The triglyceride-glucose index, an insulin resistance marker in newborns?
The study aims to assess the utility of the triglyceride-glucose index (TyG) as a marker of insulin resistance (IR) in neonates. TyG and the homeostatic model assessment (HOMA-IR) values were compared in 196 singleton, term normoweight and without distress newborns. A Decision Tree procedure (CHAID) was used to classify cases into groups or predict values of a dependent (Ln HOMA-IR) variable. Three nodes were drawn for TyG: ≤ 6.7, > 6.7–7.8 and > 7.8 (p < 0.0001; F = 20.52). The predictability of those TyG values vs HOMA-IR was statistically significant (p < 0.0001). It was neither affected by gender (p = 0.084), glucose challenge test (p = 0.138) classifications nor by the TyG node* glucose challenge test and TyG node*gender interactions (p = 0.456 and p = 0.209, respectively). Glucose, HOMA-IR, and the triglyceride/HDL cholesterol ratio increased progressively from node 1 to 3 for TyG while QUICKI decreased.
Conclusion: In conclusion, TyG appears to be a suitable tool for identifying IR at birth, justifying the further insulin determination in those neonates. TyG ≥ 7.8 is recommended as cut-off point in neonates. The need for a follow-up study to confirm the TyG as early IR marker is desirable.
What is Known
• HOMA-IR and the triglyceride-glucose index (TyG) show a high correlation.
• The TyG has been used as an insulin resistance marker in adults.
What is New
• This is the first study where TyG has been assessed in neonates.
• TyG appears to be a suitable and cheap tool for identifying insulin resistance at birth.
KeywordsTyG Neonates Insulin Glucose HOMA-IR QUICKI TG/HDLc
Chi-squared automatic interaction detection
Gestational diabetes mellitus
High density lipoprotein cholesterol
Homeostatic model assessment-insulin resistance
Insulin-like growth factor 1
Impaired glucose tolerance
Quantitative insulin sensitivity check index
Type 2 diabetes mellitus
We thank the Gynaecology and Obstetrics Department and Laboratory Services of Mérida Hospital (Extremadura, Spain) and participant mothers and neonates.
E Gesteiro contributed to the data acquisition, analysis, discussion and writing of the paper; FJ Sánchez-Muniz contributed to the study design, data discussion, writing of the paper and is the corresponding author and guarantor of the paper; S Bastida contributed to the study design and data discussion; L Barrios has contributed to the design and discussion of the statistical study.
Partially supported by the Spanish Project AGL 2014-53207-C2-2-R.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
The study performed in accordance with the Helsinki Declaration of 1975 as revised in year 2000, following approval by the Management and Ethical Committee of the Hospital. Data were obtained from an anonymous hospital screening record.
Nonetheless, informed consent is available from 35 mothers whose pregnancy diet was studied and wished to be engaged in a follow-up study.
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