Evaluation of triglyceride/glucose level index as a predictor of gestational diabetes mellitus: a comparative study with haemoglobin A1c

Rachna; Rupali Sharma; Nilakshi Baranwal; Mansi Tuteja

doi:10.18203/2320-1770.ijrcog20250202

Authors

Rachna Department of Obstetrics and Gynecology, GS Medical College and Hospital, Dhuri, Hapur, Uttar Pradesh, India
Rupali Sharma Department of Obstetrics and Gynecology, GS Medical College and Hospital, Dhuri, Hapur, Uttar Pradesh, India
Nilakshi Baranwal Department of Obstetrics and Gynecology, GS Medical College and Hospital, Dhuri, Hapur, Uttar Pradesh, India
Mansi Tuteja Department of Obstetrics and Gynecology, Maharashtra Institute of Medical Sciences, Latur, Maharashtra, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20250202

Keywords:

Biomarkers, Early prediction, HbA1c, Insulin resistance, Gestational diabetes mellitus, Triglyceride-glucose index

Abstract

Background: Gestational diabetes mellitus (GDM) is a pregnancy complication characterized by chronic hyperglycaemia, which increases the risk of adverse outcomes for both the mother and foetus. Early identification and intervention are crucial for improving pregnancy outcomes. The triglyceride-glucose (TyG) index, calculated using fasting triglyceride and glucose levels, has shown promise as a predictor of insulin resistance and metabolic disturbances. This study aims to evaluate the potential of the TyG index, along with HbA1c, as early biomarkers for GDM prediction.

Methods: This prospective study was conducted at GS Medical College & Hospital, Pilkhuwa, Hapur, over 18 months (January 2022 to June 2024), involving 144 pregnant women aged 18-30 years. The study included fasting glucose, triglyceride, and HbA1c measurements, along with the oral glucose tolerance test (OGTT) to diagnose GDM. The TyG index was calculated as [fasting triglycerides (mg/dl) × fasting glucose (mg/dl)/2]. Statistical analysis was performed using SPSS version 26.0, with Chi-square, t-tests, and regression models.

Results: The study revealed that 11.8% of participants were diagnosed with GDM. The GDM group had significantly higher levels of HbA1c (6.34±0.59%) compared to the non-GDM group (4.32±1.26%) (p<0.0001). The TyG index was also significantly higher in the GDM group (150.4±25.2) compared to the non-GDM group (129.27±20.66) (p = 0.0002). Both markers showed strong associations with GDM, suggesting their utility for early prediction.

Conclusions: The study supports the use of HbA1c and the TyG index as effective early biomarkers for GDM. These markers can help identify high-risk women and enable timely intervention to reduce adverse maternal and fetal outcomes. Early screening using these biomarkers should be prioritized, particularly for high-risk populations. Further research is needed to validate their diagnostic utility and integrate them into routine clinical practice.

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References

Anastasiou E, Gerede A, Koukkou E, Farmakidis G, Mamopoulos A, Stefos T, et al. Clinical practice guidelines on diabetes mellitus and pregnancy: ΙI. Gestational diabetes mellitus. Hormones. 2020;19(4):601-7. DOI: https://doi.org/10.1007/s42000-020-00193-y

Plows JF, Stanley JL, Reynolds CM, Vickers MH, Baker PN. The Pathophysiology of Gestational Diabetes Mellitus. Int J Mol Sci. 2018;19(11):3342. DOI: https://doi.org/10.3390/ijms19113342

Kim JA, Kim J, Roh E, Hong S-H, Lee Y-B, Baik SH, et al. Triglyceride and glucose index and the risk of gestational diabetes mellitus: A nationwide population-based cohort study. Diabetes Res Clin Pract. 2020;171:108533. DOI: https://doi.org/10.1016/j.diabres.2020.108533

Zeng Y, Yin X, Zhao D, Yin L. Association of triglyceride-glucose index levels with gestational diabetes mellitus in the US pregnant women: a cross-sectional study. Front Endocrinol. 2023;14. DOI: https://doi.org/10.3389/fendo.2023.1241372

Yoon JS, Hwang IT, Jeong HR, Kang MJ, Lee HJ, Shim YS. Triglyceride glucose index is superior biomarker for predicting type 2 diabetes mellitus in children and adolescents. Endocr J. 2022;69(5):559-65. DOI: https://doi.org/10.1507/endocrj.EJ21-0560

