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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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

Table 1 Baseline characteristics of women with gestational diabetes mellitus classified by the trajectory analysis (n = 1118), n (%)

Variables	Total GDM women (n = 1118)	Good PGC group (n = 609)	Bad PGC group (n = 509)	Statistic	P value
Age (years), mean (SD)	30.5 (4.3)	30.3 (4.1)	30.7 (4.6)	1.23	0.22
Age group (years)
< 35	924 (82.6)	514 (55.6)	410 (44.4)	2.87	0.09
≥ 35	194 (17.4)	95 (49.0)	99 (51.0)
Education
Primary/Junior high	231 (20.7)	106 (45.9)	125 (54.1)	19.84	< 0.01
Senior high	210 (18.8)	98 (46.7)	112 (53.3)
College and above	677 (60.5)	405 (59.8)	272 (40.2)
Monthly income (RMB)
≤ 5000	261 (23.3)	120 (46.0)	141 (54.0)	11.38	< 0.01
5001-10000	584 (52.2)	325 (55.7)	259 (44.3)
> 10000	273 (24.4)	164 (60.1)	109 (39.9)
Residency status
Local resident	358 (32.0)	200 (55.9)	158 (44.1)	0.41	0.52
Non-local resident	760 (68.0)	409 (53.8)	351 (46.2)
Balanced diet with suggestion
Yes	455 (40.7)	254 (55.8)	201 (44.2)	0.57	0.45
No	663 (59.3)	355 (53.5)	308 (46.5)
Pre-pregnancy BMI (kg/m²)
< 24 (low/normal weight)	726 (64.9)	440 (60.6)	286 (39.4)	31.41	< 0.01
≥ 24 (overweight/obesity)	392 (35.1)	169 (43.1)	223 (56.9)
Preterm delivery
Yes	57 (5.1)	30 (52.6)	27 (47.4)	0.08	0.78
No	1061 (94.9)	579 (54.6)	482 (45.4)
Pregnant status
Primipara	532 (47.6)	296 (55.6)	236 (44.4)	0.56	0.46
Multipara	586 (52.4)	313 (53.4)	273 (46.6)
Daily PE time (minute/day), median (IQR)	65 (45-90)	70 (48-90)	65 (45-85)	-2.68	< 0.01
Daily PE time group (minute/day)
< 30	52 (4.7)	25 (48.1)	27 (51.9)	13.68	< 0.01
30-59	385 (34.4)	196 (50.9)	189 (49.1)
60-89	375 (33.5)	204 (54.4)	171 (45.6)
90-119	220 (19.7)	122 (55.5)	98 (44.5)
≥ 120	86 (7.7)	62 (72.1)	24 (27.9)
Lab test at 24-28 gestational weeks
FPG (mmol/L), mean (SD)	5.1 (0.4)	4.9 (0.4)	5.3 (0.4)	11.86	< 0.01
1-hPG (mmol/L), mean (SD)	9.1 (1.9)	9.2 (1.9)	9.1 (2.0)	-1.64	0.10
2-hPG (mmol/L), mean (SD)	7.5 (1.5)	7.5 (1.5)	7.5 (1.5)	-0.76	0.45
TG (mmol/L), mean (SD)	2.8 (1.1)	2.6 (1.0)	2.9 (1.2)	5.44	< 0.01
CHOL (mmol/L), mean (SD)	5.9 (1.1)	6.1 (1.1)	5.8 (1.1)	-4.55	< 0.01

GDM: Gestational diabetes mellitus; PGC: Plasma glucose control; BMI: Body mass index; PE: Physical exercise; IQR: Interquartile range; FPG: Fasting plasma glucose; PG: Plasma glucose; TG: Triglyceride; CHOL: Cholesterol.

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Table 2 Triglyceride-glucose index in women with gestational diabetes mellitus classified by the trajectory analysis (n = 1118), n (%)

Variables	Total GDM women (n = 1118)	Good PGC group (n = 609)	Bad PGC group (n = 509)	Statistic	P value
TyG index, mean (SD)	9.3 (0.4)	9.2 (0.4)	9.4 (0.4)	8.15	< 0.01
TyG index, tertile
T1 (8.19-9.09]	373 (33.4)	258 (69.2)	115 (30.8)	55.56	< 0.01
T2 (9.09-9.39]	372 (33.3)	193 (51.9)	179 (48.1)
T3 (9.39-10.68]	373 (33.4)	158 (42.4)	215 (57.6)
TyG index, quartile
Q1 (8.19-8.99]	279 (25.0)	198 (71.0)	81 (29.0)	58.08	< 0.01
Q2 (8.99-9.23]	280 (25.0)	164 (58.6)	116 (41.4)
Q3 (9.23-9.47]	279 (25.0)	131 (47.0)	148 (53.0)
Q4 (9.47-10.68]	280 (25.0)	116 (41.4)	164 (58.6)

GDM: Gestational diabetes mellitus; PGC: Plasma glucose control; TyG: Triglyceride-glucose.

