Triglyceride glucose-body mass index (TyG-BMI), a non-insulin-based marker of insulin resistance, is a powerful predictor of adverse pregnancy outcomes, including gestational diabetes mellitus (GDM), hypertensive disorders of pregnancy (HDP), and large for gestational age (LGA) infants. Published in the journal of BMC Pregnancy and Childbirth, the study underscores the importance of early identification of insulin resistance in pregnant women to reduce risks and improve maternal and fetal health.
The retrospective study identified three distinct TyG-BMI trajectories: low-stable, moderate-stable, and high-stable. Women in the “high-stable” trajectory group were found to have significantly higher risks of GDM (aOR = 2.01), HDP (aOR = 6.05), and LGA (aOR = 2.83) compared to those in the “low-stable” group.
The first-trimester TyG-BMI index emerged as a particularly strong predictor of adverse outcomes. Women in the highest quartile of the first-trimester TyG-BMI index had a 3.27-fold increased risk of GDM, a 9.26-fold increased risk of HDP, and a 2.26-fold increased risk of LGA. The study also found a significant linear association between the first-trimester TyG-BMI index and the risks of GDM, HDP, small for gestational age (SGA), and LGA. The TyG-BMI index outperformed other traditional markers of insulin resistance, such as the TyG index and the triglyceride/high-density lipoprotein cholesterol (TG/HDL-c) ratio, in predicting adverse outcomes. ROC curve analysis demonstrated that the first-trimester TyG-BMI index had superior predictive ability for HDP (AUC = 0.726), LGA (AUC = 0.619), and GDM (AUC = 0.664). The DeLong test further confirmed that the TyG-BMI index was a more valuable predictor for LGA and HDP compared to the TyG index and TG/HDL-c ratio.
These findings are consistent with previous research that illustrates the role of insulin resistance in pregnancy complications. Lin et al. found that insulin resistance during early pregnancy was strongly linked to the development of gestational diabetes mellitus (GDM) increased risk of hypertensive disorders and having a large baby for gestational age. Similarly, Pan et al. suggested that the TyG index measured in the first trimester was closely associated with the development of hypertensive disorders during pregnancy and other adverse outcomes, highlighting the importance of early metabolic screening in prenatal care.
TyG-BMI is a composite metabolic marker that integrates triglyceride levels, fasting glucose, and body mass index (BMI) to assess insulin resistance and metabolic health. It is calculated by multiplying the TyG index—derived from fasting triglyceride and glucose levels—by BMI. Higher TyG-BMI values correlate with visceral fat accumulation, making it a more effective marker for obesity-related metabolic complications compared to BMI alone.
Early identification of insulin resistance using the TyG-BMI index enables targeted interventions to reduce adverse pregnancy outcomes. Integrating this marker into clinical practice can help safeguard maternal and fetal health, improving outcomes for both mother and baby.
References:
- Meng Z, Lin M, Song L, Chen Y, Deng S, Xia S, et al. The first-trimester triglyceride glucose-body mass index is a valuable predictor for adverse pregnancy outcomes. BMC Pregnancy and Childbirth. 2025 Feb 11;25(1):142.
- Lin J, Jin H, Chen L. Associations between insulin resistance and adverse pregnancy outcomes in women with gestational diabetes mellitus: a retrospective study. BMC Pregnancy Childbirth. 2021 Jul 23;21:526.
- Pan Y, Zou S, Xu Y, Di R, Gu H, Wang Z, et al. Is there any association between early trimester Triglyceride–glucose index and incidence of hypertensive disorder of pregnancy and adverse pregnancy outcomes? Front Endocrinol [Internet]. 2023 Mar 6 [cited 2025 Feb 12];14.