First-Trimester TyG Index during first trimester may predict GDM and gestational hypertension: Study

A new study published in the journal of BMC Pregnancy and Childbirth showed that gestational diabetes mellitus (GDM) and gestational hypertension (GH) are closely linked to an increased triglyceride-glucose (TyG) index during the first trimester.

TyG index is a surrogate measure of insulin resistance and has drawn attention. Insulin resistance typically rises throughout pregnancy to promote the growth of the fetus, but high resistance in the early stages of pregnancy can put women at risk for complications like preterm delivery, preeclampsia, GDM, and fetal overgrowth. Early-trimester TyG index evaluation provides a chance to detect high-risk pregnancies before clinical issues develop.

According to recent research, aberrant placental development, endothelial dysfunction, and poor glucose metabolism are all linked to high TyG levels. Clinicians can enhance maternal-fetal outcomes and implement early treatments by being aware of these relationships. Thus, this study assessed the TyG index's prediction ability for unfavorable pregnancy outcomes in the first trimester.

This study included 2,847 singleton pregnant women who did not have preconception hypertension or diabetes. The association between the TyG score and unfavorable pregnancy outcomes was investigated using the multivariate logistic regression model.

In the first trimester of pregnancy, the TyG index was a risk factor for both gestational hypertension (GH) (OR = 1.95, 95% CI 1.14–3.33, P < 0.05) and gestational diabetes mellitus (GDM) (OR = 2.16, 95% CI 1.63–2.87, P < 0.001). The area under the curve (AUC) was 0.630 (95% CI 0.600–0.660, P < 0.001), and the best cut-off point of the TyG index for GDM was 8.345 (sensitivity 53.33%, specificity 70.19%).

The TyG index's ideal cut-off point for GH prediction was 8.425 (95%CI 0.578–0.665, P < 0.001), with sensitivity 46.67% and specificity 76.19%. When the early trimester TyG index was >8.167, the restricted cubic spline (RCS) curve indicated a substantial linear connection between it and either GDM or GH.

Overall, the development of GDM and GH in women was closely linked to a higher TyG index in the first trimester of pregnancy. These results indicates that an increased TyG index in the first trimester of pregnancy may aid in predicting the risk of GDM and GH.

Source:

He, X., He, X., Zhou, Y., Liu, J., & Wang, G. (2025). Associations between triglyceride-glucose index in the early trimester of pregnancy and adverse pregnancy outcomes. BMC Pregnancy and Childbirth, 25(1), 986. https://doi.org/10.1186/s12884-025-08121-x