The triglyceride-glucose index, an insulin resistance marker in newborns?

Eur J Pediatr. 2018 Apr;177(4):513-520. doi: 10.1007/s00431-018-3088-z. Epub 2018 Jan 19.


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 determination 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.

Keywords: Glucose; HOMA-IR; Insulin; Neonates; QUICKI; TG/HDLc; TyG.

MeSH terms

  • Anthropometry
  • Biomarkers / blood*
  • Blood Glucose / analysis*
  • Female
  • Homeostasis / physiology
  • Humans
  • Infant, Newborn
  • Insulin Resistance / physiology*
  • Male
  • Triglycerides / blood*


  • Biomarkers
  • Blood Glucose
  • Triglycerides