Association of the Triglyceride–Glucose Index During the First Trimester of Pregnancy with Adverse Perinatal Outcomes

<b>Background/Objectives</b>: 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 r...

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Main Authors: Guillermo Gurza, Nayeli Martínez-Cruz, Ileana Lizano-Jubert, Lidia Arce-Sánchez, Blanca Vianey Suárez-Rico, Guadalupe Estrada-Gutierrez, Araceli Montoya-Estrada, José Romo-Yañez, Juan Mario Solis-Paredes, Johnatan Torres-Torres, Isabel González-Ludlow, Ameyalli Mariana Rodríguez-Cano, Maricruz Tolentino-Dolores, Otilia Perichart-Perera, Enrique Reyes-Muñoz
Format: Article
Language:English
Published: MDPI AG 2025-04-01
Series:Diagnostics
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Online Access:https://www.mdpi.com/2075-4418/15/9/1129
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author Guillermo Gurza
Nayeli Martínez-Cruz
Ileana Lizano-Jubert
Lidia Arce-Sánchez
Blanca Vianey Suárez-Rico
Guadalupe Estrada-Gutierrez
Araceli Montoya-Estrada
José Romo-Yañez
Juan Mario Solis-Paredes
Johnatan Torres-Torres
Isabel González-Ludlow
Ameyalli Mariana Rodríguez-Cano
Maricruz Tolentino-Dolores
Otilia Perichart-Perera
Enrique Reyes-Muñoz
author_facet Guillermo Gurza
Nayeli Martínez-Cruz
Ileana Lizano-Jubert
Lidia Arce-Sánchez
Blanca Vianey Suárez-Rico
Guadalupe Estrada-Gutierrez
Araceli Montoya-Estrada
José Romo-Yañez
Juan Mario Solis-Paredes
Johnatan Torres-Torres
Isabel González-Ludlow
Ameyalli Mariana Rodríguez-Cano
Maricruz Tolentino-Dolores
Otilia Perichart-Perera
Enrique Reyes-Muñoz
author_sort Guillermo Gurza
collection DOAJ
description <b>Background/Objectives</b>: 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. <b>Methods</b>: A prospective cohort study was conducted involving 333 pregnant women in Mexico City, divided into two groups: Group 1 (TyG index > 8.6, <i>n</i> = 153) and Group 2 (TyG index ≤ 8.6, <i>n</i> = 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). <b>Results</b>: 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. <b>Conclusions</b>: 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.
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spelling doaj-art-3e3412a569e746fe8ab1a98f9f2f3bf62025-08-20T01:49:20ZengMDPI AGDiagnostics2075-44182025-04-01159112910.3390/diagnostics15091129Association of the Triglyceride–Glucose Index During the First Trimester of Pregnancy with Adverse Perinatal OutcomesGuillermo Gurza0Nayeli Martínez-Cruz1Ileana Lizano-Jubert2Lidia Arce-Sánchez3Blanca Vianey Suárez-Rico4Guadalupe Estrada-Gutierrez5Araceli Montoya-Estrada6José Romo-Yañez7Juan Mario Solis-Paredes8Johnatan Torres-Torres9Isabel González-Ludlow10Ameyalli Mariana Rodríguez-Cano11Maricruz Tolentino-Dolores12Otilia Perichart-Perera13Enrique Reyes-Muñoz14Coordination of Endocrinology, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City 11000, MexicoCoordination of Endocrinology, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City 11000, MexicoCoordination of Gynecological and Perinatal Endocrinology, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City 11000, MexicoCoordination of Endocrinology, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City 11000, MexicoCoordination of Gynecological and Perinatal Endocrinology, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City 11000, MexicoDepartment of Immunobiochemistry, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City 11000, MexicoCoordination of Gynecological and Perinatal Endocrinology, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City 11000, MexicoCoordination of Gynecological and Perinatal Endocrinology, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City 11000, MexicoClinical Research Branch, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City 11000, MexicoClinical Research Branch, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City 11000, MexicoDepartment of Nutrition and Bioprogramming, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City 11000, MexicoDepartment of Nutrition and Bioprogramming, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City 11000, MexicoDepartment of Nutrition and Bioprogramming, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City 11000, MexicoDepartment of Nutrition and Bioprogramming, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City 11000, MexicoCoordination of Gynecological and Perinatal Endocrinology, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City 11000, Mexico<b>Background/Objectives</b>: 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. <b>Methods</b>: A prospective cohort study was conducted involving 333 pregnant women in Mexico City, divided into two groups: Group 1 (TyG index > 8.6, <i>n</i> = 153) and Group 2 (TyG index ≤ 8.6, <i>n</i> = 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). <b>Results</b>: 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. <b>Conclusions</b>: 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.https://www.mdpi.com/2075-4418/15/9/1129triglyceride–glucose indexperinatal outcomesgestational diabetespreeclampsiapregnancy
spellingShingle Guillermo Gurza
Nayeli Martínez-Cruz
Ileana Lizano-Jubert
Lidia Arce-Sánchez
Blanca Vianey Suárez-Rico
Guadalupe Estrada-Gutierrez
Araceli Montoya-Estrada
José Romo-Yañez
Juan Mario Solis-Paredes
Johnatan Torres-Torres
Isabel González-Ludlow
Ameyalli Mariana Rodríguez-Cano
Maricruz Tolentino-Dolores
Otilia Perichart-Perera
Enrique Reyes-Muñoz
Association of the Triglyceride–Glucose Index During the First Trimester of Pregnancy with Adverse Perinatal Outcomes
Diagnostics
triglyceride–glucose index
perinatal outcomes
gestational diabetes
preeclampsia
pregnancy
title Association of the Triglyceride–Glucose Index During the First Trimester of Pregnancy with Adverse Perinatal Outcomes
title_full Association of the Triglyceride–Glucose Index During the First Trimester of Pregnancy with Adverse Perinatal Outcomes
title_fullStr Association of the Triglyceride–Glucose Index During the First Trimester of Pregnancy with Adverse Perinatal Outcomes
title_full_unstemmed Association of the Triglyceride–Glucose Index During the First Trimester of Pregnancy with Adverse Perinatal Outcomes
title_short Association of the Triglyceride–Glucose Index During the First Trimester of Pregnancy with Adverse Perinatal Outcomes
title_sort association of the triglyceride glucose index during the first trimester of pregnancy with adverse perinatal outcomes
topic triglyceride–glucose index
perinatal outcomes
gestational diabetes
preeclampsia
pregnancy
url https://www.mdpi.com/2075-4418/15/9/1129
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