Int J Obes (Lond). 2026 Jun 5. doi: 10.1038/s41366-026-02044-z. Online ahead of print.
ABSTRACT
OBJECTIVE: The association between the longitudinal trajectory changes of triglyceride-glucose (TyG) index and type 2 diabetes mellitus (T2DM) is still unclear among the population with normal weight; hence, we aimed to identify the trajectories of TyG index and to explore their association with T2DM in the Chinese population with normal weight.
METHODS: We included 21,373 participants with normal weight who participated in at least 3 surveys in the project entitled Prediction for Atherosclerotic Cardiovascular Disease Risk in China (China-PAR Project). Latent mixture modeling was used to identify the distinct trajectories. The associations between TyG index trajectories and the incident risk of T2DM were examined using the logistic regression model.
RESULTS: We identified five TyG index trajectories: low-increasing (28.01%), moderate-increasing (53.93%), moderate high-increasing (14.81%), high-U shape (1.09%), and high-increasing (2.16%). During the mean 12.9 years of follow-up, 1215 participants developed T2DM. After adjusting for confounders, the odds ratio (OR) and 95% confidence interval (CI) of T2DM were 3.00 (2.41-3.76) for the moderate-increasing group, 8.19 (6.43-10.51) for the moderate high-increasing group, 8.42 (5.27-13.17) for the high-U shape group, and 17.39 (12.53-24.17) for the high-increasing group, when compared with participants in the low-increasing group. The sex-specific trajectories and their association with the incident risk of T2DM were similar to those in the total population. The associations remained robust with sensitivity analysis and subgroup analysis.
CONCLUSION: Among the Chinese population with normal weight, those with a high-increasing TyG index trajectory may face a higher risk of T2DM compared with those with a low-increasing trajectory. Persistently lower TyG levels are associated with a reduced risk of T2DM in the normal-weight population.
PMID:42249133 | DOI:10.1038/s41366-026-02044-z