Triglyceride and glucose index and the risk of gestational diabetes mellitus: A nationwide population-based cohort study

Jung A. Kim, Jinsil Kim, Eun Roh, So hyeon Hong, You Bin Lee, Sei Hyun Baik, Kyung Mook Choi, Eunjin Noh, Soon Young Hwang, Geum Joon Cho, Hye Jin Yoo

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23 Citations (Scopus)


Aims: Pre-pregnancy insulin resistance is one of the main pathophysiologies of gestational diabetes mellitus (GDM). Triglyceride-glucose (TyG) index is a marker of insulin resistance. We aimed to evaluate the association between pre-pregnancy TyG index and GDM in primipara women. Methods: A total of 380,208 women who underwent a Korean national health screening exam within 2 years before their first delivery, between January 1, 2012 and December 31, 2015, were included. The TyG index was calculated as ln [triglyceride (mg/dL) × fasting plasma glucose (mg/dL)/2]. Results: Among the 380,208 primipara women, 17,239 women were diagnosed with GDM (4.53%). Multivariate logistic regression analysis adjusted for risk factors showed a higher odds ratio of 1.73 for GDM (95% CI 1.65-1.81) in the highest quartile than that in the lowest quartile. A 1-SD increase in the TyG index increased the risk of GDM (31%) and GDM requiring insulin therapy (82%) in the fully adjusted model. A 1-unit increase in the TyG index significantly increased the risk of GDM and GDM requiring insulin treatment by 1.81 and 3.69 times, respectively.The impact of a high TyG index on the risk of GDM was more profound in the subjects aged ≥ 35 years, with obesity, with impaired fasting glucose, who are current smokers, and with a family history of diabetes mellitus. Conclusions: Increased pre-pregnancy TyG index is associated with a risk of GDM. Elevation of the TyG index may be an early marker of GDM.

Original languageEnglish
Article number108533
JournalDiabetes Research and Clinical Practice
Publication statusPublished - 2021 Jan

Bibliographical note

Funding Information:
This research was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (2018R1D1A1B07047587), the grant of the Establish R&D Platform Project through the Korea University Medical Center and Korea University Guro Hospital, funded by the Korea University Guro Hospital (O1903761), and Korea University Guro Hospital ‘Korea research-driven hospitals’ grant (O1905431). The funders had no role in the study design, data collection, analysis, and interpretation, decision to publish, or preparation of the manuscript.

Publisher Copyright:
© 2020 Elsevier B.V.


  • Gestational diabetes mellitus
  • Glucose
  • Triglyceride
  • Triglyceride-glucose index

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology


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