Research Article
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Trigliserid-Glukoz İndeksinin Diyabete İlerleme Riskindeki Rolü: Vaka Kontrol Çalışması

Year 2025, Volume: 9 Issue: 3, 242 - 250, 31.12.2025

Abstract

Amaç: Bu çalışmanın amacı, TyG indeksinin prediyabeti öngörmedeki tanısal performansını değerlendirmek ve birinci basamak sağlık
hizmetlerinde bir tarama aracı olarak uygulanabilirliğini incelemektir.
Gereç ve Yöntemler: Tek merkezli, retrospektif olgu-kontrol çalışmamıza, aile hekimliği birimine kayıtlı ≥18 yaş bireyler dahil
edilmiştir. Çalışmaya 350 prediyabetik birey ve 350 normoglisemik kontrol grubu dahil edilmiş; gruplar cinsiyet açısından eşleştirilmiş,
yaş farklılıkları ise regresyon modellerinde düzeltilmiştir. Klinik, antropometrik ve laboratuvar verileri elektronik sağlık kayıtlarından
elde edilmiştir. TyG indeksi, açlık glukozu ve trigliserid düzeylerinden hesaplanmıştır. Prediyabet öngörüsünde TyG indeksinin tanısal
gücü lojistik regresyon modelleri ve ROC analizi ile değerlendirilmiştir.
Bulgular: Prediyabet grubunda TyG indeksi anlamlı derecede yüksek bulunmuştur (8.75 ± 0.52 vs. 8.41 ± 0.52; p<0.001). TyG
indeksindeki her bir birimlik artış, prediyabet riskini 2.26 kat artırmıştır (OR=2.26; %95 GA: 1.58–3.22; p<0.001). En yüksek TyG
çeyreğinde yer alan bireylerin, en düşük çeyreğe göre 3.71–4.20 kat daha fazla prediyabet riski taşıdığı belirlenmiştir (p<0.001). ROC
analizinde TyG indeksinin tek başına ayırt edici gücü orta düzeyde bulunmuş (AUC=0.680); açlık plazma glukozu ve yaşam tarzı
değişkenleri eklendiğinde tanısal doğruluk artmıştır (AUC=0.834). TyG indeksi, HbA1c, açlık glukozu, lipid parametreleri ve bel çevresi
ile anlamlı ilişki göstermiştir.
Sonuç: TyG indeksi, birinci basamak sağlık hizmetlerinde prediyabetin erken tanısında kullanılabilecek, düşük maliyetli, erişilebilir ve
etkili bir tarama aracıdır. Çalışmamız tek merkezli bir çalışma olduğu için elde edilen bulgular yalnızca bu hasta grubunu yansıtmaktadır.
Bu konu ile ilgili ülkemiz adına çok merkezli ileri çalışmalara ihtiyaç vardır. Bununla birlikte, TyG indeksinin klinik uygulamalara
entegrasyonu tip 2 diyabetin önlenmesine yönelik risk sınıflandırmasını geliştirebilir

