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ORIGINAL RESEARCH article

Front. Psychiatry

Sec. Public Mental Health

Associations of the Triglyceride-Glucose Index and Its Combined Indices with Non-Suicidal Self-Injury in Adolescents with Depressive Disorders: The Mediating Role of Sleep Quality

Provisionally accepted
Pule  LiuPule Liu1Shuo  GaoShuo Gao1Yan  ZhangYan Zhang2Jiao  LiJiao Li1Jing  DuJing Du1Ning  YangNing Yang1Qiangli  DongQiangli Dong1*
  • 1Department of Mental Health, Lanzhou University Second Hospital, Lanzhou, China
  • 2Department of Psychiatry, Second Xiangya Hospital, Central South University, Changsha, China

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

Objective: This study examined the associations between the Triglyceride-Glucose (TyG) index and its combined indices (TyG-BMI, TyG-WC, TyG-WHtR) with non-suicidal self-injury (NSSI) in adolescents with Major Depressive Disorder (MDD). It also explored whether sleep quality mediated these relationships. Method: A total of 157 adolescents (12–18 years) with MDD were recruited. Participants were divided into NSSI (n = 78) and non-NSSI (n = 79) groups based on DSM-5 criteria. The TyG index and its derivatives were calculated from fasting blood samples. Analyses included multivariable logistic regression, restricted cubic spline (RCS) analysis, mediation analysis, and receiver operating characteristic (ROC) curves. Results: The NSSI group had higher TyG index values (Median [Q₁, Q₃]: 8.23 [7.95, 8.45]) than the non-NSSI group (7.73 [7.33, 8.21], P < 0.001). Adjusted regression models confirmed significant associations between TyG indices and NSSI (e.g., TyG: OR = 3.50, 95% CI: 1.82–6.74, P < 0.001), especially in female adolescents. Sleep quality partially mediated the link between TyG and NSSI (proportion mediated = 17.1%, P = 0.026). ROC analysis showed moderate predictive accuracy for TyG-WC (AUC = 0.745, 95% CI: 0.666–0.824). Conclusion: The TyG index and its combined indices are positively associated with NSSI in adolescents with MDD. Sleep quality partially mediates this relationship. These indices may serve as low-cost markers for early identification of adolescents at risk for NSSI in clinical practice.

Keywords: Depressive Disorder, adolescents, Triglyceride-glucose index, Non-suicidal self-injury, sleep quality

Received: 05 Sep 2025; Accepted: 24 Nov 2025.

Copyright: © 2025 Liu, Gao, Zhang, Li, Du, Yang and Dong. 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: Qiangli Dong

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