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Fasting plasma glucose is a stronger predictor of diabetes than triglyceride–glucose index, triglycerides/high-density lipoprotein cholesterol, and homeostasis model assessment of insulin resistance: Tehran Lipid and Glucose Study

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Abstract

Aims

To compare the impact of triglyceride–glucose index (TyG-index), the product of fasting plasma glucose (FPG) and triglycerides (TG) with FPG, 2 h post-challenge plasma glucose (2 h-PCPG), TG/high-density lipoprotein cholesterol (TG/HDL-C), and homeostasis model assessment of insulin resistance (HOMA-IR) indices for prediction of type 2 diabetes (T2D) in Iranian adults during a median follow-up of 12 years.

Methods

Study population included 4419 (1858 men) subjects with mean age of 40.6 ± 13.2 years. Multivariable Cox proportional hazard models were used to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs) for each 1-standard deviation increase in each predictor. Areas under the receiver operating characteristics curves (AUC) and 95% CIs were calculated.

Results

During follow-up, 215 men and 288 women developed T2D. The multivariable HRs for FPG, 2 h-PCPG, TyG-index, HOMA-IR, HOMA2-IR, and TG/HDL-C were 2.20, 1.97, 1.71, 1.33, 1.30, and 1.35 in men and 2.13, 2.11, 1.44, 1.37, 1.32, and 1.36 in women (all P < 0.001). Among the total population, the AUC for FPG [0.752 (0.727–0.776)] was similar to 2 h-PCPG but higher than TyG-index [0.697 (0.673–0.720)], TG/HDL-C [0.644 (0.620–0.669)], HOMA-IR [0.684 (0.659–0.710)], and HOMA2-IR [0.656 (0.630–0.682)]. In men, AUC of TyG-index was higher than TG/HDL-C but did not differ with HOMA-IR indices. In women, the AUC of TyG-index was higher than HOMA2-IR and TG/HDL-C, but was similar to that of HOMA-IR.

Conclusions

FPG is a stronger predictor of T2D than the TyG-index, TG/HDL-C, and HOMA-IR indices. Although TyG-index was better than TG/HDL-C in both genders, it did not rank above HOMA-IR.

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Acknowledgements

The authors wish to thank the study participants for their enthusiastic cooperation. We would also like to acknowledge Ms. Niloofar Shiva, for critical editing of English grammar and syntax of the manuscript. This manuscript is the result of the MD thesis of Dr Aidin Baghbani-Oskouei.

Funding

This study was supported in part by grant No. 12545-2 from the Shahid Beheshti University of Medical Sciences and by grant No. 121 from the National Research Council of the Islamic Republic of Iran.

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Author notes

  1. Maryam Tohidi and Aidin Baghbani-Oskouei contributed equally to this work and should be considered as co-first authors.

Authors and Affiliations

  1. Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, No. 24, Aarabi St. Velenjak area, Tehran, Iran

    Maryam Tohidi, Aidin Baghbani-Oskouei, Noushin Sadat Ahanchi & Farzad Hadaegh

  2. Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, No. 24, Aarabi St. Velenjak area, Tehran, Iran

    Fereidoun Azizi

Authors
  1. Maryam Tohidi
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  2. Aidin Baghbani-Oskouei
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  3. Noushin Sadat Ahanchi
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  4. Fereidoun Azizi
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  5. Farzad Hadaegh
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Contributions

MT, ABO, FH, and FA participated in the conception and design of the study; MT, ABO, and NA carried out the literature search and participated in data collection and analysis; FH, MT, ABO, and NA participated in interpretation of analysis and writing the manuscript; FA and FH participated in final approval of the version to be submitted. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Farzad Hadaegh.

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The authors declare that they have no conflict of interest.

Human and animal rights

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008.

Informed consent

Informed consent was obtained from all patients for being included in the study.

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Tohidi, M., Baghbani-Oskouei, A., Ahanchi, N. et al. Fasting plasma glucose is a stronger predictor of diabetes than triglyceride–glucose index, triglycerides/high-density lipoprotein cholesterol, and homeostasis model assessment of insulin resistance: Tehran Lipid and Glucose Study. Acta Diabetol 55, 1067–1074 (2018). https://doi.org/10.1007/s00592-018-1195-y

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