The Product of Fasting Glucose and Triglycerides As Surrogate for Identifying Insulin Resistance in Apparently Healthy Subjects

Background: Because the insulin test is expensive and is not available in most laboratories in the cities of undeveloped countries, we tested whether the product of fasting triglycerides and glucose levels (TyG) is a surrogate for estimating insulin resistance compared with the homeostasis model assessment of insulin resistance (HOMA-IR) index.

Methods: We performed a population-based cross-sectional study. Sampling strategy was based on a randomized two-stage cluster sampling procedure. Only apparently healthy subjects, men and nonpregnant women aged 18-65 years, with newly diagnosed impaired fasting glucose (IFG), impaired glucose tolerance (IGT), or IFG + IGT were enrolled. Renal disease, malignancy, and diabetes were exclusion criteria. Sensitivity, specificity, predictive values, and the probability of disease given a positive test were calculated. The optimal TyG index for estimating insulin resistance was established using a receiver operating characteristic scatter plot analysis.

Results: A total of 748 apparently healthy subjects aged 41.4 +/- 11.2 years were enrolled. Insulin resistance was identified in 241 (32.2%) subjects (HOMA-IR index 4.4 +/- 1.6). New diagnoses of IFG, IGT, and IFG + IGT were established in 145 (19.4%), 54 (7.2%), and 75 (10.0%) individuals. respectively. The best TyG index for diagnosis of insulin resistance was Ln 4.65, which showed the highest sensitivity (84.0%) and specificity (45.0%) values. The positive and negative predictive values were 81.1% and 84.8%, and the probability of disease, given a positive test, was 60.5%.

Conclusions: The TyG index could be useful as surrogate to identify insulin resistance in apparently healthy subjects.