{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T14:26:14Z","timestamp":1785767174260,"version":"3.56.0"},"reference-count":39,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T00:00:00Z","timestamp":1757635200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The triglyceride-glucose (TyG) index, as a novel biomarker for assessing insulin resistance, may possess predictive value for metabolic syndrome (MS) in patients with type 2 diabetes mellitus (T2DM). However, its dose-response relationship requires further investigation. Therefore, this cross-sectional study aimed to examine the association between the TyG index and MS, along with their dose-response relationship, in a T2DM population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This cross-sectional study enrolled patients with T2DM from a tertiary hospital in Chengdu between January 2018 and December 2023. Participants were stratified into quartiles (Q1-Q4) based on TyG index levels. We employed multivariable logistic regression to analyze associations between TyG index and MS and its components. Predictive performance was evaluated using receiver operating characteristic (ROC) curve analysis, while restricted cubic spline analysis was utilized to examine the dose-response relationship between TyG index and MS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>This study included a total of 1,560 patients with T2DM. With increasing TyG index levels, patients were significantly younger, had lower HDL-C levels, higher rates of current alcohol consumption, and elevated BMI, TG, TC, LDL-C and FPG values (all P&amp;lt;0.05). The prevalence of MS, overweight\/obesity and dyslipidemia also progressively increased with higher TyG quartiles (all P&amp;lt;0.05). Pearson correlation analysis showed the TyG index was positively correlated with BMI, TG, TC, LDL-C and FPG (all P&amp;lt;0.001), while negatively correlated with HDL-C (P&amp;lt;0.001). After adjusting for confounding factors, multivariate logistic regression analysis revealed that compared with the Q1 group, the Q4 group had a significantly higher risk of MS (OR=26.994), overweight\/obesity and dyslipidemia (all P&amp;lt;0.001). The area under the curve (AUC) for TyG index in predicting MS was 0.793,with a sensitivity of 0.864 and a specificity of 0.611. Furthermore, a nonlinear dose-response relationship was observed between TyG index and MS, with MS risk increasing progressively when TyG index exceeded 9.31.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The TyG index serves as an independent predictor of MS risk in patients with T2DM, demonstrating a significant dose-response relationship with MS.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2025.1615380","type":"journal-article","created":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T04:15:21Z","timestamp":1757650521000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Dose-response relationship between the triglyceride-glucose index and metabolic syndrome risk in patients with type 2 diabetes: a cross-sectional analysis of 1,560 cases"],"prefix":"10.3389","volume":"16","author":[{"given":"Feng","family":"Chen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zixue","family":"Gu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rong","family":"Peng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,9,12]]},"reference":[{"key":"B1","article-title":"Recommendations of the Chinese Medical Association Diabetes Branch on metabolic syndrome","volume":"12","year":"2004","journal-title":"China Diabetes Magazine"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.3502","article-title":"Metabolic syndrome and cardiovascular diseases: going beyond traditional risk factors","volume":"38","author":"Silveira","year":"2022","journal-title":"Diabetes Metab Res Rev"},{"key":"B3","doi-asserted-by":"publisher","first-page":"786","DOI":"10.3390\/ijms23020786","article-title":"Metabolic syndrome: updates on pathophysiology and management in 2021","volume":"23","author":"Fahed","year":"2022","journal-title":"Int J Mol Sci"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.3969\/j.issn.1001-1242.2024.10.018","article-title":"Network meta-analysis of different exercise interventions for metabolic syndrome patients","volume":"39","author":"Wang","year":"2024","journal-title":"Chin J Rehabil Med"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1240457","DOI":"10.1155\/2024\/1240457","article-title":"Exploring the prevalence and components of metabolic syndrome in sub-Saharan African type 2 diabetes mellitus patients","volume":"2024","author":"Musilanga","year":"2024","journal-title":"J Obes"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1111\/ene.14805","article-title":"Impact of metabolic syndrome on peripheral nerve structure and function in type 2 diabetes","volume":"28","author":"Issar","year":"2021","journal-title":"Eur