TyG-HbA1c Index Independently Predicts Prediabetes and Diabetes in Postmenopausal Women: Study
China: In middle-aged and older postmenopausal women, a higher TyG-HbA1c index was identified as a significant independent risk factor for both prediabetes and diabetes. This combined metabolic marker may help improve early identification of postmenopausal women at increased risk of dysglycemia. The findings were published in Frontiers in Endocrinology by Ziran Xiu, Clinical Skills Training Center, Central Hospital of Dalian University of Technology (Dalian Municipal Central Hospital), Dalian, China, and colleagues.
Postmenopausal women experience metabolic changes that increase their susceptibility to impaired glucose regulation and type 2 diabetes. Since abnormalities in lipid and glucose metabolism often occur together, researchers explored whether the triglyceride-high density lipoprotein cholesterol-glucose body index (TyHGB) could serve as a simple predictor of future dysglycemia in this high-risk population.
To investigate this, the researchers analyzed data from the REACTION study conducted in Dalian, China. The longitudinal study included postmenopausal women with normal glucose tolerance at baseline who were followed for three years. Multivariable logistic regression was used to examine the association between TyHGB and the development of prediabetes and diabetes, while restricted cubic spline analysis assessed dose-response relationships. Receiver operating characteristic (ROC) curve analysis compared the predictive performance of TyHGB with conventional metabolic indicators.
The study included 2,138 middle-aged and older postmenopausal women with normal blood glucose levels at enrollment. During the three-year follow-up, 598 women developed prediabetes and 124 progressed to diabetes.
Key findings
- Higher TyHGB levels were independently associated with an increased risk of both prediabetes and diabetes.
- A nonlinear dose-response relationship was observed, with prediabetes risk rising sharply until a TyHGB value of 8.52 before leveling off.
- Diabetes risk remained relatively stable at lower TyHGB values but increased markedly once the index exceeded 6.47.
- The association between TyHGB and dysglycemia remained consistent regardless of age, hypertension, hyperlipidemia, or coronary heart disease status.
- ROC analysis indicated that TyHGB showed good predictive performance for identifying women at risk of developing diabetes.
The findings suggest that TyHGB may serve as a practical and easily obtainable marker for identifying postmenopausal women who are at increased risk of developing glucose abnormalities before clinical diabetes develops. Early identification of these high-risk individuals could support timely lifestyle interventions and preventive strategies.
The authors acknowledged limitations including the single-center cohort, absence of HbA1c data, the relatively short three-year follow-up, incomplete information on medication use and hormone replacement therapy, potential residual confounding, and the lack of external validation of the TyHGB index. They concluded that although TyHGB shows promise as a simple predictor of prediabetes and diabetes in postmenopausal women, larger multicenter studies in diverse populations are needed before its routine clinical use can be recommended.
