/ajcn/68.4.899
Zhang L, Zeng L. Non-linear association of triglyceride-glucose index with prevalence of prediabetes and diabetes: a cross-sectional study. Frontiers in Endocrinology. 2023; [cited July 15, 2025]; 14: 1295641. Available at: https://doi.org/10.3389/fendo.2023.1295641
Bae JC, Seo SH, Hur KY, Kim JH, Lee MS, Lee MK, et al. Association between Serum Albumin, Insulin Resistance, and Incident Diabetes in Nondiabetic Subjects. Endocrinology and Metabolism. 2013; [cited July 15, 2025]; 28(1): 26–32. Available at: https://doi.org/10.3803/EnM.2013.28.1.26
Kim S, Kang S. Serum Albumin Levels: A Simple Answer to a Complex Problem? Are We on the Right Track of Assessing Metabolic Syndrome? Endocrinology and Metabolism. 2013; [cited July 15, 2025]; 28(1): 17–19. Available at: https://doi.org/10.3803/EnM.2013.28.1.17
Darshan An V, Rajput R, Meena, Mohini, Garg R, Saini S. Comparison of triglyceride glucose index and HbA1C as a marker of prediabetes – A preliminary study. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2022; [cited July 15, 2025]; 16(9): 102605. Available at: https://doi.org/10.1016/j.dsx.2022.102605
Liu Y, Chi R, Jiang Y, Chen B, Chen Y, Chen Z. Triglyceride glycemic index as a biomarker for gestational diabetes mellitus: a systemic review and meta-analysis. 2021; [cited July 15, 2025]; Available at: https://doi.org/10.1530/EC-21-0234
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Derechos de autor 2026 Revista Eugenio Espejo
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