{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T06:09:07Z","timestamp":1789711747730,"version":"4.0.1"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:00:00Z","timestamp":1789689600000},"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. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The triglyceride-glucose body mass index (TyG-BMI), a novel composite measure integrating lipid-glucose metabolism and obesity, has shown promise in predicting diabetes risk. Nevertheless, its association with the onset of prediabetes remains insufficiently investigated, particularly concerning potential nonlinear relationships.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Cox proportional hazards models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). Nonlinear relationships were evaluated through the use of smooth curve fitting and threshold effect models. Additionally, interaction tests and subgroup analyses were undertaken to examine the robustness of the associations found.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Following comprehensive adjustment, a 10-unit increment in TyG-BMI correlated with an 11% elevated risk of developing prediabetes (Hazard Ratio [HR] 1.11, 95% Confidence Interval [CI] 1.09\u20131.13). A significant nonlinear association was observed, with an inflection point identified at a TyG-BMI value of 189.37. Below the threshold, each unit increase in TyG-BMI was linked to a 2% rise in risk (HR 1.02, 95% CI 1.02\u20131.03), whereas above this point, the risk increase diminished to 1% per unit (HR 1.01, 95% CI 1.01\u20131.01).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This research identifies a significant, nonlinear association between TyG-BMI and the likelihood of developing prediabetes. Additional research is required to thoroughly examine their relationship and clarify the underlying mechanisms.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1916726","type":"journal-article","created":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T05:38:28Z","timestamp":1789709908000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Nonlinear relationship between triglyceride glucose-body mass index and the risk of prediabetes: a multi-center retrospective cohort study"],"prefix":"10.3389","volume":"14","author":[{"given":"Hui","family":"Peng","sequence":"first","affiliation":[{"name":"Department of General Medicine, Shenzhen Second People\u2019s Hospital, The First Affiliated Hospital of Shenzhen University","place":["Shenzhen, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhimao","family":"Cai","sequence":"additional","affiliation":[{"name":"Department of General Medicine, Shenzhen Second People\u2019s Hospital, The First Affiliated Hospital of Shenzhen University","place":["Shenzhen, Guangdong, China"]},{"name":"Shenzhen University Health Science Center","place":["Shenzhen, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongqiang","family":"Zhan","sequence":"additional","affiliation":[{"name":"Department of Hepatopancreatobiliary Surgery, Shenzhen Second People\u2019s Hospital, The First Affiliated Hospital of Shenzhen University","place":["Shenzhen, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of General Medicine, Shenzhen Second People\u2019s Hospital, The First Affiliated Hospital of Shenzhen University","place":["Shenzhen, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaomei","family":"Zeng","sequence":"additional","affiliation":[{"name":"Department of General Medicine, Shenzhen Second People\u2019s Hospital, The First Affiliated Hospital of Shenzhen University","place":["Shenzhen, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan","family":"Dai","sequence":"additional","affiliation":[{"name":"Department of General Medicine, Shenzhen Second People\u2019s Hospital, The First Affiliated Hospital of Shenzhen University","place":["Shenzhen, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junhong","family":"Pan","sequence":"additional","affiliation":[{"name":"Department of General Medicine, Shenzhen Second People\u2019s Hospital, The First Affiliated Hospital of Shenzhen University","place":["Shenzhen, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui","family":"Jia","sequence":"additional","affiliation":[{"name":"Department of General Medicine, Shenzhen Second People\u2019s Hospital, The First Affiliated Hospital of Shenzhen University","place":["Shenzhen, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Youlian","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of General Medicine, Shenzhen Second People\u2019s Hospital, The First Affiliated Hospital of Shenzhen University","place":["Shenzhen, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hualang","family":"Cai","sequence":"additional","affiliation":[{"name":"Department of Hepatology, National Clinical Research Center for Infectious Diseases, The Third People\u2019s Hospital of Shenzhen, Shenzhen University Health Science Center","place":["Shenzhen, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weifeng","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of General Medicine, Shenzhen Second People\u2019s Hospital, The First Affiliated Hospital of Shenzhen University","place":["Shenzhen, Guangdong, China"]},{"name":"Department of Family Medicine, Shenzhen University Medical School; Shenzhen","place":["Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of General Medicine, Shenzhen Second People\u2019s Hospital, The First Affiliated Hospital of Shenzhen