ESPE Abstracts

Background: Triglyceride and glucose (TyG) index is significantly associated with higher risk of developing type 2 diabetes mellitus (T2DM). The mechanism of the role of TyG index in the development of T2DM is not clear. There are few studies on the relationship between the TyG index and homeostatic model assessment of insulin resistance (HOMA-IR).

Aims: To elucidate the role of the TyG index, studies are needed on the association between TyG index and HOMA-IR. We explored the role of the TyG index in comparison with HOMA-IR in children and adolescents with T2DM.

Research Design and Methods: A total of 180 subjects with suspected insulin resistance disease including obese, overweight, or acanthosis nigricans were involved. TyG index was calculated using ln(fasting triglyceride [mg/dL] × fasting glucose [mg/dL]/2), and HOMA-IR was calculated as (Fasting insulin [mIU/L] x Fasting glucose [mg/dL]/405). T2DM was diagnosed according to the American Diabetes Association criteria.

Results: The mean age of non-T2DM and T2DM was 9.92 ± 2.56 and 14.25 ± 2.29 years, respectively. T2DM was identified in 57(32%) participants. Significant differences were observed in the TyG index between T2DM and non-T2DM (P < 0.001). TyG index had a positive correlation with fasting serum glucose (FSG) (r = 0.519, P < 0.001), HOMA-IR (r = 0.189, P < 0.017), HbA1c (r = 0.429, P < 0.001), total cholesterol (r = 0.257, P=0.001), triglyceride (TG)(r = 0.759, P < 0.001), and low–density lipoprotein cholesterol (LDL-C)(r = 0.152, P < 0.001), and a negative correlation with high–density lipoprotein cholesterol (HDL-C)(r = -0.107, P < 0.001) after controlling for sex, age and BMI SDS. In the ROC analysis, the TyG index [area under the curve (AUC) 0.839)] showed a better performance compared to HOMA-IR (AUC 0.645) in identifying patients with T2DM (P < 0.001). The multivariable regression analysis showed that elevated TyG index was significantly associated with age, FSG, HOMA-IR, TG, LDL-C, and HDL-C (adjusted R² 0.918, P < 0.001).

Conclusions: The TyG index has significant association with higher risk of developing T2DM and is superior to HOMA-IR in predicting T2DM in children and adolescents.