{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:15:27Z","timestamp":1787066127600,"version":"build-2736575974"},"reference-count":29,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T00:00:00Z","timestamp":1771545600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100004006","name":"Bilimsel Ara\u015ftirma Projeleri Birimi, Istanbul \u00dcniversitesi","doi-asserted-by":"crossref","award":["TSA-2021-37919"],"award-info":[{"award-number":["TSA-2021-37919"]}],"id":[{"id":"10.13039\/501100004006","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Metabolic Syndrome and Related Disorders"],"published-print":{"date-parts":[[2026,5,1]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>Adrenal insufficiency (AI) is an endocrine condition requiring lifelong glucocorticoid replacement treatment. Long-term exposure to glucocorticoids may result in significant metabolic problems, such as insulin resistance, abdominal obesity, dyslipidemia, and increased cardiometabolic risk. The triglyceride\u2013glucose (TyG) index is a simple, inexpensive marker of insulin resistance and metabolic syndrome (MetS), increasingly used in endocrine and metabolic research, but its role in AI remains insufficiently researched. This study aimed to assess the clinical utility of the TyG index in patients with AI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method:<\/jats:title>\n                    <jats:p>This was a single-center, cross-sectional observational study including 58 patients with primary or secondary AI receiving glucocorticoid replacement therapy. Demographic, clinical, and anthropometric data were recorded, and body composition was assessed by bioelectrical impedance analysis. The TyG index was calculated using fasting triglyceride and glucose values. MetS was diagnosed according to the International Diabetes Federation 2009 criteria. The relationships between TyG and metabolic risk factors were examined, and TyG levels were investigated in the primary AI and secondary AI groups. The discriminative value of TyG for MetS was determined using receiver operating characteristic (ROC) analysis, including pairwise area under the curve (AUC) comparisons and the Youden-optimal threshold.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The mean age was 44.8 \u00b1 15.6 years, and 28 patients (48.3%) were female. Secondary and primary AI were present in 53.4% and 46.6% of patients, respectively. MetS prevalence was 31.0%. TyG was higher in secondary AI compared with primary AI (8.8 \u00b1 0.7 vs. 8.4 \u00b1 0.5;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.014). TyG values were higher in patients with elevated waist-to-height ratio (WHtR), high waist-to-hip ratio, obesity, and MetS (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.05). ROC analysis showed that TyG had the strongest discriminative value for identifying MetS (AUC = 0.840, 95% confidence interval [CI]: 0.722\u20130.959;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001), with a cut-off of 8.49 yielding 94.4% sensitivity and 67.5% specificity, followed by WHtR (AUC = 0.826, 95% CI: 0.719\u20130.932,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001) and body mass index (AUC = 0.757, 95% CI: 0.631\u20130.883,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.002).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>This study evaluates TyG in AI and indicates which it is a simple, low-cost marker associated with metabolic risk. TyG may support early identification and risk stratification in this vulnerable population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15578518261425510","type":"journal-article","created":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T17:06:47Z","timestamp":1771607207000},"page":"164-171","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Metabolic Risk Assessment Using the Triglyceride\u2013Glucose Index in Patients with Adrenal Insufficiency on Glucocorticoid Therapy"],"prefix":"10.1177","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-8351-1537","authenticated-orcid":false,"given":"Abdurrahman","family":"Sad\u0131\u00e7","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Division of Endocrinology and Metabolism, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00dcmm\u00fc","family":"Mutlu","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Endocrinology and Metabolism, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nubar","family":"Rasulova","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Endocrinology and Metabolism, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H\u00fclya","family":"Hac\u0131\u015fahino\u011fullar\u0131","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Endocrinology and Metabolism, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G\u00fcl\u015fah","family":"Yenid\u00fcnya Yal\u0131n","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Endocrinology and Metabolism, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nurdan","family":"G\u00fcl","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Endocrinology and Metabolism, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ay\u015fe","family":"Kubat \u00dcz\u00fcm","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Endocrinology and Metabolism, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00d6zlem","family":"Soyluk Sel\u00e7ukbiricik","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Endocrinology and Metabolism, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,2,20]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(14)70142-1"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.abd.2023.05.005"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgab063"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1155\/2017\/3691913"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1089\/met.2008.0034"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2010-0288"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.2147\/JMDH.S511047"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hlc.2017.05.142"},{"issue":"1","key":"e_1_3_4_10_2","first-page":"44","article-title":"Triglyceride-glucose index as a biomarker of insulin resistance, diabetes mellitus, metabolic syndrome, and cardiovascular disease: A review","volume":"35","author":"Kurniawan LB","year":"2024","unstructured":"Kurniawan LB. Triglyceride-glucose index as a biomarker of insulin resistance, diabetes mellitus, metabolic syndrome, and cardiovascular disease: A review. EJIFCC, 2024; 35(1):44\u201351.","journal-title":"EJIFCC"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40618-025-02668-4"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afy169"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2016.02.002"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.2006.01858.x"},{"key":"e_1_3_4_15_2","volume-title":"Waist Circumference and Waist\u2013Hip Ratio: Report of a WHO Expert Consultation, Geneva, 8\u201311 December 2008","author":"World Health Organization","year":"2011","unstructured":"World Health Organization. Waist Circumference and Waist\u2013Hip Ratio: Report of a WHO Expert Consultation, Geneva, 8\u201311 December 2008. 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The cut-off value for the triglyceride-glucose index (TyG) discriminating insulin resistance based on the SHBG level and HOMA-IR values in women with polycystic ovary syndrome. 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