References

  • 1. Huang Y, Cai X, Mai W, Li M, Hu Y. Association between prediabetes and risk of cardiovascular disease and allcause mortality: systematic review and meta-analysis. BMJ. 2016;355:i5953. doi:10.1136/bmj.i5953
  • 2. Tabák AG, Herder C, Rathmann W, Brunner EJ, Kivimäki M. Prediabetes: a high-risk state for diabetes development. Lancet. 2012;379(9833):2279–90. doi:10.1016/S0140-6736(12)60283- 9
  • 3. Turkish Endocrinology and Metabolism Society. Diabetes Mellitus Diagnosis and Treatment Guide 2024. [Accessed 2025 Apr 17]. Available from: https://file.temd.org.tr/Uploads/ publications/guides/documents/diabetesmellitus2024. pdf
  • 4. Martin BC, Warram JH, Krolewski AS, Bergman RN, Soeldner JS, Kahn CR. Role of glucose and insulin resistance in development of type 2 diabetes mellitus: results of a 25-year follow-up study. Lancet. 1992;340(8825):925–9. doi:10.1016/0140- 6736(92)92814-V
  • 5. Bastard JP, Lavoie ME, Messier V, Prud’homme D, Rabasa- Lhoret R. Evaluation of two new surrogate indices including parameters not using insulin to assess insulin sensitivity/ resistance in non-diabetic postmenopausal women: a MONET group study. Diabetes Metab. 2012;38(3):258–63. doi:10.1016/j.diabet.2012.01.004
  • 6. Guerrero-Romero F, Simental-Mendía LE, González-Ortiz M, Martínez-Abundis E, Ramos-Zavala MG, Hernández- González SO, et al. The product of triglycerides and glucose, a simple measure of insulin sensitivity. Comparison with the euglycemic-hyperinsulinemic clamp. J Clin Endocrinol Metab. 2010;95(7):3347–51. doi:10.1210/jc.2010-0288
  • 7. Akdeniz YŞ, Pişkinpaşa H, Sevgillioğlu Polat Ö, Öğredici G, Tevetoğlu İ, Esen A, et al. Ötiroid Tip 2 diyabeti olan hastalarda HbA1c ve TSH düzeylerinin trigliserid düzeylerine etkisi. Turk J Diab Obes. 2018;2(3):119–24.
  • 8. Fakı S, Tam AA, İnce N, Altay FP, Karaahmetli G, Houssein M, et al. Relationship between triglyceride-glucose index and microvascular complications in hospitalized patients with Type 2 Diabetes Mellitus. Turk J Diab Obes. 2024;8(1):13–18. doi:10.25048/tudod.1359840
  • 9. American Diabetes Association Professional Practice Committee. Diagnosis and classification of diabetes: Standards of Care in Diabetes—2024. Diabetes Care. 2024;47(Suppl 1):S20– S42. doi:10.2337/dc24-S002.
  • 10. Faul F, Erdfelder E, Lang A-G, Buchner A. G*Power 3… Behav Res Methods. 2007;39(2):175–191. doi:10.3758/BF03193146
  • 11. Zhang L, Zeng L. Non-linear association of triglyceride-glucose index with prevalence of prediabetes and diabetes: a cross-sectional study. Front Endocrinol (Lausanne). 2023;14:1295641. doi:10.3389/fendo.2023.1295641
  • 12. Chen X, Liu D, He W, Hu H, Wang W. Predictive performance of triglyceride-glucose index (TyG index) to identify glucose status conversion: a 5-year longitudinal cohort study in Chinese pre-diabetes people. J Transl Med. 2023;21(1):624. doi:10.1186/s12967-023-04402-1
  • 13. Wen J, Wang A, Liu G, Wu Y, Zhang H, Li Y, et al. Elevated triglyceride-glucose (TyG) index predicts incidence of prediabetes: a prospective cohort study in China. Lipids Health Dis. 2020;19(1):226. doi:10.1186/s12944-020-01401-9
  • 14. Cao C, Hu H, Xiao P, Gong W, Zhang Y, Chen L, et al. Nonlinear relationship between triglyceride-glucose index and the risk of prediabetes and diabetes: a secondary retrospective cohort study. Front Endocrinol. 2024;15:1416634. doi:10.3389/ fendo.2024.1416634
  • 15. Maddatu J, Anderson-Baucum E, Evans-Molina C. Smoking and the risk of type 2 diabetes. Transl Res. 2017;184:101–7. doi:10.1016/j.trsl.2017.02.004
  • 16. Chen CL, Liu L, Lo K, Yu Y, Huang Y, Feng YQ, et al. Association between triglyceride-glucose index and risk of new-onset diabetes among Chinese adults: findings from the China Health and Retirement Longitudinal Study. Front Cardiovasc Med. 2020;7:610322. doi:10.3389/fcvm.2020.610322

The Role of the Triglyceride-Glucose Index in the Risk of Progression to Type 2 Diabetes Mellitus: A Case Control Study

Year 2025, Volume: 9 Issue: 3, 242 - 250, 31.12.2025

Abstract

Aim: The objective of this research was to investigate the diagnostic ability of the triglyceride–glucose (TyG) index in identifying
prediabetes and to determine whether it could serve as a feasible screening instrument in primary healthcare.
Material and Methods: Our single-center, retrospective case–control study enrolled individuals aged 18 years or older who were
registered at a family medicine unit. A total of 350 prediabetic individuals and 350 normoglycemic controls were included; the groups
were matched by gender, while age differences were adjusted for in the regression models. Clinical, anthropometric, and laboratory
data were retrieved from electronic health records. Fasting plasma glucose and triglyceride levels were used to calculate the TyG index.
The diagnostic performance of the TyG index for predicting prediabetes was assessed through logistic regression modeling and receiver
operating characteristic (ROC) analysis.
Results: The TyG index was markedly elevated in individuals with prediabetes compared with those in the control group (8.75 ± 0.52 vs.
8.41 ± 0.52; p<0.001). Each one-unit increase in the TyG index was associated with a 2.26-fold higher risk of prediabetes (OR=2.26; 95%
CI: 1.58–3.22; p<0.001). Individuals in the highest TyG quartile had a 3.71–4.20-fold greater risk of prediabetes compared with those in the lowest quartile (p<0.001). ROC analysis demonstrated moderate discriminatory ability of the TyG index alone (AUC=0.680);
however, diagnostic accuracy improved when fasting plasma glucose and lifestyle variables were incorporated (AUC=0.834). The TyG
index showed significant correlations with HbA1c, fasting plasma glucose, lipid parameters, and waist circumference.
Conclusion: The TyG index is a low-cost, accessible, and effective screening tool that may facilitate the early detection of prediabetes
in primary healthcare settings. As the study setting was restricted to a single center, the findings reflect only the characteristics of the
studied patient group; therefore, multicenter studies at the national level are warranted. Nevertheless, the integration of the TyG index
into clinical practice may enhance risk stratification strategies and help reduce the risk of progression to diabetes mellitus