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Table 3 Factors associated with the rate of good plasma glucose control among women with gestational diabetes mellitus (n = 1118)

Variables	LRa¹		LRb²		LRc³
Variables	OR (95%CI)	P value	OR (95%CI)	P value	OR (95%CI)	P value
Daily PE time group (minute/day)
< 30	1.00		1.00		1.00
30-59	1.03 (0.89-1.19)	0.70	1.02 (0.88-1.17)	0.83	1.02 (0.89-1.18)	0.74
60-89	1.07 (0.92-1.23)	0.39	1.04 (0.90-1.19)	0.59	1.05 (0.91-1.20)	0.51
90-119	1.08 (0.93-1.25)	0.33	1.05 (0.91-1.22)	0.48	1.06 (0.92-1.23)	0.42
≥ 120	1.27 (1.07-1.51)	< 0.01	1.25 (1.06-1.48)	0.01	1.25 (1.06-1.47)	0.01
Age group (years)
< 35	1.00		1.00
≥ 35	0.94 (0.87-1.01)	0.09	0.94 (0.86-1.01)	0.10
Education
Primary/Junior high	1.00		1.00		1.00
Senior high	1.01 (0.92-1.11)	0.87	0.98 (0.90-1.08)	0.73	0.99 (0.90-1.08)	0.79
College and above	1.15 (1.07-1.24)	< 0.01	1.10 (1.00-1.21)	0.04	1.11 (1.03-1.19)	< 0.01
Monthly income (RMB)
≤ 5000	1.00		1.00
5001-10000	1.10 (1.02-1.18)	0.01	1.04 (0.96-1.13)	0.36
> 10000	1.15 (1.06-1.25)	< 0.01	1.05 (0.94-1.16)	0.39
Residency status
Local resident	1.00		1.00
Non-local resident	0.98 (0.92-1.04)	0.52	1.01 (0.95-1.08)	0.78
Pre-pregnancy BMI (kg/m²)
< 24 (low/normal weight)	1.00		1.00		1.00
≥ 24 (overweight/obesity)	0.84 (0.79-0.89)	< 0.01	0.89 (0.83-0.94)	< 0.01	0.88 (0.83-0.94)	< 0.01
Balanced diet with suggestion
Yes	1.00		1.00
No	0.98 (0.92-1.04)	0.45	0.99 (0.94-1.06)	0.87
Pregnant status
Primipara	1.00		1.00
Multipara	0.98 (0.92-1.04)	0.46	1.03 (0.97-1.09)	0.37
TyG index	0.73 (0.67-0.78)	< 0.01	0.76 (0.70-0.82)	< 0.01	0.76 (0.70-0.82)	< 0.01

¹LRa indicates univariate logistic regression model to explore the influence of variables on the rate of good plasma glucose control among women with gestational diabetes mellitus (GDM).

²LRb indicates multivariate logistic regression model to explore the influence of variables on the rate of good plasma glucose control among GDM women with the inclusion of all variables.

³LRc indicates multivariate logistic regression model adjusted for the influence of daily physical exercise time, education, pre-pregnancy body mass index, and triglyceride-glucose index on the rate of good plasma glucose control among GDM women.

OR: Odds ratio; PE: Physical exercise; BMI: Body mass index; TyG: Triglyceride-glucose.

Full Size Table

Table 4 Parameters related to the receiver operating characteristic curves of four indicators for predicting plasma glucose control after the diagnosis of gestational diabetes mellitus

Variables	AUC (95%CI)	Sensitivity	Specificity	PPV	NPV	YI
TyG	0.74 (0.71-0.77)	0.70	0.69	0.73	0.66	0.39
Pre-pregnancy BMI	0.63 (0.59-0.66)	0.51	0.73	0.69	0.55	0.24
Daily PE time	0.53 (0.50-0.57)	0.19	0.86	0.63	0.47	0.06
Education	0.55 (0.52-0.58)	0.65	0.45	0.58	0.52	0.10
TyG + pre-pregnancy BMI	0.75 (0.72-0.78)	0.68	0.72	0.75	0.66	0.41
TyG + daily PE time	0.74 (0.71-0.77)	0.61	0.78	0.77	0.63	0.40
TyG + education	0.74 (0.71-0.77)	0.70	0.70	0.73	0.66	0.40
TyG + pre-pregnancy BMI + daily PE time	0.75 (0.72-0.78)	0.62	0.78	0.77	0.63	0.40
TyG + pre-pregnancy BMI + education	0.75 (0.72-0.78)	0.64	0.76	0.77	0.64	0.41
TyG + daily PE time + education	0.74 (0.71-0.77)	0.75	0.65	0.72	0.68	0.40
TyG + pre-pregnancy BMI + daily PE time + education	0.75 (0.72-0.78)	0.66	0.74	0.75	0.64	0.40

AUC: Area under curve; PPV: Positive predictive value; NPV: Negative predictivevalue; YI: Youden index; TyG: Triglyceride-glucose; BMI: Body mass index; PE: Physical exercise.

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Citation: Zhang XQ, Cheng CX, Duan Z, Cai RQ, Gao XJ, Zhang R, Yang Q, Wang RP. Elevated triglyceride-glucose index predicts poor third-trimester glycemic control among gestational diabetes mellitus women: A prospective study in Shanghai. World J Diabetes 2026; 17(10): 124659
URL: https://www.wjgnet.com/1948-9358/full/v17/i10/124659.htm
DOI: https://dx.doi.org/10.4239/wjd.124659

Zhang XQ, Cheng CX, Duan Z, Cai RQ, Gao XJ, Zhang R, Yang Q, Wang RP. Elevated triglyceride-glucose index predicts poor third-trimester glycemic control among gestational diabetes mellitus women: A prospective study in Shanghai. World J Diabetes 2026; 17(10): 124659 [DOI: 10.4239/wjd.124659]

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