Triglyceride-glucose index demonstrates reasonable performance as a screening tool but exhibits limited diagnostic utility for insulin resistance: Data from the ELSA-Brasil cohort
Phablo Wendell C. Oliveira , José Geraldo Mill , Itamar de Souza Santos , Paulo Andrade Lotufo , Maria del Carmen Bisi Molina , Fernanda Duarte Mendes , Hully Cantão dos Santos , Carolina Perim de Faria
{"title":"Triglyceride-glucose index demonstrates reasonable performance as a screening tool but exhibits limited diagnostic utility for insulin resistance: Data from the ELSA-Brasil cohort","authors":"Phablo Wendell C. Oliveira , José Geraldo Mill , Itamar de Souza Santos , Paulo Andrade Lotufo , Maria del Carmen Bisi Molina , Fernanda Duarte Mendes , Hully Cantão dos Santos , Carolina Perim de Faria","doi":"10.1016/j.nutres.2024.01.016","DOIUrl":null,"url":null,"abstract":"<div><p>Insulin resistance (IR) is a key risk factor for chronic metabolic diseases, but its laboratory diagnosis is still costly; thus, the triglyceride-glucose (TyG) index has been proposed as a surrogate method. Our aim was to provide a detailed analysis of cutoffs and test the hypothesis that the TyG index would present reasonable performance parameters for IR screening. This is a cross-sectional study with baseline data from 12,367 eligible participants of both sexes (aged 35–74 years) from the Brazilian Longitudinal Study of Adult Health. TyG correlation and agreement with the Homeostasis Model Assessment for Insulin Resistance were analyzed. Positive and negative predictive values (PV+, PV–) and likelihood ratio (LR+, LR–) were calculated. A moderate positive correlation between TyG and Homeostasis Model Assessment for Insulin Resistance was observed (Pearson <em>r</em> = 0.419). The area under the receiver operating characteristic curve of TyG for IR diagnosis was 0.742 and the optimal cutoff was 4.665, reaching a kappa agreement value of 0.354. For this cutoff, a PV+ of 59.3% and PV– of 76.0%, as well as an LR+ of 2.07 and LR– of 0.45 were obtained. Alternatively, because high sensitivity is desired for screening tests, selecting a lower cutoff, such as 4.505, increases the PV– to 82.1%, despite decreasing the PV+ to 50.8%. We conclude that TyG has important performance limitations for detecting IR, but that it may still be reasonably useful to help screening for IR in adults because it can be calculated from low-cost routine blood tests.</p></div>","PeriodicalId":19245,"journal":{"name":"Nutrition Research","volume":null,"pages":null},"PeriodicalIF":3.4000,"publicationDate":"2024-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Nutrition Research","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0271531724000186","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"NUTRITION & DIETETICS","Score":null,"Total":0}
引用次数: 0
Abstract
Insulin resistance (IR) is a key risk factor for chronic metabolic diseases, but its laboratory diagnosis is still costly; thus, the triglyceride-glucose (TyG) index has been proposed as a surrogate method. Our aim was to provide a detailed analysis of cutoffs and test the hypothesis that the TyG index would present reasonable performance parameters for IR screening. This is a cross-sectional study with baseline data from 12,367 eligible participants of both sexes (aged 35–74 years) from the Brazilian Longitudinal Study of Adult Health. TyG correlation and agreement with the Homeostasis Model Assessment for Insulin Resistance were analyzed. Positive and negative predictive values (PV+, PV–) and likelihood ratio (LR+, LR–) were calculated. A moderate positive correlation between TyG and Homeostasis Model Assessment for Insulin Resistance was observed (Pearson r = 0.419). The area under the receiver operating characteristic curve of TyG for IR diagnosis was 0.742 and the optimal cutoff was 4.665, reaching a kappa agreement value of 0.354. For this cutoff, a PV+ of 59.3% and PV– of 76.0%, as well as an LR+ of 2.07 and LR– of 0.45 were obtained. Alternatively, because high sensitivity is desired for screening tests, selecting a lower cutoff, such as 4.505, increases the PV– to 82.1%, despite decreasing the PV+ to 50.8%. We conclude that TyG has important performance limitations for detecting IR, but that it may still be reasonably useful to help screening for IR in adults because it can be calculated from low-cost routine blood tests.
期刊介绍:
Nutrition Research publishes original research articles, communications, and reviews on basic and applied nutrition. The mission of Nutrition Research is to serve as the journal for global communication of nutrition and life sciences research on diet and health. The field of nutrition sciences includes, but is not limited to, the study of nutrients during growth, reproduction, aging, health, and disease.
Articles covering basic and applied research on all aspects of nutrition sciences are encouraged, including: nutritional biochemistry and metabolism; metabolomics, nutrient gene interactions; nutrient requirements for health; nutrition and disease; digestion and absorption; nutritional anthropology; epidemiology; the influence of socioeconomic and cultural factors on nutrition of the individual and the community; the impact of nutrient intake on disease response and behavior; the consequences of nutritional deficiency on growth and development, endocrine and nervous systems, and immunity; nutrition and gut microbiota; food intolerance and allergy; nutrient drug interactions; nutrition and aging; nutrition and cancer; obesity; diabetes; and intervention programs.