Diagnostic accuracy of the triglyceride-glucose index for gestational diabetes screening: a practical approach

Abstract

The oral glucose tolerance test (OGTT) remains as the gold standard to diagnose gestational diabetes mellitus (GDM); however, this test may be inconvenient and costly. Hence, other easy to perform and accurate diagnostic alternatives would be valuable for maternal care. The objective of the study was to assess the diagnostic performance of the TyG index to screen for GDM at 24–28 of pregnancy. A total of 140 pregnant women who received the one-step 2 h 75 g OGTT were included. Overall GDM prevalence was 27.1% according to IADSPG criteria. The mean TyG index value in the GDM group was significantly higher than the TyG index for the no GDM group (4.88 ± 0.70 versus 4.68 ± 0.19, p<.001). A sensitivity of 89% [95% CI 0.75–0.97] and a specificity of 50% [95% CI 0.39–0.60)], accompanied by a high negative predictive value of 93% was observed. No differences were found in maternal and neonatal outcomes irrespective of the TyG cutoff value for GDM. According to our results, the TyG index may be a highly sensitive and easy to perform screening test for GDM.

摘要

口服葡萄糖耐量试验(OGTT)仍然是诊断妊娠期糖尿病(GDM)的金标准, 但这项检验可能不方便并且昂贵。因此, 其他容易执行并且准确的替代诊断方案对于孕妇的管理将是有价值的。该研究的目的是评估TyG指数在妊娠24-28周女性筛查妊娠期糖尿病的诊断性能。共有140名孕妇接受了一次性2小时75g口服葡萄糖耐量试验。根据IADSPG标准, 妊娠期糖尿病总患病率为27.1%。妊娠期糖尿病组的TyG指数均值显著高于非妊娠期糖尿病组(4.88±0.70比4.68±0.19, P<0.001)。敏感性为89%[95%CI为0.75∼0.97], 特异性为50%[95%CI为0.39∼0.60], 阴性预测值为93%。无论妊娠期糖尿病的TyG临界值如何, 母婴结局均无差异。根据我们的结果, TyG指数可能是一种高度敏感且容易进行的GDM筛查试验。

Keywords:

• TyG index
• triglycerides
• glucose
• insulin resistance
• gestational diabetes
• screening

Acknowledgments

The authors wish to thank Sergio Lozano-Rodríguez, M.D., for his critical reading of the paper, and Carlo Bonilla-Baez, B. Sc., for biochemical assays performance.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability

The data that support the findings of this study are available from the corresponding author, JGGG, upon reasonable request.

Additional information

Funding

This work was supported by the Endocrinology Division of the “Dr José Eleuterio González” University Hospital; and by the Universidad Autónoma de Nuevo León under grant [PAICYT SA750-19].