The triglyceride-glucose (TyG) index and its relation to metabolic indices in women with PCOS: a phenotype-based analysis

Lena Radic; Sanja Ognjanovic; Bojana Popovic; Dusan Ilic; Kovacevic Valentina Elezovic; Palibrk Milica Opalic; Katarina Krstic; Macut Jelica Bjekic; Tamara Baltic; Milutinovic Danijela Vojnovic; Olivera Stanojlovic; Djuro Macut

doi:10.1530/endoabs.110.P1039

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Endocrine Abstracts (2025) 110 P1039 | DOI: 10.1530/endoabs.110.P1039

ECEESPE2025 Poster Presentations Reproductive and Developmental Endocrinology (93 abstracts)

The triglyceride-glucose (TyG) index and its relation to metabolic indices in women with PCOS: a phenotype-based analysis

Lena Radic ¹ , Sanja Ognjanovic ^1,2 , Bojana Popovic ^1,2 , Dusan Ilic ¹ , Valentina Elezovic Kovacevic ^1,2 , Milica Opalic Palibrk ¹ , Katarina Krstic ¹ , Jelica Bjekic Macut ^2,3 , Tamara Baltic ³ , Danijela Vojnovic Milutinovic ⁴ , Olivera Stanojlovic ⁵ & Djuro Macut ^1,2

Author affiliations

¹Clinic for Endocrinology, Diabetes and Metabolic Diseases, University Clinical Center of Serbia, Department for Endocrine Tumors and Hereditary Cancer Syndromes, Belgrade, Serbia; ²Faculty of Medicine University of Belgrade, Belgrade, Serbia; ³CHC Bezanijska kosa, Department of Endocrinology, Belgrade, Serbia; ⁴Institute for biological research “Sinisa Stankovic”, Belgrade, Serbia; ⁵Institute of Medical Physiology, Faculty of Medicine University of Belgrade, Belgrade, Serbia

JOINT2221

Introduction: Polycystic ovary syndrome (PCOS) is an endocrine disorder linked to insulin resistance (IR), dyslipidemia, and hyperandrogenism. The triglyceride-glucose (TyG) index is a proposed surrogate marker for IR, but its relevance across PCOS phenotypes remains unclear. This study aimed to assess the metabolic significance of TyG in women with PCOS from a Serbian population.

Subjects and Methods: A total of 160 women with PCOS, diagnosed using the ESHRE/ASRM criteria, were divided into four phenotypic groups with 40 patients each: A (oligo/anovulation-OA + clinical/biochemical hyperandrogenism-HA + polycystic ovarian morphology-PCOM), B (OA+HA), C (HA+PCOM), D (OA+PCOM). Fasting glucose, insulin, lipid profile, total testosterone and SHBG were analyzed, while HOMA-IR, FAI and the TyG index were calculated. Patients were stratified by the TyG median calculated from our cohort (7.9).

Results: Our patients had a mean age of 25.98±6.03 years, BMI 24.05±5.64 kg/m², and waist circumference (WC) 79.73±13.94 cm. Initial analysis showed significant differences in BMI, WC, fasting glucose, HOMA-IR, and androgens across phenotypes, while insulin, lipid indices, and the TyG index did not differ significantly. Stratification by the TyG median (7.9) revealed significant differences in all metabolic parameters except androgens, with insulin showing borderline significance (P = 0.056). Pairwise comparisons showed that the TyG was lower in phenotype D (7.92±0.37 mmol/l) than in A (8.16±0.51, P = 0.027) and B (8.19±0.62, P = 0.030), though these differences did not remain statistically significant after adjustment. In phenotypes A and B, TyG correlated positively with most metabolic parameters and negatively with HDL. Stratification based on the TyG median confirmed that individuals with higher TyG had significantly higher BMI, WC, impaired glucose homeostasis, and dyslipidemia. In phenotype D, TyG correlated only with triglycerides and HDL, with higher triglycerides in the high TyG group, whereas HDL levels were lower but did not reach statistical significance (P = 0.051). ROC curve analysis for TyG in relation to HOMA-IR cut-offs (2.5, 2.0, 1.5) showed AUC values of 0.617 (95% CI: 0.530-0.703), 0.641 (95% CI: 0.553-0.729), and 0.658 (95% CI: 0.552-0.764).

Conclusion: Our analysis confirmed that the TyG index correlates with anthropometric and metabolic parameters, showing phenotype-dependent differences. Larger cohort analyses are needed for the assessment of insulin sensitivity in PCOS phenotypes using this simple non-insulin index.