Triglyceride-Glucose Index as an Alternative Tool for Identifying Prediabetes and Insulin Resistance

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Background and Objectives: The triglyceride glucose (TyG) index has emerged as a cheaper alternative to hemoglobin A1c (HbA1c) and Homeostasis Model Assessment for Insulin Resistance (HOMA-IR) for diagnosing prediabetes and insulin resistance (IR), respectively. This study evaluated the utility of the TyG index as a marker of prediabetes and IR compared to HbA1c and HOMA-IR in Bangladeshi adults. Materials and Methods: This cross-sectional comparative study evaluated 100 prediabetics and 100 age-sex-matched normoglycemic subjects attending the outpatient department of Chittagong Diabetic General Hospital between October 2021 to September 2022. Anthropometric data were collected; laboratory data included oral glucose tolerance test, HbA1c, fasting triglyceride, serum insulin, and HOMA-IR. Comparative analyses were done between the TyG Index and HbA1c and HOMA-IR with the receiver operator characteristics (ROC) curves. Results: The areas under the curves (AUC) for diagnosing prediabetes for HbA1c and TyG Index were 0.923 (P < 0.001) and 0.874 (P < 0.001), respectively; TyG Index is comparable to HbA1c (P = 0.062). TyG Index >4.762 had 84.5% sensitivity and 80.5% specificity for diagnosing prediabetes. The AUC for the TyG index for IR was 0.792 (P < 0.001); TyG Index >4.762 had 84.5% sensitivity and 46.8% specificity for diagnosing IR. The Pearson correlation coefficients between the various anthropometric measurements related to IR with TyG Index and HOMA-IR demonstrate a highly significant difference in weight (0.186 vs. 0.154) in favor of the TyG index (P < 0.01). It also shows a significant difference (P < 0.05) in body mass index (0.421 vs. 0.372), waist circumference (0.286 vs. 0.253), and waist-to-height ratio (0.392 vs. 0.333) in favor of the TyG index. Conclusion: The TyG index is a reliable surrogate marker for IR and comparable to HbA1c for identifying prediabetes. Hence, it can be used as an alternative screening tool for diagnosing prediabetes and IR.