Surrogate Indices of Insulin Resistance in the Assessment of Glycemic Status with PTG-1h
Keywords:
diabetes mellitus; prediabetic state; glucose tolerance test; insulin resistance; mass screeningAbstract
Introduction: Direct measurement of insulin resistance is complex and expensive, so surrogate indices such as triglycerides-glucose (TyG) and triglycerides-glucose-Body mass index (TyG-BMI) are used, which require validation in the 1-hour glucose tolerance test (GTT).
Objective: To identify the relationship of the triglyceride-glucose and triglyceride-glucose-BMI indices with dysglycemia detected by 1 and 2 hours glucose tolerance test.
Methods: A cross-sectional and analytical study was carried out between February and July 2025 with 674 subjects. Clinical, biochemical and anthropometric evaluation was carried out. In participants with fasting glucose ≥5.6 mmol/L, 1 and 2 hours GTTs were applied. TyG and TyG-BMI values were analyzed according to dysglycemia and their diagnostic capacity was evaluated with ROC curves.
Results: The 1 hour glucose tolerance test (GTT) detected 8.5% dysglycemia, 3.1 % more than the 2h-GTT. Both indices increased significantly with glycemic deterioration (p < 0.001). The area under the curve (AUC) for diagnosis was ≥ 0.77 for both indices and tests. The 1h-GTT showed a better AUC for TyG (0.814) than the 2h-GTT (0.798), while the 2h-GTT was higher for TyG-IMC (0.825 vs. 0.779).
Conclusions: Both indices were useful and discriminative to identify dysglycemia in both GTTs. TyG performed better in 1h-GTT, TyG-IMC in 2h-GTT. Cutoffs were consistent for TyG, but TyG-BMI requires adjustment based on GTT timing.
Downloads
References
1. Vidal-Ostos de Lara F. El índice trigliceridos-glucosa marcador de insulino resistencia, adiposidad y predictor metabólico-prandrial en programas dietéticos de control del peso [tesis en Internet]. Madrid: Universidad Nacional de Educación a Distancia (UNED); 2023 [citado 27/06/2025]. Disponible en: https://dialnet.unirioja.es/servlet/dctes?codigo=369369
2. Coniglio RI, Vásquez LA, Ferraris R, et al. Índices triglicéridos-glucosa como estimadores de insulinorresistencia en personas con riesgo de desarrollar diabetes tipo 2. Acta Bioquím Clín Latinoam [Internet]. 2020 [citado 27/06/2025];54(3):257-66. Disponible en: https://www.scielo.org.ar/pdf/abcl/v54n3/v54n3a02.pdf
3. Cabezas-Cerrato J, Araujo Vilar D. Resistencia a la acción de la insulina. Evolución histórica del concepto. Técnicas para el estudio in vivo en humanos. Endocrinol Nutr [Internet]. 2003 [citado 27/06/2025];50(10):396-406. Disponible en: https://www.sciencedirect.com/science/article/abs/pii/S1575092203745653
4. Almeda-Valdés P, Bello-Chavolla OY, Caballeros-Barragán CR, et al. Índices para la evaluación de la resistencia a la insulina en individuos mexicanos sin diabetes. Gac Med Mex [Internet]. 2018 [citado 27/06/2025];154(Supl 2):S50-5. Disponible en: https://pubmed.ncbi.nlm.nih.gov/30532124/
5. Mehta R, Antonio-Villa NE, Bello-Chavolla OY, et al. La asociación entre la resistencia a la insulina y la rigidez arterial en pacientes mexicanos sin diabetes mellitus tipo 2. Gac Med Mex [Internet]. 2021 [citado 27/06/2025];157(5):539-47. Disponible en: https://www.scielo.org.mx/pdf/gmm/v157n5/0016-3813-gmm-157-5-539.pdf
6. Vega-Cárdenas M, Flores-Sánchez J, Torres-Rodríguez ML, et al. Distribución del índice triglicéridos y glucosa (TyG) y el modelo homeostático para la evaluación de la resistencia a la insulina en la adolescencia tardía en mexicanos. Nutr Hosp [Internet]. 2022 [citado 27/06/2025];39(6):1349-56. Disponible en: http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0212-16112022001000018&nrm=iso
7. Kırtıl G, Alpdemir M, Alpdemir MF, et al. Evaluation of the Triglyceride Glucose Index as a Marker of Insulin Resistance in Adults with Isolated Impaired Glucose Tolerance. Ahi Evran Med J. 2023;7(2):205-11. DOI: 10.46332/aemj.1140228.
