Insulin resistance plays a key role in the development of type 2 diabetes, metabolic syndrome, and heart disease. The most common way to measure insulin resistance is the HOMA-IR index, but it requires fasting insulin tests, which are not always available in clinical practice.

This study aims to assess two simpler and more accessible alternatives: the triglyceride-glucose index (TGI) and its body mass index-adjusted version (TGI-BMI). Data from 150 adult patients were analyzed retrospectively and divided into groups according to their insulin resistance status. Standard laboratory and body measurements were compared between groups, and statistical analyses were used to determine how well TGI and TGI-BMI identify insulin resistance.

The results showed that both TGI and TGI-BMI were closely related to insulin resistance and demonstrated high diagnostic accuracy, similar to HOMA-IR. The TGI-BMI index was particularly effective in individuals with obesity. These findings suggest that TGI and TGI-BMI could serve as practical, low-cost alternatives to HOMA-IR for evaluating insulin resistance in clinical and population settings where insulin testing is not routinely available.

Insulin resistance (IR) is a central feature of metabolic and cardiovascular disorders, yet the routine measurement of fasting insulin required for HOMA-IR limits its clinical applicability. The triglyceride-glucose index (TGI) and its body mass index-adjusted form (TGI-BMI) have emerged as simple, cost-effective surrogates that rely only on standard biochemical data.

This retrospective study analyzed data from 150 adults evaluated at Hisar Intercontinental Hospital. Participants were categorized into insulin-resistant (HOMA-IR > 2.5) and non-resistant (HOMA-IR < 2.5) groups. Anthropometric and biochemical variables were obtained from medical records. TGI and TGI-BMI values were calculated for each participant, and comparisons were made between groups. Correlation and receiver operating characteristic (ROC) analyses were used to determine the relationship and diagnostic accuracy of these indices relative to HOMA-IR.

The study aims to validate TGI and TGI-BMI as reliable, low-cost indicators of insulin resistance applicable in both clinical and epidemiological settings, especially in laboratories where insulin assays are unavailable. The findings may contribute to improved screening and risk assessment strategies in metabolic disease management.

Inclusion Criteria:

• Eligible participants were adults aged 18-65 years with complete fasting biochemical and anthropometric data. Only patients who were not receiving antidiabetic medications at the time of evaluation were included.

Exclusion Criteria:

• Patients were excluded if they had any of the following:

  • Known endocrine disorders (e.g., thyroid dysfunction, Cushing's syndrome)
  • Chronic kidney or liver disease
  • Active infection or systemic inflammatory disease
  • Ongoing use of medications known to affect glucose or lipid metabolism (e.g., corticosteroids, statins, metformin, or insulin)
  • Incomplete or missing laboratory data

Adult patients who underwent routine biochemical testing and metabolic evaluation at Hisar Intercontinental Hospital. Data were obtained retrospectively from medical records. Participants were divided into two cohorts based on insulin resistance status determined by HOMA-IR values:

Non-Insulin Resistant (HOMA-IR < 2.5)

Insulin Resistant (HOMA-IR > 2.5)

Participant data (PD) and supporting information will be available starting from the date of publication of the study results. The data will remain accessible for a period of 5 years after publication.

Access to the Individual Participant Data (IPD) and supporting information will be limited to authorized members of the study team and independent researchers who submit a formal request for scientific evaluation. Accessible materials will include the de-identified IPD dataset, study protocol, and relevant analysis outputs