The triglyceride-glucose index, an insulin resistance
marker in newborns?
Francisco J Sánchez-Muniz
Received: 10 October 2017 / Revised: 18 December 2017 / Accepted: 9 January 2018 / Published online: 19 January 2018
Springer-Verlag GmbH Germany, part of Springer Nature 2018
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 deter-
mination 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.
CHAID Chi-squared automatic interaction detection
GDM Gestational diabetes mellitus
GH Growth hormone
HDLc High density lipoprotein cholesterol
HOMA-IR Homeostatic model assessment-insulin resistance
IGF-1 Insulin-like growth factor 1
IGT Impaired glucose tolerance
IR Insulin resistance
MS Metabolic syndrome
QUICKI Quantitative insulin sensitivity check index
T2DM Type 2 diabetes mellitus
TyG Triglyceride-glucose index
Communicated by Mario Bianchetti
* Francisco J Sánchez-Muniz
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
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
Centro de CálculoCientífico de la SGAI. Investigación Operativa y
Estadística Aplicada. CSIC, Calle Pinar 19, 28006 Madrid, Spain
European Journal of Pediatrics (2018) 177:513–520