Fasting plasma glucose is stronger predictor of diabetes than triglyceride-glucose index, triglyceride /high density lipoprotein cholesterol, and homeostasis model assessment of insulinresistance

INTRODUCTION: The high incidence of type 2 diabetes (T2D) necessitates determining simple predicting biomarkers. OBJECTIVE: To compare the impact of the triglyceride-glucose index (TyGindex), the product of fasting plasma glucose (FPG) and triglycerides (TG) with FPG, 2h-post challenge plasma glucose (2h-PCPG), TG/high density lipoprotein cholesterol (TG/HDL-C), and homeostasis model assessment of insulin resistance (HOMA-IR) indices for prediction of T2D in Iranian adults during a median follow-up of twelve years. METHODS: Study population included 4419 (1858 men) subjects with mean age of 40.6 ±13.2 years. Multivariable Cox proportional hazard models were used to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs) for each 1-SD increase in each predictor. Areas under the receiver operating characteristics curves(AUC) and 95% CIs were calculated. RESULTS: During follow-up, 215 men and 288 women developed T2D. The multivariable HRs for FPG, 2h-PCPG, TyG-index, HOMA-IR, HOMA2-IR, and TG/HDL-C were 2.20, 1.97, 1.71, 1.33, 1.30 and 1.35 in men and 2.13, 2.11, 1.44, 1.37, 1.32 and 1.36 in women (all P<0.001). Among the total population the AUC for FPG [0.752 (0.727-0.776)] was similar to 2h-PCPG but higher than TyG-index [0.697 (0.673-0.720)], TG/HDL-C [0.644(0.620-0.669)], HOMA-IR [0.684 (0.659-0.710)], andHOMA2-IR [0.656(0.630-0.682)]. In men, AUC of TyG-index was higher than TG/HDL-C but did not differ with HOMA-IR indices. In women, the AUC of TyGindex was higher than HOMA2-IR and TG/HDL-C, but was similar to that of HOMA-IR. CONCLUSION: FPG is a stronger predictor of T2D than the TyG-index, TG/HDLC, and HOMA-IR indices. Although TyG-index was better than TG/HDL-C in both genders, it did not rank above HOMA-IR.

Keywords:

type 2 diabetes , triglycerides , glucose , insulin resistance , cohort study