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ORIGINAL RESEARCH article

Front. Endocrinol.

Sec. Clinical Diabetes

Volume 16 - 2025 | doi: 10.3389/fendo.2025.1668021

This article is part of the Research TopicWorld Diabetes Day 2024: Exploring Mechanisms, Innovations, and Holistic Approaches in Diabetes CareView all 22 articles

Association between triglyceride-glucose and triglyceride glucose body mass index with risk of prediabetes: A multicenter Chinese medical examination cohort study

Provisionally accepted
  • 1Deyang Jingyang Maternal and Child Health Hospital, Deyang, Sichuan, China, Deyang, China
  • 2Department of Clinical Laboratory, Chengdu BOE Hospital, Chengdu, 610000, Sichuan, China, Chengdu, China
  • 3Department of Clinical Laboratory, The First People's Hospital of Nanning, 530022, Nanning, China, Nanning, China

The final, formatted version of the article will be published soon.

Background & aims Although triglyceride-glucose (TyG) indices reliably identify insulin resistance and diabetes, their link to prediabetes risk is understudied. We analyze the associations of TyG and TyG-body mass index (TyG-BMI) with prediabetes risk in a Chinese population. Methods This retrospective cohort study used data from 11 urban physical-examination centers of the Rich Healthcare Group. A total of 161606 Chinese adults free of diabetes at baseline were included. Participants were categorized by quartiles of the TyG index and the TyG-BMI. Cox proportional hazards regression and Kaplan–Meier analyses were used to estimate the associations between these exposures and incident prediabetes. Restricted cubic splines with piecewise Cox models were applied to explore potential non-linear relationships and identify inflection points. Subgroup and sensitivity analyses were performed to assess the robustness of the findings. Results Over a median follow-up of 3.0 years, 18339 participants (11.3%) developed incident prediabetes. After multivariable adjustment, both TyG and TyG-BMI were positively associated with prediabetes risk. Restricted cubic splines revealed non-linear relationships (P < 0.001) with distinct threshold effects. The associations were stronger among adults younger than 45 years and among women, with significant additive interactions observed. Kaplan–Meier curves showed the highest cumulative incidence of prediabetes in the top quartiles of both TyG and TyG-BMI. Conclusions In this Chinese cohort, TyG and TyG-BMI showed non-linear associations with incident prediabetes, with steeper risk increases among women and adults younger than 45 years. These indices may identify high-risk insulin resistance states preceding dysglycemia.

Keywords: Triglyceride-glucose index, triglyceride-glucose–body mass index, prediabetes, Chinese adults, cohort study

Received: 18 Jul 2025; Accepted: 29 Sep 2025.

Copyright: © 2025 Feng, Wang and Luo. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Chengya Feng, chengya202312@163.com

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