University","place":["Shenzhen, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,18]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"620","DOI":"10.1002\/nur.22413","article-title":"Risk factors for prediabetes in community-dwelling adults: a generalized estimating equation logistic regression approach with natural language processing insights","volume":"47","author":"Kim","year":"2024","journal-title":"Res Nurs Health"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"109119","DOI":"10.1016\/j.diabres.2021.109119","article-title":"IDF diabetes atlas: global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045","volume":"183","author":"Sun","year":"2022","journal-title":"Diabetes Res Clin Pract"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1206","DOI":"10.1001\/jama.2023.4063","article-title":"Diagnosis and management of prediabetes: a review","volume":"329","author":"Echouffo-Tcheugui","year":"2023","journal-title":"JAMA"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1097\/med.0b013e3283514e13","article-title":"What causes the insulin resistance underlying obesity?","volume":"19","author":"Hardy","year":"2012","journal-title":"Curr Opin Endocrinol Diabetes Obes"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"923","DOI":"10.3390\/jcm3030923","article-title":"Importance of beta cell function for the treatment of type 2 diabetes","volume":"3","author":"Saisho","year":"2014","journal-title":"J Clin Med"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"109","DOI":"10.4239\/wjd.v6.i1.109","article-title":"\u0392-cell dysfunction: its critical role in prevention and management of type 2 diabetes","volume":"6","author":"Saisho","year":"2015","journal-title":"World J Diabetes"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"S43","DOI":"10.2337\/dc24-S003","article-title":"Prevention or delay of diabetes and associated comorbidities: standards of care in diabetes-2024","volume":"47","year":"2024","journal-title":"Diabetes Care"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1549","DOI":"10.1002\/oby.23503","article-title":"Measuring and estimating insulin resistance in clinical and research settings","volume":"30","author":"Gastaldelli","year":"2022","journal-title":"Obesity"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"E214","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 Phys"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"641","DOI":"10.4093\/dmj.2021.0220","article-title":"Assessment of insulin secretion and insulin resistance in human","volume":"45","author":"Park","year":"2021","journal-title":"Diabetes Metab J"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2019\/5101423","article-title":"Effect of inulin-type carbohydrates on insulin resistance in patients with type 2 diabetes and obesity: a systematic review and meta-analysis","volume":"2019","author":"Rao","year":"2019","journal-title":"J Diabetes Res"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1186\/s12944-020-01414-4","article-title":"Inverse association between triglyceride glucose index and muscle mass in korean adults: 2008\u20132011 KNHANES","volume":"19","author":"Ahn","year":"2020","journal-title":"Lipids Health Dis"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1186\/s12933-019-0898-x","article-title":"Association between macro- and microvascular damage and the triglyceride glucose index in community-dwelling elderly individuals: the northern shanghai study","volume":"18","author":"Zhao","year":"2019","journal-title":"Cardiovasc Diabetol"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"12196","DOI":"10.1073\/pnas.1708744114","article-title":"DsbA-l prevents obesity-induced inflammation and insulin resistance by suppressing the mtDNA release-activated cGAS-cGAMP-STING pathway","volume":"114","author":"Bai","year":"2017","journal-title":"Proc Natl Acad Sci USA"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"9635","DOI":"10.1073\/pnas.1207287109","article-title":"Development of insulin resistance in mice lacking PGC-1\u03b1 in adipose tissues","volume":"109","author":"Kleiner","year":"2012","journal-title":"Proc Natl Acad Sci USA"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"e0324483","DOI":"10.1371\/journal.pone.0324483","article-title":"Association of triglyceride glucose-body mass index (TyG-BMI) with metabolic dysfunction-associated steatotic liver disease: a systematic review and meta-analysis","volume":"20","author":"Boushehri","year":"2025","journal-title":"PLoS One"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"1328601","DOI":"10.3389\/fmed.2024.1328601","article-title":"Association between the triglyceride glucose index, triglyceride-glucose body mass index and diabetic kidney disease in adults with newly diagnosed type 2 diabetes","volume":"11","author":"Jiang","year":"2024","journal-title":"Front Med"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"555","DOI":"10.3390\/nu15030555","article-title":"Triglyceride\u2013glucose index as a potential indicator of sarcopenic obesity in older people","volume":"15","author":"Kim","year":"2023","journal-title":"Nutrients"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"e0149731","DOI":"10.1371\/journal.pone.0149731","article-title":"Triglyceride glucose-body mass index is a simple and clinically useful surrogate marker for insulin resistance in nondiabetic individuals","volume":"11","author":"Er","year":"2016","journal-title":"PLoS One"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1186\/s12944-024-02060-w","article-title":"Relative