Diagnostic Performance of the TyG Index in Detecting Metabolic Syndrome: A Cross-Sectional Study from Western Iran

Metabolic Syndrome (MetS) is a prevalent endocrine disorder characterized by metabolic abnormalities such as abdominal obesity, dyslipidemia, hypertension, and impaired glucose metabolism. Early identification and screening are vital for effective management. The triglyceride-glucose (TyG) index, derived from fasting triglycerides and glucose levels, is emerging as a potential surrogate marker for insulin resistance and MetS. This study evaluates the TyG index as a standalone predictor of MetS risk and progression.

This cross-sectional study utilized data from the Dehgolan Prospective Cohort Study (DehPCS), involving 3,800 participants aged 35–70 from western Iran. MetS was defined using World Health Organization (WHO) criteria. The diagnostic performance of the TyG index, its variants, and anthropometric indices was assessed using regression analysis, receiver operating characteristic (ROC) curves, and the area under the curve (AUC).

MetS prevalence in the study population was 35.19%. The TyG-WHtR (waist-to-height ratio) index demonstrated the highest AUC (0.86) in the total population, with sensitivity and specificity of 84.56% and 72.23%, respectively. In males, the TyG-WC (waist circumference) index showed the highest AUC (0.90, sensitivity: 79.29%, specificity: 85.4%). In females, the TyG index alone ranked highest with an AUC of 0.87 (sensitivity: 76.12%, specificity: 87.1%).

The TyG index and its anthropometric variants showed excellent diagnostic accuracy for MetS, highlighting their potential as cost-effective screening tools, especially in resource-constrained settings. Further validation across diverse populations is recommended.