Abstract
BackgroundTriglyceride glucose-body mass index (TyG-BMI) has been recommended as an alternative indicator of insulin resistance. However, the association between TyG-BMI and pre-diabetes remains to be elucidated.MethodsMore than 100,000 subjects with normal glucose at baseline received follow-up. The main outcome event of concern was pre-diabetes defined according to the diagnostic criteria recommended by the American Diabetes Association (ADA) in 2018 and the World Health Organization (WHO) in 1999. A Cox proportional hazard regression model was used to evaluate the role of TyG-BMI in identifying people at high risk of pre-diabetes.ResultsAt a mean observation period of 3.1 years, the incidence of pre-diabetes in the cohort was 3.70 and 12.31% according to the WHO and ADA diagnostic criteria for pre-diabetes, respectively. The multivariate Cox regression analysis demonstrated that TyG-BMI was independently positively correlated with pre-diabetes, and there was a special population dependence phenomenon. Among them, non-obese people, women and people under 50 years old had a significantly higher risk of TyG-BMI-related pre-diabetes (P-interaction< 0.05).ConclusionsThese findings suggest that a higher TyG-BMI significantly increases an individual’s risk of pre-diabetes, and this risk is significantly higher in women, non-obese individuals, and individuals younger than 50 years of age.
Highlights
Triglyceride glucose-body mass index (TyG-BMI) has been recommended as an alternative indicator of insulin resistance
Clinical characteristics of subjects in the triglyceride glucose (TyG)-BMI quartile groups The dataset for inclusion and exclusion according to the World Health Organization (WHO) diagnostic criteria for pre-diabetes included 110,838 people
In the two datasets included on the subjects according to American Diabetes Association (ADA) and WHO standards, we found significant differences in the clinical characteristics of the subjects among the quartiles of TyG-BMI (Table 1)
Summary
Triglyceride glucose-body mass index (TyG-BMI) has been recommended as an alternative indicator of insulin resistance. The association between TyG-BMI and pre-diabetes remains to be elucidated. Pre-diabetes is a subclinical high-risk state that progresses to diabetes and typical diabetes complications. It comprises two characteristics of impaired fasting glucose (IFG) and/or impaired glucose tolerance, and the glucose level is between normal and diabetic [1, 2]. At present, there is no unified standard for an IFG-based diagnosis of pre-diabetes [1]. In the standards recommended by the World Health Organization (WHO), the definition of IFG uses fasting plasma glucose (FPG) in the range of 6.1–6.9 mmol/L [3], while the American Diabetes Association (ADA) uses a lower threshold for the definition of IFG (FPG: 5.6–6.9 mmol/L) [4]. Early identification of modifiable risk factors is critical to reducing the long-term medical burden of pre-diabetes
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