8. Meroño T, Alonso E, Kabakian L, et al. Utilidad de la glucosa 1-hora post-carga para la evaluación del riesgo de diabetes y sus complicaciones asociadas. Bioquim Patol Clin [Internet]. 2018 [citado 27/06/2025];82(1):46-57. Disponible en: https://revistabypc.org.ar/index.php/bypc/article/view/81/190
9. Massimino M, Monea G, Marinaro G, et al. The Triglycerides and Glucose (TyG) Index Is Associated with 1-Hour Glucose Levels during an OGTT. Int J Environ Res Public Health. 2022;20(1):787. DOI: 10.3390/ijerph20010787.
10. Lu J, Ni J, Su H, et al. One-Hour Postload Glucose Is a More Sensitive Marker of Impaired β-Cell Function Than Two-Hour Postload Glucose. Diabetes. 2025;74(1):36-42. DOI: 10.2337/db24-0652.
11. Nie P, Ding L, Sousa-Poza A, et al. Socioeconomic position and the health gradient in Cuba: dimensions and mechanisms. BMC Public Health. 2020;20(1):866. DOI: 10.1186/s12889-020-08980-3.
12. Park SK, Ryoo JH, Oh CM, et al. 1-Hour and 2-Hour Postload Glucose Level on Oral Glucose Tolerance Test and the Risk of Incident Metabolic Syndrome. J Clin Endocrinol Metab. 2019;104(2):539-49. DOI: 10.1210/jc.2018-01102.
13. Lee MH, Febriana E, Lim M, et al. Performance of the 1 h oral glucose tolerance test in predicting type 2 diabetes and association with impaired β-cell function in Asians: a national prospective cohort study. Lancet Reg Health West Pac. 2024;54:101482. DOI: 10.1016/j.lanwpc.2024.101278.
14. Joshipura KJ, Andriankaja MO, Hu FB, et al. Relative utility of 1-h Oral Glucose Tolerance Test as a measure of abnormal glucose homeostasis. Diabetes Res Clin Pract. 2011;93(2):268-75. DOI: 10.1016/j.diabres.2011.05.035.
15. Gajjar M, Mishra MK, Shah TJ, et al. Triglyceride-Glucose Index and Atherogenic Index as Alternative Biomarkers for Glycemic Control in Type 2 Diabetes Mellitus. Cureus. 2025;17(3):e81550. DOI: 10.7759/cureus.81550.
16. Li X, Sun M, Yang Y, et al. Predictive Effect of Triglyceride Glucose-Related Parameters, Obesity Indices, and Lipid Ratios for Diabetes in a Chinese Population: A Prospective Cohort Study. Front Endocrinol (Lausanne). 2022;13:862919. DOI: 10.3389/fendo.2022.862919.
17. Shan Y, Liu Q, Gao T. Triglyceride-glucose index in predicting the risk of new-onset diabetes in the general population aged 45 years and older: a national prospective cohort study. BMC Endocr Disord. 2025;25(1):25. DOI: 10.1186/s12902-025-01848-w.
18. Zhou T, Xie C. Association between Triglyceride-Glucose index and onset of type 2 diabetes in metabolic Dysfunction-Associated steatotic liver disease population. Sci Rep. 2025;15(1):18044. DOI: 10.1038/s41598-025-03453-2.
19. Khan SH, Hafeez A, Khan Y, et al. Association Between Triglyceride-Glucose Index and Homeostasis Model Assessment for Insulin Resistance with Estimated Glucose Disposal Rate. J Coll Physicians Surg Pak. 2024;34(5):617-9. DOI: 10.29271/jcpsp.2024.05.617.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Rubén González-Tabares, Yoselín González-Montero, Leydiana Trimiño-Galindo, María del Carmen Díaz-de-Armas, Junior Vega-Jiménez
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All content published in this journal is Open Access, distributed under the terms of the CC BY-NC 4.0 License.
It allows:
- Copy and redistribute published material in any medium or format.
- Adapt the content.
This will be done under the following terms:
- Attribute the authors' credits and indicate whether changes were made, in which case it must be in a reasonable way.
- Non-commercial use.
- Recognize the journal where it is published.
The copyrights of each article are maintained, without restrictions.
