Elevated triglyceride-glucose index predicts poor third-trimester glycemic control among gestational diabetes mellitus women: A prospective study in Shanghai

doi:10.4239/wjd.124659

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Publication Name

World Journal of Diabetes

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1948-9358

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Prospective Study

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Diabetes. Oct 15, 2026; 17(10): 124659
Published online Oct 15, 2026. doi: 10.4239/wjd.124659

Elevated triglyceride-glucose index predicts poor third-trimester glycemic control among gestational diabetes mellitus women: A prospective study in Shanghai

Xiu-Qi Zhang, Cai-Xia Cheng, Zhen Duan, Rui-Qi Cai, Xiang-Jin Gao, Rui Zhang, Qing Yang, Rui-Ping Wang

Xiu-Qi Zhang, School of Medicine, Tongji University, Shanghai 200331, China

Xiu-Qi Zhang, Zhen Duan, Rui-Qi Cai, Xiang-Jin Gao, Rui Zhang, Rui-Ping Wang, Clinical Research Center, Shanghai Skin Diseases Hospital, Shanghai 200443, China

Cai-Xia Cheng, Department of Obstetrics and Gynecology, Songjiang Maternal and Children’s Health-Care Hospital, Shanghai 201620, China

Rui-Qi Cai, School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China

Qing Yang, Office of Public Health Management, Songjiang Maternal and Children’s Health-Care Hospital, Shanghai 201620, China

Co-first authors: Xiu-Qi Zhang and Cai-Xia Cheng.

Author contributions: Zhang XQ and Cheng CX drafted the manuscript, contributed equally to this study as co-first authors; Zhang XQ, Cheng CX, Duan Z and Cai RQ designed the study; Zhang XQ and Wang RP performed statistical analyses; Duan Z, Cai RQ, Gao XJ and Zhang R supervised the study; Gao XJ, Zhang R and Yang Q collected data; Wang RP revised the manuscript; all authors contributed to drafting and revising the manuscript and approved to submit the final version.

AI contribution statement: No AI tool was used to generate research data, interpret results, or formulate conclusions.

Supported by the Clinical Research Program of Shanghai Municipal Health Commission, No. 202240371; the Science and Technology Research Project in Songjiang District, No. 22SJKJGG53; the Clinical Research Plan of SHDC, No. SHDC2022CRS053 and No. SHDC2024CRX032; the Intelligence Fund of Shanghai Skin Diseases Hospital, No. 2021KYQD01; and the Shanghai Talent Development Fund, No. 2021073.

Institutional review board statement: The study was reviewed and approved by Institution Review Board of Songjiang Maternal and Children’s Health-Care Hospital (No. 2019-12-003).

Clinical trial registration statement: The study is registered at the Chinese Clinical Trial Registry. The registration identification number is ChiCTR2000028832. Details are available at https://www.chictr.org.cn/showproj.html?proj=47913.

Informed consent statement: All participants provided informed consent.

Conflict-of-interest statement: All authors declare no conflict of interest in publishing the manuscript.

CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.

Data sharing statement: There is no additional data available.

Corresponding author: Rui-Ping Wang, MD, PhD, Chief Physician, Professor, Clinical Research Center, Shanghai Skin Diseases Hospital, No. 1278 Baode Road, Jing’an District, Shanghai 200443, China. w19830901@126.com

Received: June 26, 2026
Revised: July 20, 2026
Accepted: September 16, 2026
Published online: October 15, 2026
Processing time: 113 Days and 17.8 Hours

Abstract

BACKGROUND

The triglyceride-glucose (TyG) index is widely recognized as an effective marker for assessing insulin resistance (IR). Previous studies have predominantly utilized TyG index to predict the risk of developing gestational diabetes mellitus (GDM) in pregnant women.

AIM

To explore the association between TyG index and glycemic control in late pregnancy based on the group-based trajectory model (GBTM) among GDM women. To investigate the value of TyG index for predicting the effect of glycemic control among GDM women during late gestational period.

METHODS

GDM women were classified into good and bad plasma glucose control (PGC) groups by applying GBTM based on a series of abnormal plasma glucose (PG) prevalence obtained at each prenatal checkup. TyG index was calculated as ln[fasting triglyceride (mg/dL) × fasting PG (mg/dL)/2]. Logistic regression analysis was used to explore the association between TyG index and the prevalence of good PGC among GDM women. A P-value less than 0.05 was viewed as statistical significance.

RESULTS

Total 1118 GDM women were classified as good PGC (609, 54.5%) and bad PGC group (509, 45.5%). Logistic regression analysis indicated that the good PGC prevalence was negatively associated with the elevated TyG index [odds ratio (OR) = 0.73; 95%CI: 0.67-0.78], even after adjusting for potential confounders (OR = 0.76, 95%CI: 0.70-0.82). GDM women in higher TyG index categories had a significantly greater risk of poor PGC compared to those in the lowest, regardless of tertile or quartile classification of TyG index. Receiver operating characteristic (ROC) curve demonstrated that TyG index could be an independent predictor for glycemic control in late pregnancy [area under curve (AUC) = 0.74, 95%CI: 0.71-0.77], with a TyG index ≥ 9.3 indicating subsequently higher rates of PG abnormalities.

CONCLUSION

The elevated TyG index was negatively associated with good PGC in late pregnancy among GDM women. TyG index less than 9.3 could predict the good glycemic control in third trimester.

Keywords: Gestational diabetes mellitus; Triglyceride-glucose index; Group-based trajectory model; Abnormal plasma glucose prevalence; Predict

Core Tip: The elevated triglyceride-glucose (TyG) index was negatively associated with good plasma glucose control in late pregnancy among women with gestational diabetes mellitus (GDM). TyG index less than 9.3 could predict good plasma glucose control in third trimester, particularly among GDM women with older age (≥ 35 years), and overweight/obesity [body mass index (BMI) ≥ 24 kg/m²]. In the future, measuring fasting plasma glucose and triglyceride levels in pregnant women with GDM at 24-28 gestational weeks and calculating TyG index, then this index could serve as an effective tool for predicting glycemic control status in late pregnancy among GDM women.