J Neurol"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2023.1164771","article-title":"Gender differences in metabolic syndrome components on incident type 2 diabetes","volume":"14","author":"Hadaegh","year":"2023","journal-title":"Front Endocrinol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"102052","DOI":"10.1016\/j.cpcardiol.2023.102052","article-title":"Diabetic cardiomyopathy: 2023 update by the international multidisciplinary board of experts","volume":"49","author":"Avagimyan","year":"2024","journal-title":"Curr Probl Cardiol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"246","DOI":"10.1186\/s12933-024-02335-7","article-title":"Economic burden of metabolic syndrome complications","volume":"23","author":"Chong","year":"2024","journal-title":"Cardiovasc Diabetol"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1152\/ajpendo.1979.237.3.E214","article-title":"Glucose clamp technique: a method for quantifying insulin secretion and resistance","volume":"237","author":"Defronzo","year":"1979","journal-title":"Am J Physiol"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.11817\/j.issn.1672-7347.2024.230592","article-title":"Triglyceride-glucose index and arterial stiffness progression","volume":"49","author":"Zhu","year":"2024","journal-title":"J Cent South Univ (Medical Sciences)"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2010-0288","article-title":"The product of triglycerides and glucose","volume":"95","author":"Guerrero-Romero","year":"2010","journal-title":"J Clin Endocrinol Metab"},{"key":"B13","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1186\/s12933-021-01274-x","article-title":"Stronger association of triglyceride glucose index than the HOMA-IR with arterial stiffness in patients with type 2 diabetes: a real-world single-center study","volume":"20","author":"Wang","year":"2021","journal-title":"Cardiovasc Diabetol"},{"key":"B14","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1186\/s12902-024-01632-2","article-title":"The discriminative ability of the triglyceride-glucose index to identify metabolic syndrome among adults of the northern Sri Lankan population","volume":"24","author":"Paramanathan","year":"2024","journal-title":"BMC Endocr Disord"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.3760\/cma.j.cn311282-20210304-00142","article-title":"China type 2 diabetes prevention and treatment guidelines (2020 edition)","volume":"37","year":"2021","journal-title":"Chin J Endocrinol Metab"},{"key":"B16","doi-asserted-by":"publisher","first-page":"132907","DOI":"10.1016\/j.ijcard.2024.132907","article-title":"Corrigendum to \u201ctriglyceride-glucose index (tyg) as a novel biomarker in the era of cardiometabolic medicine\u201d [international journal of cardiology volume 418, 1 january 2025, 132663","volume":"421","author":"Avagimyan","year":"2025","journal-title":"Int J Cardiol"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1177\/204748730000700505","article-title":"The insulin resistance syndrome: impact on lipoprotein metabolism and atherothrombosis","volume":"7","author":"Ginsberg","year":"2000","journal-title":"J Cardiovasc Risk"},{"key":"B18","doi-asserted-by":"publisher","first-page":"216","DOI":"10.1038\/s41392-022-01073-0","article-title":"Trends in insulin resistance: insights into mechanisms and therapeutic strategy","volume":"7","author":"Li","year":"2022","journal-title":"Signal Transduct Target Ther"},{"key":"B19","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1038\/s41586-019-1797-8","article-title":"The integrative biology of type 2 diabetes","volume":"576","author":"Roden","year":"2019","journal-title":"Nature"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.4161\/cc.7.20.6882","article-title":"Foxo1 integrates insulin signaling to VLDL production","volume":"7","author":"Kamagate","year":"2008","journal-title":"Cell Cycle"},{"key":"B21","doi-asserted-by":"publisher","first-page":"155","DOI":"10.3390\/metabo11030155","article-title":"Insulin resistance across the spectrum of nonalcoholic fatty liver disease","volume":"11","author":"Armandi","year":"2021","journal-title":"Metabolites"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.11613\/BM.2013.033","article-title":"Diabetes and beta cell function: from mechanisms to evaluation and clinical implications","volume":"23","author":"Cernea","year":"2013","journal-title":"Biochem Med (Zagreb)"},{"key":"B23","doi-asserted-by":"publisher","first-page":"6275","DOI":"10.3390\/ijms21176275","article-title":"Pathophysiology of type 2 diabetes mellitus","volume":"21","author":"Galicia-Garcia","year":"2020","journal-title":"Int J Mol Sci"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2021.615895","article-title":"Mechanism and basis of traditional Chinese medicine against obesity: prevention and treatment