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Eur J Pediatr. 2018 Apr;177(4):513-520. doi: 10.1007/s00431-018-3088-z. Epub 2018 Jan 19.

The triglyceride-glucose index, an insulin resistance marker in newborns?

Author information

1
Departamento de Nutrición y Ciencia de los Alimentos (Nutrición). Facultad de Farmacia, Universidad Complutense de Madrid e Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Plaza Ramón y Cajal s/n., 28040, Madrid, Spain.
2
Departamento de Salud y Rendimiento Humano, Facultad de Ciencias de la Actividad Física y del Deporte-INEF, Universidad Politécnica de Madrid, Calle Martín Fierro 7, 28040, Madrid, Spain.
3
Centro de CálculoCientífico de la SGAI. Investigación Operativa y Estadística Aplicada. CSIC, Calle Pinar 19, 28006, Madrid, Spain.
4
Departamento de Nutrición y Ciencia de los Alimentos (Nutrición). Facultad de Farmacia, Universidad Complutense de Madrid e Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Plaza Ramón y Cajal s/n., 28040, Madrid, Spain. frasan@ucm.es.

Abstract

The study aims to assess the utility of the triglyceride-glucose index (TyG) as a marker of insulin resistance (IR) in neonates. TyG and the homeostatic model assessment (HOMA-IR) values were compared in 196 singleton, term normoweight and without distress newborns. A Decision Tree procedure (CHAID) was used to classify cases into groups or predict values of a dependent (Ln HOMA-IR) variable. Three nodes were drawn for TyG: ≤ 6.7, > 6.7-7.8 and > 7.8 (p < 0.0001; F = 20.52). The predictability of those TyG values vs HOMA-IR was statistically significant (p < 0.0001). It was neither affected by gender (p = 0.084), glucose challenge test (p = 0.138) classifications nor by the TyG node* glucose challenge test and TyG node*gender interactions (p = 0.456 and p = 0.209, respectively). Glucose, HOMA-IR, and the triglyceride/HDL cholesterol ratio increased progressively from node 1 to 3 for TyG while QUICKI decreased.

CONCLUSION:

In conclusion, TyG appears to be a suitable tool for identifying IR at birth, justifying the further insulin determination in those neonates. TyG ≥ 7.8 is recommended as cut-off point in neonates. The need for a follow-up study to confirm the TyG as early IR marker is desirable.

WHAT IS KNOWN:

• HOMA-IR and the triglyceride-glucose index (TyG) show a high correlation. • The TyG has been used as an insulin resistance marker in adults.

WHAT IS NEW:

• This is the first study where TyG has been assessed in neonates. • TyG appears to be a suitable and cheap tool for identifying insulin resistance at birth.

KEYWORDS:

Glucose; HOMA-IR; Insulin; Neonates; QUICKI; TG/HDLc; TyG

PMID:
29350334
DOI:
10.1007/s00431-018-3088-z
[Indexed for MEDLINE]

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