{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T14:36:45Z","timestamp":1777905405289,"version":"3.51.4"},"reference-count":35,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T00:00:00Z","timestamp":1765324800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.mdpi.com"],"crossmark-restriction":true},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Objectives: This study aimed to evaluate whether first-trimester metabolic markers\u2014including the triglyceride-glucose (TyG) index and lipid-related ratios (TG\/HDL-c, LDL-c\/HDL-c, and TyG\/BMI)\u2014could predict the development of late-onset preeclampsia, and to assess their associations with birthweight and birth length. Methods: A retrospective cohort study was conducted on 306 pregnant women (153 with late-onset PE and 153 normotensive controls). Demographic and clinical data, including maternal lipid profiles, TyG index, and other biochemical markers, were collected during the first trimester. Statistical analyses, including Mann\u2013Whitney, two-sided t-tests, and receiver operating characteristic curves (ROC), were performed to assess the predictive value of the TyG index and other ratios in predicting late-onset PE. Results: Significant differences between the PE and control groups were observed in delivery method, birthweight, and birthlength (p &lt; 0.05). ROC analysis revealed that the TyG index had an area under the curve (AUC) of 0.79, with a sensitivity of 69.3% and specificity of 75.8%. The TyG index was inversely associated with birthweight (\u03c1 = \u22120.288) and gestational age at delivery (\u03c1 = \u22120.218), while positively correlating with systolic blood pressure (\u03c1 = 0.441). Conclusions: The TyG index, along with TG\/HDL and LDL-c\/HDL ratios, demonstrated predictive value for late-onset PE. These findings suggest that elevated TyG index levels may contribute to adverse pregnancy outcomes such as intrauterine growth restriction and preterm delivery. First-trimester lipid profiles and the TyG index may serve as valuable markers for early prediction of late-onset PE.<\/jats:p>","DOI":"10.3390\/diagnostics15243141","type":"journal-article","created":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T14:22:40Z","timestamp":1765376560000},"page":"3141","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["First Trimester Triglyceride-Glucose Index and Lipid Profile as Predictive Factors in the Diagnosis of Late-Onset Preeclampsia: Can We Prevent It?"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4128-499X","authenticated-orcid":false,"given":"Cagla Bahar","family":"Bulbul","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Balikesir Ataturk City and Research Hospital, Altieylul, Gaziosmanpasa, 209. Sk. No:26, 10100 Balikesir, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Betul","family":"Yakistiran","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Balikesir Ataturk City and Research Hospital, Altieylul, Gaziosmanpasa, 209. Sk. No:26, 10100 Balikesir, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Torres-Torres, J., Espino-y-Sosa, S., Martinez-Portilla, R., Borboa-Olivares, H., Estrada-Gutierrez, G., Acevedo-Gallegos, S., Ruiz-Ramirez, E., Velasco-Espin, M., Cerda-Flores, P., and Ramirez-Gonzalez, A. (2024). A Narrative Review on the Pathophysiology of Preeclampsia. Int. J. Mol. Sci., 25.","DOI":"10.3390\/ijms25147569"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"S1102","DOI":"10.1016\/j.ajog.2020.10.047","article-title":"The prediction of preeclampsia: The way forward","volume":"226","author":"Myatt","year":"2022","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.ejogrb.2013.05.005","article-title":"Global and regional estimates of preeclampsia and eclampsia: A systematic review","volume":"170","author":"Abalos","year":"2013","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"119922","DOI":"10.1016\/j.cca.2024.119922","article-title":"Preeclampsia: A comprehensive review","volume":"563","author":"Ali","year":"2024","journal-title":"Clin. Chim. Acta"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1421","DOI":"10.1111\/1471-0528.16683","article-title":"Pre-eclampsia and long-term health outcomes for mother and infant: An umbrella review","volume":"128","author":"Pittara","year":"2021","journal-title":"BJOG Int. J. Obstet. Gynaecol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e323","DOI":"10.1016\/S2214-109X(14)70227-X","article-title":"Global causes of maternal death: A WHO systematic analysis","volume":"2","author":"Say","year":"2014","journal-title":"Lancet Glob. Health"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1007\/s11906-024-01299-z","article-title":"The Role of Obesity in the Development of Preeclampsia","volume":"26","author":"Schiavone","year":"2024","journal-title":"Curr. Hypertens. Rep."