Association between triglyceride-glucose index in early pregnancy and risk of preeclampsia: a multicenter retrospective cohort study.

IF 3.9 2区医学 Q2 BIOCHEMISTRY & MOLECULAR BIOLOGY

Lipids in Health and Disease Pub Date : 2025-04-23 DOI:10.1186/s12944-025-02556-z

Qiong Li, Chenyang Zhao, Miao Liu, Meng Li, Ying Zhang, Chaoyan Yue

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引用次数: 0

Abstract

Background: Previous evidence has indicated that insulin resistance may be an early pathological state of preeclampsia (PE). As a novel biomarker, the triglyceride glucose (TyG) index can reflect the level of insulin resistance in the body. The present study aimed to investigate the association between the TyG index and risk of PE.

Methods: This study included 41,694 singleton pregnant women, comprising 2,308 PE patients and 39,386 healthy controls from three tertiary hospitals from January 2019 to June 2024. Datas were retrospectively collected via medical record review. The TyG index was measured before 20 weeks of gestation, and participants were grouped via the TyG index quartiles. The primary outcome was PE, and the secondary outcomes were preterm birth and low birth weight (LBW). Multivariable logistic regression was used to calculate the odds ratios (ORs) for the TyG index quartiles compared to the lowest quartile for the primary and secondary outcomes. Subgroup analyses were conducted to evaluate the effect of age, body mass index (BMI), parity and TyG test week on these associations. The predictive efficacy of the TyG index for PE was assessed using receiver operating characteristic (ROC) curve analysis.

Results: After adjusting for confounders, compared to TyG index Q1, a higher TyG index was positively associated with PE (TyG index Q3 OR = 1.23, 95% confidence interval (CI): 1.06-1.43, P = 0.0067; TyG index Q4 OR = 1.31, 95% CI: 1.11-1.53, P = 0.0011) and preterm birth (TyG index Q4 OR = 1.18, 95% CI: 1.01-1.37, P = 0.0376), negatively associated with LBW (TyG index Q3 OR = 0.84, 95% CI: 0.74-0.97, P = 0.0147). In Model I, a significant association was observed between higher TyG quartiles and preterm birth (P = 0.0472 for Q3 and P = 0.0000 for Q4), but this association was not significant in Model II after adjusting for confounders. Subgroup analyses revealed that age, pre-pregnancy BMI, parity and test week did not influence these associations (interaction P > 0.05). The area under the ROC curve (AUC) for the predictive model was 0.596 (95% CI: 0.584-0.608), with a sensitivity of 65.4% and a specificity of 49.6%.

Conclusion: The present findings suggested that the TyG index associated with a high risk of PE. Clinical evaluation incorporating the TyG index during early pregnancy may help in screening for patients at high risk of PE.

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妊娠早期甘油三酯-葡萄糖指数与子痫前期风险的关系：一项多中心回顾性队列研究

背景：既往证据表明胰岛素抵抗可能是子痫前期（PE）的早期病理状态。甘油三酯葡萄糖（TyG）指数作为一种新型的生物标志物，可以反映机体的胰岛素抵抗水平。本研究旨在探讨TyG指数与PE风险之间的关系。方法：本研究纳入了2019年1月至2024年6月来自三家三级医院的41694名单胎孕妇，其中2308名PE患者和39386名健康对照。资料通过病历回顾收集。在妊娠20周之前测量TyG指数，并通过TyG指数四分位数对参与者进行分组。主要结局是PE，次要结局是早产和低出生体重（LBW）。使用多变量逻辑回归计算TyG指数四分位数与最低四分位数的主要和次要结果的比值比（ORs）。进行亚组分析以评估年龄、体重指数（BMI）、胎次和TyG检测周对这些关联的影响。采用受试者工作特征（ROC）曲线分析评价TyG指标对PE的预测效果。结果：调整混杂因素后，与TyG指数Q1相比，较高的TyG指数与PE呈正相关(TyG指数Q3 OR = 1.23, 95%可信区间（CI）： 1.06-1.43, P = 0.0067；TyG指数Q4 OR = 1.31, 95% CI: 1.11 ~ 1.53, P = 0.0011)和早产（TyG指数Q4 OR = 1.18, 95% CI: 1.01 ~ 1.37, P = 0.0376）与低体重呈负相关（TyG指数Q3 OR = 0.84, 95% CI: 0.74 ~ 0.97, P = 0.0147）。在模型1中，较高的TyG四分位数与早产之间存在显著关联（第三季度P = 0.0472，第四季度P = 0.0000），但在调整混杂因素后，这种关联在模型2中不显著。亚组分析显示，年龄、孕前BMI、胎次和测试周对这些关联没有影响（相互作用P < 0.05）。预测模型的ROC曲线下面积（AUC）为0.596 (95% CI: 0.584-0.608)，敏感性为65.4%，特异性为49.6%。结论：本研究提示TyG指数与PE高风险相关。妊娠早期结合TyG指数的临床评估有助于筛查PE高危患者。

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来源期刊

Lipids in Health and Disease 生物-生化与分子生物学

CiteScore

7.70

自引率

2.20%

发文量

122

审稿时长

3-8 weeks

期刊介绍： Lipids in Health and Disease is an open access, peer-reviewed, journal that publishes articles on all aspects of lipids: their biochemistry, pharmacology, toxicology, role in health and disease, and the synthesis of new lipid compounds. Lipids in Health and Disease is aimed at all scientists, health professionals and physicians interested in the area of lipids. Lipids are defined here in their broadest sense, to include: cholesterol, essential fatty acids, saturated fatty acids, phospholipids, inositol lipids, second messenger lipids, enzymes and synthetic machinery that is involved in the metabolism of various lipids in the cells and tissues, and also various aspects of lipid transport, etc. In addition, the journal also publishes research that investigates and defines the role of lipids in various physiological processes, pathology and disease. In particular, the journal aims to bridge the gap between the bench and the clinic by publishing articles that are particularly relevant to human diseases and the role of lipids in the management of various diseases.