Triglyceride-Fasting Glucose Index and Homeostatic Model Assessment for Insulin Resistance as Predictors of Type 2 Diabetes Mellitus in South Indians With Normal Body Mass Index

• Published in: Curēus (Palo Alto, CA) Vol. 16; no. 6; p. e62742
• Main Authors: Ca, Jayashankar, Joshi, Amey, Ishaq, Mohammed, Adoor, Gurucharan, V, Mahesh, Jampugumpula, Harshavardhan, R, Kavitha, Sanjay, Bhangdiya G, Bhupathiraju, Prafulla K
• Format: Journal Article
• Language: English
• Published: United States Cureus Inc 20.06.2024
• Subjects: Body mass index; Cardiovascular disease; Cholesterol; Chronic obstructive pulmonary disease; Diabetes; Glucose; High density lipoprotein; Insulin resistance; Lipoproteins; Plasma; Statistical analysis; Thyroid gland; Triglycerides; Validity; Variance analysis; India; type 2 diabetes mellitus; tyg; homa-ir; insulin resistance; endocrinology and diabetes
• ISSN: 2168-8184; 2168-8184
• DOI: 10.7759/cureus.62742

 Early detection of type 2 diabetes mellitus (T2DM) is imperative to prevent the complications associated with the disease. Current guidelines for diagnosis rely on the assessment of serum glucose (fasting and post-prandial) and glycosylated hemoglobin (HbA1c) levels. Insulin resistance, a phenomenon associated with T2DM, has been observed before the changes in these metrics. The homeostatic model assessment for insulin resistance (HOMA-IR) has been widely used to assess the degree of insulin resistance. The triglyceride-fasting glucose (TyG) index is a newer marker of insulin resistance that merits further study.  Aim: The study aimed to assess the validity of the TyG index and HOMA-IR as markers for the development of T2DM in non-obese individuals.  Materials and methods: One hundred eight non-obese patients without T2DM were included in this prospective cohort study and followed up for eight years. Anthropometric and biochemical parameters, including fasting glucose levels, HbA1c, fasting serum insulin, low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglycerides (TG), were measured at enrolment and eight years follow-up, and HOMA-IR and TyG index were calculated.  Results: Twenty participants out of 108 (18.5%) developed T2DM over eight years. On performing the area under the curve (AUC)-receiver operating characteristic curve analysis, TyG of >8.61 and HOMA-IR of >1.5 had the highest validity (ability) to predict new-onset T2DM in the study population (TyG: AUC: 0.612 (95% CI: 0.514-0.705); HOMA-IR: AUC: 0.529 (95% CI: 0.431-0.626)); however, this was not statistically significant.  Conclusion: At an eight-year follow-up, TyG and HOMA-IR were unreliable predictors of the development of T2DM in non-obese individuals.