},{"key":"ref_8","first-page":"671","article-title":"Role of Hyperinsulinemia and Insulin Resistance in Hypertension: Metabolic Syndrome Revisited","volume":"36","author":"Li","year":"2020","journal-title":"Can. J. Cardiol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1489","DOI":"10.1111\/jdi.14269","article-title":"Second-Trimester Triglyceride-Glucose Index to Predict Adverse Outcomes in Women with Gestational Diabetes Mellitus: A Retrospective Multicenter Cohort Study","volume":"15","author":"Bai","year":"2024","journal-title":"J. Diabetes Investig."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1007\/s40618-020-01352-z","article-title":"PREDIM index: A useful tool for the application of the euglycemic hyperinsulinemic clamp","volume":"44","author":"Rebelos","year":"2021","journal-title":"J. Endocrinol. Investig."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"11","DOI":"10.18869\/acadpub.jcbr.1.1.11","article-title":"Triglyceride-Glucose Index Simulation","volume":"1","author":"Hosseini","year":"2017","journal-title":"J. Clin. Basic Res."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2783","DOI":"10.1080\/10408398.2020.1788501","article-title":"Predictive capacity of triglyceride-glucose (TyG) index for insulin resistance and cardiometabolic risk in children and adolescents: A systematic review","volume":"61","author":"Brito","year":"2021","journal-title":"Crit. Rev. Food Sci. Nutr."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1186\/s12944-024-02076-2","article-title":"Triglyceride-glucose index in early pregnancy predicts the risk of gestational diabetes: A prospective cohort study","volume":"23","author":"Guo","year":"2024","journal-title":"Lipids Health Dis."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"3705","DOI":"10.2147\/DMSO.S378964","article-title":"First-Trimester Triglyceride-Glucose Index and Risk of Pregnancy-Related Complications: A Prospective Birth Cohort Study in Southeast China","volume":"15","author":"Li","year":"2022","journal-title":"Diabetes Metab. Syndr. Obes."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1167","DOI":"10.1080\/14767058.2017.1402876","article-title":"Association of first-trimester maternal lipid profiles and triglyceride-glucose index with the risk of gestational diabetes mellitus and large for gestational age newborn","volume":"32","author":"Pazhohan","year":"2019","journal-title":"J. Matern.-Fetal Neonatal Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1112","DOI":"10.1080\/09513590.2020.1742687","article-title":"Diagnostic accuracy of the triglyceride-glucose index for gestational diabetes screening: A practical approach. Gynecol Endocrinol","volume":"36","year":"2020","journal-title":"Gynecol. Endocrinol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1080\/09513590.2021.1940932","article-title":"Triglyceride\u2013glucose index predicts the risk of gestational diabetes mellitus: A systematic review and meta-analysis","volume":"38","author":"Song","year":"2022","journal-title":"Gynecol. Endocrinol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1093\/clinchem\/18.6.499","article-title":"Estimation of the Concentration of Low-Density Lipoprotein Cholesterol in Plasma, Without Use of the Preparative Ultracentrifuge","volume":"18","author":"Friedewald","year":"1972","journal-title":"Clin. Chem."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"261878","DOI":"10.1155\/2014\/261878","article-title":"Validation of the Friedewald Formula in Patients with Metabolic Syndrome","volume":"2014","author":"Knopfholz","year":"2014","journal-title":"Cholesterol"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"(2020). Gestational Hypertension and Preeclampsia: ACOG Practice Bulletin Summary, Number 222. Obstet. Gynecol., 135, 1492.","DOI":"10.1097\/AOG.0000000000003892"},{"key":"ref_21","unstructured":"(2025, January 28). NICE_guidance_on-Pre-eclampsia_VB2020.pdf [Internet]. Available online: https:\/\/action-on-pre-eclampsia.org.uk\/wp-content\/uploads\/2020\/01\/NICE_guidance_on-Pre-eclampsia_VB2020.pdf."