Title

Comparative evaluation of triglyceride-glucose index, triglyceride/HDL ratio and HbA1c as surrogate markers of insulin resistance: A cross sectional analytical study

Authors

Saket Verma¹, Sushma Kumari^2, Priyanka Shrivastava³,*, Abhay Kumar⁴, Usha Saroj⁵, Amlan Swain⁶ & Seelora Sahu⁶

Affiliation

¹Department of Biochemistry (Trauma Centre), Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India; ²Department of Transfusion Medicine and Blood Centre, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India; ³Department of Anesthesia, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India; ⁴Department of Medicine, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India; ⁵Department of Pathology, Shahid Nirmal Mahto Medical College, Dhanbad, Jharkhand, India; ⁶Department of Anesthesia, Tata Main Hospital, Jamshedpur, Jharkhand, India; *Corresponding author

Email

Saket Verma - E-mail: drsaketverma@gmail.com
Sushma Kumari - E-mail: ksushmaxyz@rediffmail.com
Priyanka Shrivastava - E-mail: shrivastava2911@gmail.com
Abhay Kumar - E-mail: drabhaykumarran@gmail.com
Usha Saroj - E-mail: ushasaroj1707@gmail.com
Amlan Swain - E-mail: amlanswain1@gmail.com
Seelora Sahu - E-mail: seelora@gmail.com

Article Type

Research Article

Date

Received September 1, 2026; Revised September 30, 2026; Accepted September 30, 2026, Published September 30, 2026

Abstract

Direct assessment of insulin resistance by the hyperinsulinemic-euglycemic clamp is impractical in routine clinical services and the comparative performance of inexpensive biochemical surrogate markers remains population-dependent. Therefore, it is of interest to compare the triglyceride-glucose (TyG) index, triglyceride/high-density lipoprotein cholesterol (TG/HDL-C) ratio and glycated hemoglobin (HbA1c) for identifying insulin resistance among 240 adults aged 30-65 years, using HOMA-IR ≥2.5 as the reference surrogate. Ninety-two participants (38.3%) met the HOMA-IR criterion and mean TyG index, TG/HDL-C ratio and HbA1c were significantly higher in the insulin-resistant group than in the non-insulin-resistant group (all p<0.001). TyG showed the strongest correlation with HOMA-IR (r=0.61) and the highest area under the curve (0.82), followed by TG/HDL-C (0.76) and HbA1c (0.69), while a combined model achieved an area under the curve of 0.87. The TyG index showed the best standalone discrimination for insulin resistance, while TG/HDL-C and HbA1c provided complementary value in combined assessment.

Keywords

Insulin resistance, triglyceride-glucose index, triglyceride/HDL ratio, HbA1c, HOMA-IR, metabolic syndrome, surrogate marker.

Citation

Verma et al. Bioinformation 22(9): 5579-5583 (2026)

Edited by

Ashwini Dhopte

ISSN

0973-2063

Publisher

Biomedical Informatics

License

This is an Open Access article which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. This is distributed under the terms of the Creative Commons Attribution License.