This retrospective cohort study included 8,678 participants who underwent comprehensive health screenings at Kuichong People's Hospital in Shenzhen. The primary exposure was the TyG-GGT index, and the primary outcome was incident diabetes mellitus observed over a 5-year follow-up period. Multivariable adjustments and subgroup analyses were performed to verify the stability of the findings.
Higher TyG-GGT levels were associated with an elevated risk of incident diabetes mellitus. The hazard ratio was 1.116 per 50-unit increase in TyG-GGT (95% CI: 1.041-1.196). A non-linear association was observed with a threshold value at 380; below this inflection point, the hazard ratio was 1.723 per 50-unit increase (95% CI: 1.500-1.979), while the association was not statistically significant above this value.
Regarding predictive capacity, the TyG-GGT index demonstrated the highest AUC value of 0.732. This exceeded the AUC values of triglycerides (0.635), GGT (0.649), fasting plasma glucose (0.660), and the TyG index (0.675). Time-dependent ROC analysis indicated that AUC values for TyG-GGT remained stable between 0.7292 and 0.7338 over a prediction horizon of 1.0 to 5.0 years.
Adverse events, serious adverse events, discontinuations, and tolerability were not reported. As an observational study, these results indicate association rather than causation. The TyG-GGT index may serve as a clinically useful predictor for early identification of high-risk individuals and optimizing clinical prevention and management of diabetes mellitus.
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ObjectiveResearch on the association between TyG-GGT index and diabetes mellitus (DM) risk remains scarce. This study aimed to investigate the relationship between TyG-GGT and DM incidence.MethodsThis retrospective cohort investigation enrolled 8,678 participants who underwent comprehensive health screenings at Kuichong People’s Hospital in Shenzhen from 2018 through 2023. Cox proportional hazards regression models were employed to assess the association between TyG-GGT and DM risk, and Cox proportional hazards regression model with restricted cubic spline functions was used to evaluate non-linear relationships. Subgroup analyses and sensitivity analyses further verified the stability of these findings. Finally, receiver operating characteristic (ROC) curve methodology and time-dependent ROC analysis were performed to determine the predictive capacity of TyG-GGT for incident DM within a 5-year period.ResultsFollowing multivariable adjustments, higher TyG-GGT levels were found to be associated with elevated DM risk, demonstrating an HR of 1.116 (95% CI: 1.041-1.196) per 50-unit increase in TyG-GGT. Additionally, a non-linear association between them was observed, exhibiting a threshold value at 380. When below this inflection point, the HR per 50-unit increase in TyG-GGT was 1.723 (95% CI: 1.500-1.979), while above this value the association was not statistically significant. Additionally, in predicting DM risk, TyG-GGT had the highest AUC value (0.732), while the AUC values of TG (0.635), GGT (0.649), FPG (0.660), and TyG (0.675) were all lower than this value. Time-dependent ROC analysis revealed that the AUC values of TyG-GGT remained stable between 0.7292-0.7338 over a prediction horizon of 1.0 to 5.0 years. The stability of these results was further corroborated via sensitivity analysis.ConclusionThis study found that TyG-GGT demonstrated an independent positive association and non-linear relationship with DM risk, with an inflection point at 380. TyG-GGT below 380 was associated with higher observed DM risk. Additionally, TyG-GGT exhibits discriminatory performance for DM risk assessment and may serve as a clinically useful predictor, thereby aiding clinicians in early identification of high-risk individuals and providing a novel perspective for optimizing clinical prevention and management of DM.