New Study Links Triglyceride-Glucose Index to Increased Risk of Periodontitis

"The observational analysis demonstrates a notable association between elevated TyG index levels and an increased risk of periodontitis," the authors wrote.

The study aimed to clarify whether elevated TyG index, a surrogate marker of insulin resistance, correlates with a higher risk of developing periodontitis. To achieve this, the researchers examined data from the National Health and Nutrition Examination Survey (NHANES, 2009–2014) and the Korea National Health and Nutrition Examination Survey (KNHANES, 2007–2018, excluding 2011).

The analysis included a total of 2,511 individuals with periodontitis from NHANES and 16,239 from KNHANES. The researchers employed multivariate logistic regression models, stratified and subgroup analyses, as well as restricted cubic spline (RCS) models to assess the nature and strength of the relationship between TyG index levels and periodontitis. Furthermore, the predictive performance of the TyG index was evaluated using receiver operating characteristic (ROC) curve analysis, and mediation analyses were conducted to explore underlying metabolic and inflammatory contributors.

The key findings include the following:

• Higher TyG index levels were significantly associated with an increased risk of periodontitis in both NHANES and KNHANES cohorts.
• In the NHANES dataset, individuals in the second quartile had a 20% higher risk of periodontitis compared to those in the lowest quartile (OR 1.20).
• In the same dataset, those in the highest quartile had a 23% increased risk (OR 1.23).
• In the KNHANES cohort, individuals in the highest quartile had a 9% greater risk of periodontitis (OR 1.09).
• These associations remained consistent even after adjusting for confounding variables, with a significant trend observed.
• Restricted cubic spline (RCS) analysis showed a nonlinear relationship between TyG index levels and periodontitis risk.
• Receiver operating characteristic (ROC) analysis showed the TyG index had moderate predictive capacity, with values of 8.24 in NHANES and 8.69 in KNHANES.
• Mediation analysis indicated that inflammatory markers (alkaline phosphatase and white blood cells) and metabolic factors (vitamin D and HDL cholesterol) partially mediated the association between the TyG index and periodontitis.

The authors concluded that this observational evidence supports a significant connection between metabolic dysfunction, as captured by the TyG index, and oral health outcomes. They call for further research to unpack the biological mechanisms and to assess whether the TyG index could serve as an early indicator for periodontal disease prevention strategies.

Reference:

Huang J, Zhang D, Li H, Zhang Y, Long T, Guo X, Cui H, Wei Z, Zhao J, Li M and Wang P (2025) Triglyceride-glucose index and periodontitis: evidence from two population-based surveys. Front. Endocrinol. 16:1558692. doi: 10.3389/fendo.2025.1558692