Yilmaz M, Odabas O, Toprak T, Tonyali S, Celik M, Karaaslan M. Triglyceride-Glucose Index (TyG) is associated with erectile dysfunction: A cross-sectional study. Androl. 2020;9(1):238-44. DOI: https://doi.org/10.1111/andr.12904

Li F, Hu Y, Zeng J, Zheng L, Ye P, Wei D, et al. Analysis of risk factors related to gestational diabetes mellitus. Taiwan J Obstet Gynecol. 2020;59(5):718-22. DOI: https://doi.org/10.1016/j.tjog.2020.07.016

Nayak V, Shenoy M, Satheesh P, Kalra S. Triglyceride Glucose (TyG) Index: A surrogate biomarker of insulin resistance. J Pak Med Assoc. 2022;72(5):986-8. DOI: https://doi.org/10.47391/JPMA.22-63

Sánchez‐García A, Rodríguez‐Gutiérrez R, González‐González JG, Guzmán‐López A, González‐Nava V, Saldívar‐Rodríguez D, et al. Early triglyceride and glucose index as a risk marker for gestational diabetes mellitus. Int J Gynecol Amp Obstet. 2020;151(1):117-23. DOI: https://doi.org/10.1002/ijgo.13311

Mantri N, Goel AD, Patel M, Baskaran P, Dutta G, Gupta MK, et al. National and regional prevalence of gestational diabetes mellitus in India: a systematic review and Meta-analysis. BMC Publ Heal. 2024;24(1). DOI: https://doi.org/10.1186/s12889-024-18024-9

Groof Z, Owayed S, Mouhsen H, Husain H, Ziyab AH, Mohammad A, et al. Prevalence, risk factors, and fetomaternal outcomes of gestational diabetes mellitus in Kuwait: a cross-sectional study. J Diabetes Res. 2019;2019(9677):1-7. DOI: https://doi.org/10.1155/2019/9136250

Xu X, Zhao Y, Sharma M, Rao Y, Liu Y, Liu D, et al. Prevalence and determinants of gestational diabetes mellitus: a cross-sectional study in China. Int J Environ Res Publ Heal. 2017;14(12):1532. DOI: https://doi.org/10.3390/ijerph14121532

Li H, Miao C, Liu W, Gao H, Li W, Wu Z, et al. First-trimester triglyceride-glucose index and risk of pregnancy-related complications: a prospective birth cohort study in Southeast China. Diabetes Metab Syndr Obes Targets Ther. 2022;15:3705-15. DOI: https://doi.org/10.2147/DMSO.S378964

Mustafa M, Dunne F, Khattak A, Carmody LA, O’Shea PM, Gaffney G, et al. Early gestational diabetes mellitus (GDM) is associated with worse pregnancy outcomes compared with GDM diagnosed at 24-28 weeks gestation despite early treatment. QJM Int J Med. 2020;114(1):17-24. DOI: https://doi.org/10.1093/qjmed/hcaa167

Punnose J, Malhotra RK, Sukhija K, Mathew A, Sharma A, Choudhary N. Glycated haemoglobin in the first trimester: A predictor of gestational diabetes mellitus in pregnant Asian Indian women. Diabetes Res Clin Pract. 2019;159:107953. DOI: https://doi.org/10.1016/j.diabres.2019.107953

Assaf-Balut C, Bordiú E, Durán A, Cuesta M, Valerio J, Torrejón M, et al. Medical nutrition therapy for gestational diabetes mellitus based on Mediterranean Diet principles: a subanalysis of the St Carlos GDM Prevention Study. BMJ Open Diabetes Res Amp Care. 2018;6(1):e000550. DOI: https://doi.org/10.1136/bmjdrc-2018-000550

Siricharoenthai P, Phupong V. Diagnostic accuracy of HbA1c in detecting gestational diabetes mellitus. J Matern Fetal Neonatal Med. 2019;33(20):3497-500. DOI: https://doi.org/10.1080/14767058.2019.1576169

Song T, Su G, Chi Y, Wu T, Xu Y, Chen C. Triglyceride–glucose index predicts the risk of gestational diabetes mellitus: a systematic review and meta-analysis. Gynecol Endocrinol. 2022;38(1):10-5. DOI: https://doi.org/10.1080/09513590.2021.1940932

O’Malley EG, Reynolds CME, Killalea A, O’Kelly R, Sheehan SR, Turner MJ. Maternal obesity and dyslipidemia associated with gestational diabetes mellitus (GDM). Eur J Obstet Amp Gynecol Reprod Biol. 2020;246:67-71. DOI: https://doi.org/10.1016/j.ejogrb.2020.01.007