strategies","volume":"12","author":"Zhang","year":"2021","journal-title":"Front Pharmacol"},{"key":"B25","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1186\/s12944-024-02277-9","article-title":"The association between triglyceride-glucose index and its combination with systemic inflammation indicators and all-cause and cardiovascular mortality in the general US population: NHANES 1999-2018","volume":"23","author":"Chen","year":"2024","journal-title":"Lipids Health Dis"},{"key":"B26","doi-asserted-by":"publisher","first-page":"1730","DOI":"10.1186\/s12889-022-14122-8","article-title":"Comparison of obesity-related indicators for identifying metabolic syndrome among normal-weight adults in rural Xinjiang, China","volume":"22","author":"Jian","year":"2022","journal-title":"BMC Public Health"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.3969\/j.issn.1004-583x.2021.09.005","article-title":"Predictive value of TG\/HDL-C, TyG, and non-HDL-C for metabolic syndrome in middle-aged and elderly women","volume":"36","author":"Zhao","year":"2021","journal-title":"Clin Focus"},{"key":"B28","doi-asserted-by":"publisher","first-page":"299","DOI":"10.1089\/met.2008.0034","article-title":"The product of fasting glucose and triglycerides as surrogate for identifying insulin resistance in apparently healthy subjects","volume":"6","author":"Simental-Mendia","year":"2008","journal-title":"Metab Syndr Relat Disord"},{"key":"B29","article-title":"Clinical application of triglyceride-glucose index and \u03b3-glutamyl transferase in the diagnosis of metabolic syndrome in young and middle-aged adults","volume":"59","author":"Liu","year":"2024","journal-title":"Chin Med J"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.3724\/zdxbyxb-2023-0585","article-title":"Research progress on the effects of sodium-glucose cotransporter 2 inhibitors on metabolic disorders related to metabolic syndrome","volume":"53","author":"Xu","year":"2024","journal-title":"J Zhejiang Univ (Med Sci)"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1007\/s40256-020-00423-z","article-title":"Blood pressure-lowering effect of newer antihyperglycemic agents (SGLT-2 inhibitors, GLP-1 receptor agonists, and DPP-4 inhibitors)","volume":"21","author":"Liakos","year":"2021","journal-title":"Am J Cardiovasc Drugs"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1210\/er.2018-00141","article-title":"Insulin resistance and atherosclerosis: implications for insulin-sensitizing agents","volume":"40","author":"Di Pino","year":"2019","journal-title":"Endocr Rev"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.2337\/dc24-2046","article-title":"Health-related quality of life and health utility after metabolic\/bariatric surgery versus medical\/lifestyle intervention in individuals with type 2 diabetes and obesity: the ARMMs-T2D study","volume":"48","author":"Simonson","year":"2025","journal-title":"Diabetes Care"},{"key":"B34","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1186\/s12902-021-00716-7","article-title":"Dynamic behavior of metabolic syndrome progression: a comprehensive systematic review on recent discoveries","volume":"21","author":"Bagheri","year":"2021","journal-title":"BMC Endocr Disord"},{"key":"B35","doi-asserted-by":"publisher","first-page":"3477","DOI":"10.3390\/plants11243477","article-title":"Fighting obesity-related micronutrient deficiencies through biofortification of agri-food crops with sustainable fertilization practices","volume":"11","author":"Guardiola-Marquez","year":"2022","journal-title":"Plants (Basel)"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-021-05397-4","article-title":"Realising the long-term promise of insulin therapy: the DCCT\/EDIC study","volume":"64","author":"Nathan","year":"2021","journal-title":"Diabetologia"},{"key":"B37","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","year":"2024","journal-title":"EJIFCC"},{"key":"B38","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1038\/s41387-024-00295-1","article-title":"TyG index and cardiovascular events after AMI","volume":"14","author":"Liu","year":"2024","journal-title":"Nutr Diabetes"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.1055\/a-2376-6044","article-title":"Triglyceride glucose index and the risk of diabetic nephropathy in patients with  type 2 diabetes: a meta-analysis","volume":"57","author":"Deng","year":"2025","journal-title":"Horm Metab Res"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2025.1615380\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T04:15:25Z","timestamp":1757650525000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2025.1615380\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,12]]},"references-count":39,"alternative-id":["10.3389\/fendo.2025.1615380"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2025.1615380","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,12]]},"article-number":"1615380"}}