Objectives: The role of the triglyceride-glucose body mass index (TyG-BMI) in glycaemic state transitions among individuals with pre-diabetes remains unclear. This study explores the association between cumulative average TyG-BMI and the likelihood of regression to normoglycaemia or progression to diabetes.
Methods: Participants with pre-diabetes from the China Health and Retirement Longitudinal Study were included. Pre-diabetes was defined using American Diabetes Association criteria. Cumulative average TyG-BMI was calculated using data from 2011 and 2015. Ordinal logistic regression and restricted cubic spline (RCS) analyses were used to evaluate the association between cumulative average TyG-BMI and glycaemic transitions.
Results: A total of 556 participants (mean age 58.5 years; 45.9% male) were included; 350 (62.9%) remained pre-diabetic, 111 (19.96%) reverted to normoglycaemia and 95 (17.09%) progressed to diabetes. After adjustment for confounding factors, higher cumulative average TyG-BMI was significantly associated with lower odds of regression to normoglycaemia and higher odds of progression to diabetes (OR=0.50; 95% CI 0.33 to 0.62; p<0.001). The RCS analysis demonstrated a negative linear relationship between cumulative average TyG-BMI and glycaemic improvement (p for overall <0.001, p for nonlinear=0.149).
Conclusions: Higher cumulative average TyG-BMI levels identify individuals with pre-diabetes who are less likely to revert to normoglycaemia and more likely to progress to diabetes, highlighting its value as a practical marker for early risk stratification and targeted clinical management of pre-diabetes.
Keywords: Diabetes Mellitus, Type 2; Follow-Up Studies; Lipid disorders.
© Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group.