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"S1071","DOI":"10.1016\/j.ajog.2020.07.020","article-title":"First trimester preeclampsia screening and prediction","volume":"226","author":"Chaemsaithong","year":"2022","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1016\/j.preghy.2019.03.005","article-title":"Prediction models for preeclampsia: A systematic review","volume":"16","author":"Hirst","year":"2019","journal-title":"Pregnancy Hypertens."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"102436","DOI":"10.1016\/j.bpobgyn.2023.102436","article-title":"Prediction of preeclampsia in asymptomatic women","volume":"92","author":"Lee","year":"2024","journal-title":"Best Pract. Res. Clin. Obstet. Gynaecol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"337","DOI":"10.2147\/CLEP.S353019","article-title":"Identification of Biomarkers for Preeclampsia Based on Metabolomics","volume":"14","author":"Yao","year":"2022","journal-title":"Clin. Epidemiol."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Lee, S.M., Moon, J.Y., Lim, B.Y., Kim, S.M., Park, C.W., Kim, B.J., Jun, J.K., Norwitz, E.R., Choi, M.H., and Park, J.S. (2019). Increased biosynthesis and accumulation of cholesterol in maternal plasma, but not amniotic fluid in pre-eclampsia. Sci. Rep., 9.","DOI":"10.1038\/s41598-018-37757-3"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"6132","DOI":"10.1080\/14767058.2021.1907335","article-title":"Maternal lipid levels in preeclampsia: Singleton vs. twin pregnancies","volume":"35","author":"Jing","year":"2022","journal-title":"J. Matern.-Fetal Neonatal Med."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"105","DOI":"10.26502\/jppch.74050189","article-title":"Serum Lipid Profiles in Preeclamptic versus Normotensive Pregnancies: A Case-Control Study","volume":"8","author":"Njoku","year":"2024","journal-title":"J. Pediatr. Perinatol. Child Health"},{"key":"ref_29","first-page":"9279","article-title":"Combining the triglyceride-glucose index and glycated hemoglobin A1c to assess the risk of preeclampsia in women with normal glucose tolerance: A cross-sectional study","volume":"27","author":"Ye","year":"2023","journal-title":"Eur. Rev. Med. Pharmacol. Sci."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"102683","DOI":"10.1016\/j.pmedr.2024.102683","article-title":"Triglyceride-glucose index: A promising biomarker for predicting risks of adverse pregnancy outcomes in Hangzhou, China","volume":"41","author":"Zhang","year":"2024","journal-title":"Prev. Med. Rep."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"8956404","DOI":"10.1155\/2018\/8956404","article-title":"Triglycerides\/Glucose and Triglyceride\/High-Density Lipoprotein Cholesterol Indices in Normal and Preeclamptic Pregnancies: A Longitudinal Study","volume":"2018","author":"Poveda","year":"2018","journal-title":"Int. J. Endocrinol."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Gonz\u00e1lez-Rojas, A., and Valencia-Narbona, M. (2024). Neurodevelopmental Disruptions in Children of Preeclamptic Mothers: Pathophysiological Mechanisms and Consequences. Int. J. Mol. Sci., 25.","DOI":"10.3390\/ijms25073632"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1016\/j.echo.2021.01.008","article-title":"Cardiovascular Dysfunction in Children Exposed to Preeclampsia During Fetal Life","volume":"34","author":"Hoodbhoy","year":"2021","journal-title":"J. Am. Soc. Echocardiogr."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1429","DOI":"10.1097\/HJH.0000000000003485","article-title":"Blood pressure, arterial stiffness, and cardiovascular risk profiles in 8\u201312-year-old children following preeclampsia (FINNCARE-study)","volume":"41","author":"Renlund","year":"2023","journal-title":"J. Hypertens."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"698","DOI":"10.1053\/j.ajkd.2023.04.010","article-title":"Preeclampsia and Long-term Kidney Outcomes: An Observational Cohort Study","volume":"82","author":"Srialluri","year":"2023","journal-title":"Am. J. Kidney Dis."}],"updated-by":[{"DOI":"10.3390\/diagnostics16081122","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T00:00:00Z","timestamp":1765324800000}}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/15\/24\/3141\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T07:48:39Z","timestamp":1775720919000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/15\/24\/3141"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,10]]},"references-count":35,"journal-issue":{"issue":"24","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["diagnostics15243141"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics15243141","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,10]]}}}