FIRST-TRIMESTER TRIGLYCERIDE–GLUCOSE INDEX AS AN EARLY PREDICTOR OF GESTATIONAL DIABETES MELLITUS AND PREECLAMPSIA: A PROSPECTIVE COHORT STUDY
ABSTRACT
Background: Gestational diabetes mellitus (GDM) and preeclampsia are major contributors to maternal and perinatal morbidity worldwide. The triglyceride–glucose (TyG) index has emerged as a simple surrogate marker of insulin resistance and may serve as an early predictor of adverse pregnancy outcomes. The objective of the study is to evaluate the association between first-trimester TyG index and the subsequent development of gestational diabetes mellitus and preeclampsia.
Materials and Methods: This prospective cohort study included 580 singleton pregnancies recruited between 11 and 13+6 weeks of gestation. Fasting plasma glucose and triglyceride levels were measured during the first trimester, and the TyG index was calculated as ln [fasting triglycerides (mg/dL) × fasting glucose (mg/dL)/2]. Participants were followed until delivery. GDM was diagnosed according to the International Association of Diabetes and Pregnancy Study Groups criteria, while preeclampsia was defined using American College of Obstetricians and Gynecologists guidelines. Multivariable logistic regression and receiver operating characteristic (ROC) curve analyses were performed.
Result: Among 580 participants, 84 (14.5%) developed GDM and 41 (7.1%) developed preeclampsia. Women who developed GDM and preeclampsia had significantly higher first-trimester TyG index values than unaffected women (both p<0.001). After adjustment for confounding factors, the TyG index remained independently associated with GDM (adjusted OR: 3.84, 95% CI: 2.41–6.11, p<0.001) and preeclampsia (adjusted OR: 3.27, 95% CI: 1.92–5.57, p<0.001). ROC analysis demonstrated good predictive performance for GDM (AUC=0.823) and preeclampsia (AUC=0.801).
Conclusion: An elevated first-trimester TyG index is independently associated with an increased risk of gestational diabetes mellitus and preeclampsia. The TyG index may represent a simple, inexpensive, and readily available biomarker for early pregnancy risk stratification and targeted preventive interventions.
Keywords: Triglyceride–glucose index, TyG index, gestational diabetes mellitus, preeclampsia, insulin resistance, pregnancy complications, first trimester, prospective cohort study.
Background: Gestational diabetes mellitus (GDM) and preeclampsia are major contributors to maternal and perinatal morbidity worldwide. The triglyceride–glucose (TyG) index has emerged as a simple surrogate marker of insulin resistance and may serve as an early predictor of adverse pregnancy outcomes. The objective of the study is to evaluate the association between first-trimester TyG index and the subsequent development of gestational diabetes mellitus and preeclampsia.
Materials and Methods: This prospective cohort study included 580 singleton pregnancies recruited between 11 and 13+6 weeks of gestation. Fasting plasma glucose and triglyceride levels were measured during the first trimester, and the TyG index was calculated as ln [fasting triglycerides (mg/dL) × fasting glucose (mg/dL)/2]. Participants were followed until delivery. GDM was diagnosed according to the International Association of Diabetes and Pregnancy Study Groups criteria, while preeclampsia was defined using American College of Obstetricians and Gynecologists guidelines. Multivariable logistic regression and receiver operating characteristic (ROC) curve analyses were performed.
Result: Among 580 participants, 84 (14.5%) developed GDM and 41 (7.1%) developed preeclampsia. Women who developed GDM and preeclampsia had significantly higher first-trimester TyG index values than unaffected women (both p<0.001). After adjustment for confounding factors, the TyG index remained independently associated with GDM (adjusted OR: 3.84, 95% CI: 2.41–6.11, p<0.001) and preeclampsia (adjusted OR: 3.27, 95% CI: 1.92–5.57, p<0.001). ROC analysis demonstrated good predictive performance for GDM (AUC=0.823) and preeclampsia (AUC=0.801).
Conclusion: An elevated first-trimester TyG index is independently associated with an increased risk of gestational diabetes mellitus and preeclampsia. The TyG index may represent a simple, inexpensive, and readily available biomarker for early pregnancy risk stratification and targeted preventive interventions.
Keywords: Triglyceride–glucose index, TyG index, gestational diabetes mellitus, preeclampsia, insulin resistance, pregnancy complications, first trimester, prospective cohort study.
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