Elevated Triglyceride-Glucose Index Is Associated With Insulin Resistance, Metabolic Syndrome Components, Nonalcoholic Fatty Liver Disease, and Adverse Pregnancy Outcomes in Chinese Women With Polycystic Ovary Syndrome

IF 2.4 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Clinical Endocrinology Pub Date : 2025-04-29 DOI:10.1111/cen.15252

Jiaxing Feng, Rong Luo, Jingshu Gao, Yu Wang, Jing Cong, Hongli Ma, Xiaoke Wu

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Abstract

Aim

To investigate the associations of triglyceride-glucose index (TyG) with anthropometric characteristics, metabolic/endocrine profiles, and pregnancy outcomes in Chinese women with polycystic ovary syndrome (PCOS).

Methods

This secondary analysis of the Acupuncture and Clomiphene for Chinese Women with Polycystic Ovary Syndrome trial (PCOSAct) included 956 participants with prospectively collected data. TyG was calculated using fasting triglyceride and glucose levels (Ln [TG (mg/dL) × FPG (mg/dL)/2]). Linear regression and trend analyses evaluated relationships between TyG and clinical parameters. Receiver operating characteristic (ROC) curves assessed TyG's predictive capacity for insulin resistance (IR), metabolic syndrome (MS), and nonalcoholic fatty liver disease (NAFLD). Multivariable logistic regression estimated risks for metabolic outcomes and pregnancy outcomes.

Results

Linear trends revealed that the TyG was positively associated with age, body mass index (BMI), waist circumference, hip circumference, waist-to-hip ratio, systolic blood pressure, diastolic blood pressure, FPG, fasting insulin, the homeostatic model assessment for insulin resistance (HOMA-IR), total cholesterol, triglycerides, low-density lipoprotein (LDL), apolipoprotein B, free androgen index, alanine aminotransferase (ALT), aspartate aminotransferase (AST), and the prevalence of IR, MS, and NAFLD across various standards. Conversely, TyG was negatively correlated with the quantitative insulin sensitivity check index (QUICKI), high-density lipoprotein (HDL), apolipoprotein A1, sex hormone-binding globulin (SHBG), and the prevalence of ovulation per cycle, conception, pregnancy, and live birth. After adjusting for age and BMI, a significant linear relationship was observed between TyG and components of MS, IR markers, and ALT. The ROC curve analysis indicated that the AUC_MS-IDF was 0.871 (95% CI: 0.846–0.896), with a sensitivity of 81.4% and specificity of 81.2% at a cut-off value of 8.745, and the AUC_IR-HOMA-IR was 0.782 (95% CI: 0.753–0.811), with 71.9% sensitivity and 70.3% specificity at a cut-off of 8.585, and the AUC_NAFLD was 0.705 (95% CI: 0.644–0.766), with 76.8% sensitivity and 59.3% specificity at a cut-off value of 8.665. Logistic regression analysis demonstrated that participants in the highest quartile (Q4) of TyG had significantly higher odds ratios (OR) for MS (OR: 38.36, 95% CI: 20.03–73.46, P-trend < 0.001) and IR (OR: 12.49, 95% CI: 7.3–21.35, P-trend < 0.001) compared to those in the lowest quartile (Q1), while NAFLD showed a marginal association (OR: 2.56, 95% CI: 1.00–6.55, P-trend = 0.069) after adjusting for confounding factors. Conversely, participants in Q1 of TyG had higher OR of conception (OR: 1.56, 95% CI: 1.04–2.35, p < 0.05), pregnancy (OR: 2.35, 95% CI: 1.46–3.79, p < 0.01), and live birth (OR: 2.32, 95% CI: 1.42–3.78, p < 0.01) compared to those in Q4 after adjusting for treatments.

Conclusions

Elevated TyG index strongly associates with adverse metabolic trajectories, and adverse pregnancy outcomes in PCOS patients. This biomarker shows particular utility for identifying metabolic dysfunction, suggesting clinical potential for risk stratification in PCOS management.

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中国多囊卵巢综合征妇女甘油三酯-葡萄糖指数升高与胰岛素抵抗、代谢综合征成分、非酒精性脂肪性肝病和不良妊娠结局相关

目的：探讨中国多囊卵巢综合征（PCOS）女性甘油三酯-葡萄糖指数（TyG）与人体测量学特征、代谢/内分泌特征和妊娠结局的关系。方法：对针刺加克罗米芬治疗中国女性多囊卵巢综合征试验（PCOSAct）进行二次分析，纳入956名前瞻性收集的受试者。通过空腹甘油三酯和葡萄糖水平（Ln [TG （mg/dL） × FPG (mg/dL)/2]）计算TyG。线性回归和趋势分析评估了TyG与临床参数之间的关系。受试者工作特征（ROC）曲线评估TyG对胰岛素抵抗（IR）、代谢综合征（MS）和非酒精性脂肪性肝病（NAFLD）的预测能力。多变量logistic回归估计了代谢结局和妊娠结局的风险。结果:线性趋势显示，TyG与年龄、体重指数（BMI）、腰围、臀围、腰臀比、收缩压、舒张压、FPG、空腹胰岛素、胰岛素抵抗稳态模型评估（HOMA-IR）、总胆固醇、甘油三酯、低密度脂蛋白（LDL）、载脂蛋白B、游离雄性激素指数、丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（AST）、IR、MS、MS患病率呈正相关。和NAFLD的不同标准相反，TyG与定量胰岛素敏感性检查指数（QUICKI）、高密度脂蛋白（HDL）、载脂蛋白A1、性激素结合球蛋白（SHBG）、月经周期排卵、受孕、妊娠和活产率呈负相关。校正年龄和BMI后，TyG与MS、IR标志物成分、ALT之间存在显著的线性关系。ROC曲线分析显示，AUCMS-IDF为0.871 (95% CI: 0.846-0.896)，敏感性为81.4%，特异性为81.2%，临界值为8.745；AUCIR-HOMA-IR为0.782 (95% CI: 0.753-0.811)，敏感性为71.9%，特异性为70.3%，临界值为8.585；AUCNAFLD为0.705 (95% CI：0.644 ~ 0.766)，敏感性76.8%，特异性59.3%，临界值为8.665。Logistic回归分析显示，TyG最高四分位数（Q4）的参与者患MS的比值比（OR）显著较高（OR: 38.36, 95% CI: 20.03-73.46）， p趋势结论：TyG指数升高与PCOS患者不良代谢轨迹和不良妊娠结局密切相关。该生物标志物在识别代谢功能障碍方面显示出特殊的效用，提示PCOS管理风险分层的临床潜力。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Endocrinology 医学-内分泌学与代谢

CiteScore

6.40

自引率

3.10%

发文量

192

审稿时长

1 months

期刊介绍： Clinical Endocrinology publishes papers and reviews which focus on the clinical aspects of endocrinology, including the clinical application of molecular endocrinology. It does not publish papers relating directly to diabetes care and clinical management. It features reviews, original papers, commentaries, correspondence and Clinical Questions. Clinical Endocrinology is essential reading not only for those engaged in endocrinological research but also for those involved primarily in clinical practice.