Ethical Statement

The study was approved by the Clinical Research Ethics Committee of İzmir Bozyaka Training and Research Hospital on February 6, 2025 (Approval No: 2025/09) and was conducted with permission from the İzmir Provincial Health Directorate.

Supporting Institution

This study did not receive any specific grant or institutional support from funding agencies in the public, commercial, or not-for-profit sectors.

References

  • 1. Huang Y, Cai X, Mai W, Li M, Hu Y. Association between prediabetes and risk of cardiovascular disease and allcause mortality: systematic review and meta-analysis. BMJ. 2016;355:i5953. doi:10.1136/bmj.i5953
  • 2. Tabák AG, Herder C, Rathmann W, Brunner EJ, Kivimäki M. Prediabetes: a high-risk state for diabetes development. Lancet. 2012;379(9833):2279–90. doi:10.1016/S0140-6736(12)60283- 9
  • 3. Turkish Endocrinology and Metabolism Society. Diabetes Mellitus Diagnosis and Treatment Guide 2024. [Accessed 2025 Apr 17]. Available from: https://file.temd.org.tr/Uploads/ publications/guides/documents/diabetesmellitus2024. pdf
  • 4. Martin BC, Warram JH, Krolewski AS, Bergman RN, Soeldner JS, Kahn CR. Role of glucose and insulin resistance in development of type 2 diabetes mellitus: results of a 25-year follow-up study. Lancet. 1992;340(8825):925–9. doi:10.1016/0140- 6736(92)92814-V
  • 5. Bastard JP, Lavoie ME, Messier V, Prud’homme D, Rabasa- Lhoret R. Evaluation of two new surrogate indices including parameters not using insulin to assess insulin sensitivity/ resistance in non-diabetic postmenopausal women: a MONET group study. Diabetes Metab. 2012;38(3):258–63. doi:10.1016/j.diabet.2012.01.004
  • 6. Guerrero-Romero F, Simental-Mendía LE, González-Ortiz M, Martínez-Abundis E, Ramos-Zavala MG, Hernández- González SO, et al. The product of triglycerides and glucose, a simple measure of insulin sensitivity. Comparison with the euglycemic-hyperinsulinemic clamp. J Clin Endocrinol Metab. 2010;95(7):3347–51. doi:10.1210/jc.2010-0288
  • 7. Akdeniz YŞ, Pişkinpaşa H, Sevgillioğlu Polat Ö, Öğredici G, Tevetoğlu İ, Esen A, et al. Ötiroid Tip 2 diyabeti olan hastalarda HbA1c ve TSH düzeylerinin trigliserid düzeylerine etkisi. Turk J Diab Obes. 2018;2(3):119–24.
  • 8. Fakı S, Tam AA, İnce N, Altay FP, Karaahmetli G, Houssein M, et al. Relationship between triglyceride-glucose index and microvascular complications in hospitalized patients with Type 2 Diabetes Mellitus. Turk J Diab Obes. 2024;8(1):13–18. doi:10.25048/tudod.1359840
  • 9. American Diabetes Association Professional Practice Committee. Diagnosis and classification of diabetes: Standards of Care in Diabetes—2024. Diabetes Care. 2024;47(Suppl 1):S20– S42. doi:10.2337/dc24-S002.
  • 10. Faul F, Erdfelder E, Lang A-G, Buchner A. G*Power 3… Behav Res Methods. 2007;39(2):175–191. doi:10.3758/BF03193146
  • 11. Zhang L, Zeng L. Non-linear association of triglyceride-glucose index with prevalence of prediabetes and diabetes: a cross-sectional study. Front Endocrinol (Lausanne). 2023;14:1295641. doi:10.3389/fendo.2023.1295641
  • 12. Chen X, Liu D, He W, Hu H, Wang W. Predictive performance of triglyceride-glucose index (TyG index) to identify glucose status conversion: a 5-year longitudinal cohort study in Chinese pre-diabetes people. J Transl Med. 2023;21(1):624. doi:10.1186/s12967-023-04402-1
  • 13. Wen J, Wang A, Liu G, Wu Y, Zhang H, Li Y, et al. Elevated triglyceride-glucose (TyG) index predicts incidence of prediabetes: a prospective cohort study in China. Lipids Health Dis. 2020;19(1):226. doi:10.1186/s12944-020-01401-9
  • 14. Cao C, Hu H, Xiao P, Gong W, Zhang Y, Chen L, et al. Nonlinear relationship between triglyceride-glucose index and the risk of prediabetes and diabetes: a secondary retrospective cohort study. Front Endocrinol. 2024;15:1416634. doi:10.3389/ fendo.2024.1416634
  • 15. Maddatu J, Anderson-Baucum E, Evans-Molina C. Smoking and the risk of type 2 diabetes. Transl Res. 2017;184:101–7. doi:10.1016/j.trsl.2017.02.004
  • 16. Chen CL, Liu L, Lo K, Yu Y, Huang Y, Feng YQ, et al. Association between triglyceride-glucose index and risk of new-onset diabetes among Chinese adults: findings from the China Health and Retirement Longitudinal Study. Front Cardiovasc Med. 2020;7:610322. doi:10.3389/fcvm.2020.610322
There are 16 citations in total.

