Associations of triglyceride-glucose index cumulative exposure and variability with the transitions from normoglycaemia to prediabetes and prediabetes to diabetes: Insights from a cohort study.

AIM

This study aimed to investigate the separate and joint associations of triglyceride-glucose (TyG) index accumulation and variability with prediabetes and diabetes risk.

METHODS

Health check-up participants who underwent 3 sequential health examinations during 2012-2016 and were followed up from 2017 to 2021 were enrolled and categorized into two subcohorts: (a) progression from normoglycaemia to prediabetes subcohort (n = 9373) and (b) progression from prediabetes to diabetes subcohort (n = 4563). Cumulative TyG (cumTyG) and TyG variability from Exams 1-3 were the exposures of interest in our study. The outcomes were newly incident prediabetes or diabetes.

RESULTS

In the prediabetes development subcohort, 2,074 participants developed prediabetes over a 2.42-year follow-up. Higher cumTyG (HR, 2.02; 95 % CI, 1.70-2.41), but not greater TyG variability alone, was significantly associated with increased prediabetes risk. In the diabetes development subcohort, 379 participants developed diabetes over a 3.0-year follow-up. Higher cumTyG (HR, 3.54; 95 % CI, 2.29-5.46), but not greater TyG variability alone, was significantly associated with increased diabetes risk. The "cumTyG+variability" combination had the highest predictive value for prediabetes and diabetes beyond a single baseline TyG measurement.

CONCLUSION

Higher cumTyG exposure independently predicts prediabetes and diabetes incidence. Coexisting cumTyG and variability could further yield incrementally greater risks.