Gurza Guillermo, Martínez-Cruz Nayeli, Lizano-Jubert Ileana, Arce-Sánchez Lidia, Suárez-Rico Blanca Vianey, Estrada-Gutierrez Guadalupe, Montoya-Estrada Araceli, Romo-Yañez José, Solis-Paredes Juan Mario, Torres-Torres Johnatan, González-Ludlow Isabel, Rodríguez-Cano Ameyalli Mariana, Tolentino-Dolores Maricruz, Perichart-Perera Otilia, Reyes-Muñoz Enrique
Coordination of Endocrinology, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City 11000, Mexico.
Coordination of Gynecological and Perinatal Endocrinology, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City 11000, Mexico.
Diagnostics (Basel). 2025 Apr 29;15(9):1129. doi: 10.3390/diagnostics15091129.
: Insulin resistance during pregnancy is a key factor underlying gestational diabetes mellitus (GDM) and other adverse perinatal outcomes (APOs). While traditional markers, such as HOMA-IR, are used to evaluate insulin resistance, they may be inaccessible in resource-limited settings. The triglyceride-glucose (TyG) index has emerged as a practical alternative. This study aimed to assess whether or not a TyG index > 8.6 during the first trimester of pregnancy is associated with an increased risk of APOs, including GDM, preeclampsia, and other maternal and neonatal complications. : A prospective cohort study was conducted involving 333 pregnant women in Mexico City, divided into two groups: Group 1 (TyG index > 8.6, = 153) and Group 2 (TyG index ≤ 8.6, = 180). Primary outcomes included gestational diabetes mellitus (GDM), hypertensive disorders of pregnancy, preeclampsia, preterm birth, cesarean section, and large-for-gestational-age (LGA) and small-for-gestational-age (SGA) neonates. Logistic regression models were used to calculate the adjusted relative risk (aRR) and 95% confidence intervals (CIs), adjusting for maternal age, pregestational weight, and body mass index (BMI). : Women with a TyG index > 8.6 had a significantly higher pregestational weight and BMI than those with a TyG index ≤ 8.6. Group 1 demonstrated a higher risk of GDM (RR 2.05; 95% CI: 1.23-3.41) and preeclampsia (RR 2.15; 95% CI: 1.10-4.21). After adjusting for maternal age, pregestational weight, and BMI, these associations remained significant: GDM (aRR 1.87; 95% CI: 1.0-2.5) and preeclampsia (aRR 2.18; 95% CI: 1.1-5.0). No significant associations were found between an elevated TyG index and other APOs, including LGA, SGA, preterm birth, or cesarean delivery. : A first-trimester TyG index > 8.6 is significantly associated with an increased risk of GDM and preeclampsia, highlighting its potential as a predictive marker for adverse perinatal outcomes. These findings underscore the utility of the TyG index as a practical, cost-effective tool for early risk stratification, particularly in resource-limited settings. Further multi-center research is needed to validate these results and refine population-specific thresholds.
孕期胰岛素抵抗是妊娠糖尿病（GDM）及其他不良围产期结局（APO）的关键潜在因素。虽然传统指标如HOMA-IR用于评估胰岛素抵抗，但在资源有限的环境中可能无法获取这些指标。甘油三酯-葡萄糖（TyG）指数已成为一种实用的替代指标。本研究旨在评估妊娠早期TyG指数>8.6是否与包括GDM、先兆子痫以及其他母婴并发症在内的APO风险增加相关。
一项前瞻性队列研究在墨西哥城的333名孕妇中进行，分为两组：第1组（TyG指数>8.6，n = 153）和第2组（TyG指数≤8.6，n = 180）。主要结局包括妊娠糖尿病（GDM）、妊娠高血压疾病、先兆子痫、早产、剖宫产以及大于胎龄儿（LGA）和小于胎龄儿（SGA）。采用逻辑回归模型计算调整后的相对风险（aRR）和95%置信区间（CI），并对孕妇年龄、孕前体重和体重指数（BMI）进行调整。
TyG指数>8.6的女性孕前体重和BMI显著高于TyG指数≤8.6的女性。第1组发生GDM（RR 2.05；95% CI：1.23 - 3.41）和先兆子痫（RR 2.15；95% CI：1.10 - 4.21）的风险更高。在对孕妇年龄、孕前体重和BMI进行调整后，这些关联仍然显著：GDM（aRR 1.87；95% CI：1.0 - 2.5）和先兆子痫（aRR 2.18；95% CI：1.1 - 5.0）。未发现TyG指数升高与其他APO之间存在显著关联，包括LGA、SGA、早产或剖宫产。
妊娠早期TyG指数>8.6与GDM和先兆子痫风险增加显著相关，突出了其作为不良围产期结局预测指标的潜力。这些发现强调了TyG指数作为一种实用、经济有效的早期风险分层工具的实用性，特别是在资源有限的环境中。需要进一步的多中心研究来验证这些结果并完善针对特定人群的阈值。