importance of triglyceride glucose index combined with body mass index in predicting recovery from prediabetic state to normal fasting glucose: a cohort analysis based on a chinese physical examination population","volume":"23","author":"Yang","year":"2024","journal-title":"Lipids Health Dis"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"e021768","DOI":"10.1136\/bmjopen-2018-021768","article-title":"Association of body mass index and age with incident diabetes in Chinese adults: a population-based cohort study","volume":"8","author":"Chen","year":"2018","journal-title":"BMJ Open"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1186\/s12933-023-01934-0","article-title":"Nonlinear relationship between atherogenic index of plasma and the risk of prediabetes: a retrospective study based on chinese adults","volume":"22","author":"Zheng","year":"2023","journal-title":"Cardiovasc Diabetol"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"795","DOI":"10.1016\/S2213-8587(15)00255-7","article-title":"Association between hyperglycaemia and adverse perinatal outcomes in south asian and white british women: analysis of data from the born in Bradford cohort","volume":"3","author":"Farrar","year":"2015","journal-title":"Lancet Diabetes Endocrinol"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"e045826","DOI":"10.1136\/bmjopen-2020-045826","article-title":"Prediction of disease severity in young children presenting with acute febrile illness in resource-limited settings: a protocol for a prospective observational study","volume":"11","author":"Chandna","year":"2021","journal-title":"BMJ Open"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"286","DOI":"10.3390\/life11040286","article-title":"Prediction of insulin resistance by modified triglyceride glucose indices in youth","volume":"11","author":"Song","year":"2021","journal-title":"Life"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"2654","DOI":"10.3390\/nu11112654","article-title":"Obesity- and lipid-related parameters in the identification of older adults with a high risk of prediabetes according to the American Diabetes Association: an analysis of the 2015 health, well-being, and aging study","volume":"11","author":"Ram\u00edrez V\u00e9lez","year":"2019","journal-title":"Nutrients"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"862919","DOI":"10.3389\/fendo.2022.862919","article-title":"Predictive effect of triglyceride glucose\u2212related parameters, obesity indices, and lipid ratios for diabetes in a Chinese population: a prospective cohort study","volume":"13","author":"Li","year":"2022","journal-title":"Front Endocrinol"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"2366","DOI":"10.1038\/s41598-021-82053-2","article-title":"Lipid indices as simple and clinically useful surrogate markers for insulin resistance in the U.S. population","volume":"11","author":"Lee","year":"2021","journal-title":"Sci Rep"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"e0163465","DOI":"10.1371\/journal.pone.0163465","article-title":"Predictive value of triglyceride glucose index for the risk of incident diabetes: a 4-year retrospective longitudinal study","volume":"11","author":"Lee","year":"2016","journal-title":"PLoS One"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1186\/s12944-016-0324-2","article-title":"Triglyceride glucose index, a marker of insulin resistance, is associated with coronary artery stenosis in asymptomatic subjects with type 2 diabetes","volume":"15","author":"Lee","year":"2016","journal-title":"Lipids Health Dis"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1186\/s12933-017-0514-x","article-title":"Cumulative increased risk of incident type 2 diabetes mellitus with increasing triglyceride glucose index in normal-weight people: the rural chinese cohort study","volume":"16","author":"Zhang","year":"2017","journal-title":"Cardiovasc Diabetol"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"713","DOI":"10.21649\/akemu.v24i1.2333","article-title":"Comparison of tumor necrosis factor alpha and insulin resistance in obeseversus non-obese type 2 diabetic patients","volume":"24","author":"Ijaz","year":"2018","journal-title":"Ann King Edward Med Univ"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"127","DOI":"10.4103\/0971-5916.93435","article-title":"Association of TNF-\u03b1 with insulin resistance in type 2 diabetes mellitus","volume":"135","author":"Swaroop","year":"2012","journal-title":"Indian J Med Res"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"264","DOI":"10.4103\/hm.HM-D-24-00106","article-title":"Effects of a diet rich in polyphenols on lipid metabolism: an updated narrative review","volume":"9","author":"Scavuzzi","year":"2025","journal-title":"Heart Mind"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"237","DOI":"10.4103\/hm.HM-D-24-00109","article-title":"Dietary trends, microbiome, and cardiovascular health: a narrative review","volume":"9","author":"Sanchis-Gomar","year":"2025","journal-title":"Heart Mind"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1916726\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T05:38:30Z","timestamp":1789709910000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1916726\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,18]]},"references-count":35,"alternative-id":["10.3389\/fpubh.2026.1916726"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2026.1916726","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,18]]},"article-number":"1916726"}}