First-Trimester Triglyceride-Glucose Index and Risk of Pregnancy-Related Complications: A Prospective Birth Cohort Study in Southeast China

Abstract

Purpose

To evaluate the relationships of the triglyceride-glucose (TyG) index with pregnancy-related complications (PRCs) and to clarify the predictability of the TyG index for PRCs.

Patients and Methods

Totally of 11,387 women with a singleton pregnancy were prospectively followed until after delivery. Maternal fasting lipids and glucose concentration were measured in the first trimester (11 weeks gestation on average). The TyG index was calculated as ln [triglyceride (mg/dL) × fasting plasma glucose (mg/dL)/2]. We used generalized linear models to calculate the relative risks and 95% confidence intervals. Receiver-operating characteristic curve analysis was employed to assess the ability of the TyG index to predict the risks of PRCs.

Results

Smooth spline reveals that the probability of gestational diabetes mellitus (GDM) is intensified with the increasing TyG index. Multivariate logistic regression adjusted for risk factors demonstrates a 1-unit and a 1-SD increment in the TyG index raises the risk of GDM by 3.63 and 1.57 times, respectively. Identically, the risk of GDM maximizes in the TyG quintile 5 (OR: 3.14; 95% CI: 2.55~3.85) relative to the lowest TyG index group. However, no association between TyG index and the risk of other PRCs was observed after full adjustment. The area under receiver operating characteristic curves is 0.647 (95% CI: 0.632–0.66) for GDM, and the optimal predictive cut-off is 8.55, with a specificity of 0.679 and sensitivity of 0.535.

Conclusion

The first-trimester TyG index is significantly associated with the risk of incident GDM, while the relationships between the TyG index and other PRCs need further exploration.

Keywords:

• first-trimester
• triglyceride-glucose index
• pregnancy-related complications
• gestational diabetes mellitus
• singleton pregnancy

Ethical Approval and Informed Consent

The studies involving human participants were reviewed and approved by the Research Ethics Committee of Fujian Maternity and Child Health Hospital (approval number: 2017KR-030) and complied with the Declaration of Helsinki. The participants provided their written informed consent to participate in this study.

Acknowledgments

The authors are grateful to all of the participants, the staff, and the other study investigators for their valuable contributions. Additionally, we thank the Free Statistics team (Beijing, China) for providing technical assistance and practical data analysis and visualization tools. Additionally, we thank Dr. Xiao, National Center for Children’s Health, Beijing Children’s Hospital, for the assistance in revising the manuscript.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in this work.

Additional information

Funding

This work was supported by the Natural Science Foundation of Fujian Province of China for Youths (Grant No. 2021J05076) (Haibo Li), the Key Project on Science and Technology Program of Fujian Health Commission (Grant No. 2021ZD01002) (Hua Cao), the provincial-level special subsidy funds for health in Fujian Province of China (Grant No. Fujian Finance Index (2019) 827) (Yibing Zhu), and the Scientific Research Foundation of Fujian Maternity and Child Health Hospital (Grant No. YCXY20-04) (Haibo Li). The funder did not contribute to the study’s design, collection, analysis, and interpretation of data.