Details

Primary Language English
Subjects Endocrinology
Journal Section Research Article
Authors

Merve Nur Alagöz 0000-0002-2474-7649

İbrahim Eryılmaz 0009-0005-7207-3182

Özge Tuncer 0000-0002-0683-1695

Submission Date July 28, 2025
Acceptance Date December 6, 2025
Publication Date December 31, 2025
Published in Issue Year 2025 Volume: 9 Issue: 3

Cite

APA Alagöz, M. N., Eryılmaz, İ., & Tuncer, Ö. (2025). The Role of the Triglyceride-Glucose Index in the Risk of Progression to Type 2 Diabetes Mellitus: A Case Control Study. Turkish Journal of Diabetes and Obesity, 9(3), 242-250.
AMA Alagöz MN, Eryılmaz İ, Tuncer Ö. The Role of the Triglyceride-Glucose Index in the Risk of Progression to Type 2 Diabetes Mellitus: A Case Control Study. Turk J Diab Obes. December 2025;9(3):242-250.
Chicago Alagöz, Merve Nur, İbrahim Eryılmaz, and Özge Tuncer. “The Role of the Triglyceride-Glucose Index in the Risk of Progression to Type 2 Diabetes Mellitus: A Case Control Study”. Turkish Journal of Diabetes and Obesity 9, no. 3 (December 2025): 242-50.
EndNote Alagöz MN, Eryılmaz İ, Tuncer Ö (December 1, 2025) The Role of the Triglyceride-Glucose Index in the Risk of Progression to Type 2 Diabetes Mellitus: A Case Control Study. Turkish Journal of Diabetes and Obesity 9 3 242–250.
IEEE M. N. Alagöz, İ. Eryılmaz, and Ö. Tuncer, “The Role of the Triglyceride-Glucose Index in the Risk of Progression to Type 2 Diabetes Mellitus: A Case Control Study”, Turk J Diab Obes, vol. 9, no. 3, pp. 242–250, 2025.
ISNAD Alagöz, Merve Nur et al. “The Role of the Triglyceride-Glucose Index in the Risk of Progression to Type 2 Diabetes Mellitus: A Case Control Study”. Turkish Journal of Diabetes and Obesity 9/3 (December2025), 242-250.
JAMA Alagöz MN, Eryılmaz İ, Tuncer Ö. The Role of the Triglyceride-Glucose Index in the Risk of Progression to Type 2 Diabetes Mellitus: A Case Control Study. Turk J Diab Obes. 2025;9:242–250.
MLA Alagöz, Merve Nur et al. “The Role of the Triglyceride-Glucose Index in the Risk of Progression to Type 2 Diabetes Mellitus: A Case Control Study”. Turkish Journal of Diabetes and Obesity, vol. 9, no. 3, 2025, pp. 242-50.
Vancouver Alagöz MN, Eryılmaz İ, Tuncer Ö. The Role of the Triglyceride-Glucose Index in the Risk of Progression to Type 2 Diabetes Mellitus: A Case Control Study. Turk J Diab Obes. 2025;9(3):242-50.

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