The triglyceride-glucose index may be a surrogate for both insulin resistance and atherogenic lipid profile in Black Africans

Authors

• CC Worthy
• J Gatete
• JS Hurston
• BR Schenk
• CW Dubiose
• LS Mabundo
• R Jagannathan
• AE Sumner

Abstract

Insulin assays are expensive and often unavailable in low-income countries, so the triglyceride-glucose index (TyG) is undergoing global evaluation as a surrogate for insulin resistance (IR) and predictor of cardiovascular disease (CVD). Yet, the value of TyG in African-born Blacks is uncertain. Therefore, in 555 African-born Blacks currently living in the Washington, DC area (Age: 39±10y (mean±SD), Male: 65% (358/555), BMI: 27.7±4.5 kg/m2) we determined: 1) the ability of TyG to predict IR; 2) correlations between four atherogenic lipid parameters and TyG; and 3) correlations between the same lipid parameters and the Matsuda Index. This analysis was conducted by measuring fasting lipid profiles and performing OGTT with glucose and insulin concentrations measured at 0, 30, 60, 90 and 120 minutes. Diabetes, prediabetes and normal glucose tolerance occurred in 7% (37/555), 31% (173/555) and 62% (345/555), respectively. IR was defined by the lowest quartile of the Matsuda Index (≤2.85). Atherogenic lipid profile was defined as low HDL-C, high LDL-C, small LDL particles, and high LDL particle number. AUC-ROC for prediction of IR by TyG was 0.75±0.02 (±SE). Pearson correlations between atherogenic lipid variables and both TyG and Matsuda Index were highly significant (P<0.001). However, each lipid parameter demonstrated significantly higher correlation with TyG than Matsuda Index (HDL-C: -0.36 vs. -0.24, P=0.03; LDL-C: 0.34 vs. 0.20, P=0.01, LDL-size: -0.38 vs. -0.25, P=0.02, LDL-particle size: 0.49 vs. 0.29, P<0.01). Overall, TyG is an acceptable marker of IR in Black Africans and may better predict CVD because of its stronger correlations with atherogenic lipids.

Scientific Focus Area: Health Disparities

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