Triglyceride–glucose index predicts the risk of gestational diabetes mellitus: a systematic review and meta-analysis

We aimed to investigate the potential predictive efficacy of triglyceride–glucose (T/Gly) index for gestational diabetes mellitus (GDM) in a systematic review and meta-analysis. Cohort studies demonstrating the association between T/Gly index measured at the first trimester or before pregnancy and the subsequent incidence of GDM were identified by search of PubMed, Embase, China National Knowledge Infrastructure, and WanFang databases. A random-effect model incorporating the heterogeneity was applied to pool the results. Five cohort studies including 382,213 women were included in this meta-analysis. Compared to those with the lowest category of T/Gly index, women with the highest category of T/Gly index were independently associated with higher risk of subsequent GDM (odds ratio [OR]: 2.52, 95% confidence interval [CI]: 1.33 ∼ 4.67, I2=65%, p=.004) after adjustment of potential confounding factors including age, body mass index, and family history of diabetes. The association was stronger in prospective cohort studies than retrospective cohort studies (p for subgroup difference=.007), and a significant association was detected in Asian women (OR: 3.30, 95% CI: 1.50–7.28, p =.003), but not in non-Asian women (OR: 0.96, 95% CI: 0.35–2.63, p=.94). Higher T/Gly index may independently predict the risk of GDM in Asian women.