ArticleFrontiers in endocrinology2026
The predictive value of surrogate insulin resistance indices for T2DM complicated with metabolic syndrome: a retrospective study based on hospitalized patients in China.
Article in Frontiers in endocrinology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objectives: To evaluate the predictive value of surrogate indices of insulin resistance (IR)- specifically, the triglyceride-glucose (TyG) index, the triglyceride glucose-body mass (TyG-BMI) index, and the triglyceride (TG) to high-density lipoprotein cholesterol (HDL-C) for metabolic syndrome (MetS) in patients with type 2 diabetes mellitus (T2DM). Methods: A single-center, retrospective study was conducted involving 2409 T2DM patients. Based on the presence of MetS, participants were divided into a T2DM-MetS group (n=1,787) and a T2DM-only group (n=622). Logistic regression was used to analyze the influencing factors for T2DM complicated with MetS, and to compare the predictive value of the TyG index, the TyG-BMI index, and the TG/HDL-C ratio. A nomogram prediction model was constructed. The model's discriminative ability, clinical utility, and calibration were evaluated using the receiver operating characteristic (ROC) curve, decision curve analysis (DCA), and a calibration curve, respectively. Results: The multivariate logistic regression analysis model revealed that Sex, Wasit-to-hip ratio (WHR), fasting C-Peptide (FCP), 2-hour C-Peptide (2hCP), the TyG index, the TyG-BMI index, and the TG/HDL-C ratio were risk factors for T2DM complicated with MetS. The area under the curve (AUC) for the TyG index, the TyG-BMI index, and the TG/HDL-C ratio in predicting T2DM complicated with MetS were 0.809, 0.807, and 0.915, respectively. The prediction model was constructed using the TG/HDL-C ratio, Sex, WHR, and FCP. The model demonstrated that the C-index for predicting the presence of MetS in T2DM patients was 0.922 (95% CI: 0.909, 0.936). The DCA showed a maximum net benefit rate of 0.742. Conclusions: The surrogate indices for IR (the TyG index, the TyG-BMI index, and the TG/HDL-C ratio) were risk factors for T2DM complicated with MetS, among which the TG/HDL-C ratio was the optimal predictor. The nomogram model constructed based on the TG/HDL-C ratio, Sex, WHR, and FCP demonstrated good predictive performance for T2DM complicated with MetS. This model shows good calibration and practicality, providing a valuable reference to aid in early identification and preventive strategies in clinical practice.
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