Triglyceride-Glucose Index Applications in Diabetes Prediction

The triglyceride-glucose (TyG) index has emerged as a simple, economical surrogate marker of insulin resistance, calculated from fasting triglyceride and fasting plasma glucose measurements. Originally developed to improve upon more complex measures of insulin sensitivity, the TyG index has since been validated across diverse populations for its ability to predict progression from normoglycaemia to prediabetes, impaired fasting glucose and overt type 2 diabetes mellitus. Cohort studies have consistently demonstrated positive, and in some cases non-linear, associations between higher baseline TyG values and subsequent glycaemic deterioration. Threshold effects and inflection points have been identified, enabling stratification of individuals at elevated risk. Its ease of integration into routine health screenings, combined with robust associations observed across ethnic groups and age ranges, has conferred global significance on the TyG index as both a research tool and a potential point-of-care risk indicator. The index is increasingly being incorporated into multivariable risk models alongside established factors such as age, body mass index and family history, enhancing early detection strategies and informing targeted preventive interventions.

Research from Nature Portfolio

A large retrospective cohort of over 17,000 Chinese individuals aged 60 and above has demonstrated a linear, positive association between baseline TyG index and the risk of developing impaired fasting glucose. Analyses using Cox proportional hazards models with spline functions revealed that each successive TyG quartile corresponded to a marked increase in hazard ratios, with the highest quartile exhibiting a 62 percent elevated risk compared to the lowest. Sensitivity and subgroup assessments confirmed the stability of this relationship across sex and comorbidity strata. These findings underscore the utility of the TyG index for identifying elderly individuals at imminent risk of glycaemic impairment.

Triglyceride-Glucose Index Applications in Diabetes Prediction publication trend

The graph below shows the total number of articles in triglyceride-glucose index applications in diabetes prediction across all publications each year (not limited to Nature Index journals).

Technical terms

Triglyceride-Glucose (TyG) index: A log-transformed product of fasting triglyceride (mg/dL) and fasting plasma glucose (mg/dL) divided by two, serving as a surrogate marker of insulin resistance.

Impaired fasting glucose (IFG): A prediabetic condition characterised by elevated fasting plasma glucose levels below the diabetic threshold, indicating increased risk of type 2 diabetes.

Cox proportional hazards model: A statistical technique used to explore the association between the time to an event and one or more predictor variables, yielding hazard ratios.

Hazard ratio (HR): A measure in survival analysis that quantifies how the presence or level of a covariate affects the instantaneous risk of an event occurring at any point in time.

References

1. 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).
2. Triglyceride-glucose index is associated with the risk of impaired fasting glucose in Chinese elderly individuals. Scientific Reports (2024).
3. Predicting the Development of Diabetes Using the Product of Triglycerides and Glucose: The Chungju Metabolic Disease Cohort (CMC) Study. PLOS ONE (2014).
4. Predictive Value of Triglyceride Glucose Index for the Risk of Incident Diabetes: A 4-Year Retrospective Longitudinal Study. PLOS ONE (2016).