Relationships among the triglyceride-glucose index, its changes, and the development of metabolically obese normal weight are strengthened by increased visceral fat area.

Authors

Jianan Wang, Jingjing Wang, Yutian Lei, Qin Yuan, Xueyao Yin, Fenping Zheng

Published in

Frontiers in nutrition. Volume 12. Pages 1642725. Epub Sep 16, 2025.

Abstract

Metabolically obese normal weight (MONW), obesity with a normal body mass index, is often neglected due to the seemingly normal weight but has a high risk of metabolic diseases. This study aimed to assess associations among the triglyceride-glucose (TyG) index, its changes (∆TyG index), and metabolically normal, normal weight (MNNW) to MONW transition via a population-based cohort study.
Participants aged 40-65 years in 15 Chinese communities were recruited. A total of 530 participants [mean age: 53.00 (48.00-58.00) years; 346 (65.3%) female participants] with complete data on anthropometry, metabolic indicators, abdominal visceral fat area (VFA), and a normal body mass index (BMI) (18.5 ≤ BMI < 24) were included in the cross-sectional analysis. In total, 253 participants [mean age: 53.00 (48.00-58.00) years; 171 (67.6%) female participants] who had follow-up and maintained a normal BMI were included in the follow-up analysis. MONW was defined as two or more abnormal metabolic components but with a normal BMI. Multivariate logistic regression, Cox proportional hazards regression, and restricted cubic spline regression were used to assess associations among the TyG index, ∆TyG index, and MONW-MONW and MNNW-MONW transition.
An incrementally higher risk of MONW was observed with the increasing TyG index quartiles in the cross-sectional analysis. The adjusted odds ratio (OR) in the TyG index quartile 4 was 31.81 (95% CI 11.47-88.20) for MONW, and there was a significant MONW risk for TyG >9.04. A positive linear association between the ∆TyG index (p trend = 0.001) instead of the TyG index (p for non-linearity = 0.034) and MNNW-MONW transition was observed. The adjusted hazard ratio (HR) in the TyG index quartile 3 was 2.35 (95% CI 1.02-5.41), and in the ∆TyG index quartile 4 was 3.60 (95% CI 1.48-8.79) for MNNW-MONW transition. Subgroup analyses revealed the correlations among the TyG index, ∆TyG index, and MONW-MONW and MNNW-MONW transition were more evident in individuals with larger VFA, and similar results were obtained in sensitivity analysis.
The elevated TyG index and ∆TyG index were associated with higher risks of MONW-MONW and MNNW-MONW transition, and these associations were strengthened by VFA. In addition, the ∆TyG index may be a better indicator for predicting MNNW-MONW transition.

PMID:
41036196
Bibliographic data and abstract were imported from PubMed on 02 Oct 2025.

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