Anthropometry-adjusted TyG indices improve insulin resistance estimation: an exploratory euglycemic-hyperinsulinemic clamp study in Japanese adults without diabetes.

IF 1.2 Q4 ENDOCRINOLOGY & METABOLISM

Diabetology International Pub Date : 2026-04-05 eCollection Date: 2026-04-01 DOI:10.1007/s13340-026-00883-9

Natsu Otowa-Suematsu, Tomoaki Nakamura, Hiroshi Miura, Tomoko Yamada, Marika Nishisaka, Hayato Fukumitsu, Yukari Katsura, Yasuko Morita, Shun-Ichiro Asahara, Kazuhiko Sakaguchi

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Abstract

Background: We evaluated the diagnostic performance of anthropometry-adjusted triglyceride-glucose (TyG)-derived indices for assessing insulin resistance (IR) in Japanese adults without diabetes, using the euglycemic-hyperinsulinemic clamp (EHC) as the reference standard.

Methods: A total of 61 Japanese individuals without diabetes underwent insulin sensitivity assessment using the gold standard EHC. IR was defined as an insulin sensitivity index (ISI) below the 25th percentile. Surrogate IR indices, including Homeostasis Model Assessment of Insulin Resistance (HOMA-IR), the original TyG index, and anthropometry-adjusted TyG-derived indices (TyG-BMI, TyG-WC, TyG-WHtR), were calculated. Correlations between these indices and the ISI were evaluated using Spearman's rank correlation. Receiver operating characteristic (ROC) analysis and linear regression were used to compare diagnostic accuracy and predictive ability. Pairwise DeLong tests were used to assess differences in the area under the curve (AUC) values.

Results: TyG-BMI and TyG-WHtR showed the stronger associations with ISI (ρ = - 0.544 and - 0.546, respectively) than both HOMA-IR and the original TyG index. TyG-BMI and TyG-WHtR had the highest AUCs (0.810 and 0.829, respectively) for identifying clamp-defined IR. The optimal cutoff value for HOMA-IR was approximately 2.5. The optimal cutoff for TyG-BMI was 203.7. Pairwise DeLong tests supported the higher diagnostic performance of selected anthropometry-adjusted TyG-derived indices compared with conventional markers.

Conclusions: Anthropometry-adjusted TyG-derived indices, particularly TyG-BMI and TyG-WHtR, showed strong associations with IR as assessed by the gold standard EHC in Japanese adults without diabetes. These findings suggest that these indices may serve as practical surrogate markers for IR in settings where direct clamp measurements are not feasible.

Supplementary information: The online version contains supplementary material available at 10.1007/s13340-026-00883-9.

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人体测量调整的TyG指数改善胰岛素抵抗估计：一项探索性的日本成人无糖尿病的正血糖-高胰岛素钳夹研究。

背景：我们以正糖-高胰岛素钳（EHC）作为参考标准，评估了人体测量调整的甘油三酯-葡萄糖（TyG）衍生指标在评估日本无糖尿病成人胰岛素抵抗（IR）中的诊断性能。方法：采用金标准EHC对61例无糖尿病的日本人进行胰岛素敏感性评估。IR定义为胰岛素敏感性指数（ISI）低于第25百分位数。计算替代IR指数，包括胰岛素抵抗稳态模型评估（HOMA-IR）、原始TyG指数和经人体测量调整的TyG衍生指数（TyG- bmi、TyG- wc、TyG- whtr）。这些指标与ISI之间的相关性使用Spearman的秩相关进行评估。采用受试者工作特征（ROC）分析和线性回归比较诊断准确性和预测能力。两两DeLong检验用于评估曲线下面积（AUC）值的差异。结果：与HOMA-IR和原始TyG指数相比，TyG- bmi和TyG- whtr与ISI的相关性更强（ρ分别为- 0.544和- 0.546）。TyG-BMI和TyG-WHtR鉴别钳型IR的auc最高（分别为0.810和0.829）。HOMA-IR的最佳临界值约为2.5。TyG-BMI的最佳临界值为203.7。与传统的标记物相比，两两DeLong检验支持选定的经人体测量调整的tyg衍生指数具有更高的诊断性能。结论：经人体测量调整的tyg衍生指数，特别是TyG-BMI和TyG-WHtR，在无糖尿病的日本成年人中被金标准EHC评估显示与IR有很强的相关性。这些发现表明，在直接钳形测量不可行的情况下，这些指标可以作为IR的实用替代标记。补充信息：在线版本包含补充资料，下载地址：10.1007/s13340-026-00883-9。

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来源期刊

Diabetology International ENDOCRINOLOGY & METABOLISM-

CiteScore

3.90

自引率

4.50%

发文量

期刊介绍： Diabetology International, the official journal of the Japan Diabetes Society, publishes original research articles about experimental research and clinical studies in diabetes and related areas. The journal also presents editorials, reviews, commentaries, reports of expert committees, and case reports on any aspect of diabetes. Diabetology International welcomes submissions from researchers, clinicians, and health professionals throughout the world who are interested in research, treatment, and care of patients with diabetes. All manuscripts are peer-reviewed to assure that high-quality information in the field of diabetes is made available to readers. Manuscripts are reviewed with due respect for the author''s confidentiality. At the same time, reviewers also have rights to confidentiality, which are respected by the editors. The journal follows a single-blind review procedure, where the reviewers are aware of the names and affiliations of the authors, but the reviewer reports provided to authors are anonymous. Single-blind peer review is the traditional model of peer review that many reviewers are comfortable with, and it facilitates a dispassionate critique of a manuscript.