Triglyceride Parameters (Tgi and Tg/Hdl) Predict Insulin Resistance as Good as Homa-Ir in Obese Adults with Insulin Resistance.

Abstract

The homeostasis model assessment intended for insulin resistance (HOMA-IR) is broadly used as anindicatorfor insulin resistance (IR) particularly in research. This indicator, however, is difficult to be validfor populations with low incomes in addition to its limited availability. Triglyceride related parameters like triglyceride-glucose index (TGI) and triglyceride high density lipoprotein (TG/HDL) which can be estimated on the other hand from a usual test (lipid profile and glucose) that is less expensive than serum insulin. In predicting the occurrence of IR which is highly desirable for public health due to the association of both obesity and IR with different health issues and complications; so simple tests for the diagnosis of IR are required. Objectives:The aim of this study is to compare (TGI) and (TG/HD) indices with HOMA-IR as a marker of Insulin Resistance (IR) in obese adults. Design and methods:The study was conducted on one hundred obese and non-obese, all non-diabetic, apparently healthy females and males aged 18 to 50 years old from the general population.BMI, waist circumference, blood pressure (BP) were measured and blood samplesfor glucose,HbA1c, triglycerides, HDL cholesterol, and serum insulin were also taken. This data was used in obtaining TG/HDL and TGIformulae;also,HOMA-IR was calculated by: HOMA-IR = {insulin mIU/L} × {glucose mg/dl} / 405. Results: About 50 % of the participants were obese had HOMA–IR level of ˃2 whereas the other 50% non-obese with HOMA-IR ≤ 2.Pearson's correlation coefficient ofTGI in two groups was (r = 0.34, P- value0.0177) and TG-HDL was (r =0.57, P-value0.0001). The mean of TGIwas(4.93±0.02) in adults with abnormal HOMA-IR and (4.44±0.01) in adults with normal HOMA-IR. Also, TG-HDL mean was (4.72±0.15, 1.80±0.04) in two groups respectively. Area under curve (AUC) for HOMA-IR, TG/HDL and TGI was in order (0.940, 0.803 and 0.721). Conclusions and Recommendations:Both TG/HDLandTGI could be used for IR prediction in obese adults with high significance (p value = 0.0001, p value = 0.0177) and cutoffs (≥ 2.7 and ≥ 4.9) for both parameters respectively. We recommend the use of TG/HDL and TGI in assessing different relations such as obesity with prediabetes, diabetes and cardiometabolic risk among adults. Additionally, it is preferable to increase sample size for better cutoff estimation.