title: Cumulative increased risk of incident type 2 diabetes mellitus with increasing triglyceride glucose index in normal-weight people: The Rural Chinese Cohort Study.
abstract: Risk of type 2 diabetes mellitus (T2DM) is increased in metabolically obese but normal-weight people. However, we have limited knowledge of how to prevent T2DM in normal-weight people. We aimed to evaluate the association between triglyceride glucose (TyG) index and incident T2DM among normal-weight people in rural China.
  
  
  
  We included data from 5706 people with normal body mass index (BMI) (18.5-23.9 kg/m2) without baseline T2DM in a rural Chinese cohort followed for a median of 6.0 years. A Cox proportional-hazard model was used to assess the risk of incident T2DM by quartiles of TyG index and difference in TyG index between follow-up and baseline (TyG-D), estimating hazard ratios (HRs) and 95% confidence intervals (CIs). A generalized additive plot was used to show the nonparametric smoothed exposure-response association between risk of T2DM and TyG index as a continuous variable. TyG was calculated as ln [fasting triglyceride level (mg/dl) × fasting plasma glucose level (mg/dl)/2].
  
  
  
  Risk of incident T2DM was increased with quartiles 2, 3 and 4 versus quartile 1 of TyG index (adjusted HR [aHR] 2.48 [95% CI 1.20-5.11], 3.77 [1.83-7.79], and 5.30 [2.21-12.71], Ptrend< 0.001 across quartiles of TyG index). Risk of incident T2DM was increased with quartile 4 versus quartile 1 of TyG-D (aHR 3.91 [2.22-6.87]). The results were consistent when analyses were restricted to participants without baseline metabolic syndrome and impaired fasting glucose level. The generalized additive plot showed cumulative increased risk of T2DM with increasing TyG index.
  
  
  
  Risk of incident T2DM is increased with increasing TyG index among rural Chinese people, so the index might be an important indicator for identifying people at high risk of T2DM.
authors.affiliation: Department of Preventive Medicine, Shenzhen University Health Sciences Center, 3688 Nanhai Avenue, Nanshan District, Shenzhen, 518060, Guangdong, People's Republic of China.
authors.forename: Ming
authors.initials: M
authors.lastname: Zhang
authors.affiliation: Department of Preventive Medicine, Shenzhen University Health Sciences Center, 3688 Nanhai Avenue, Nanshan District, Shenzhen, 518060, Guangdong, People's Republic of China.|The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China.|Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China.
authors.forename: Bingyuan
authors.initials: B
authors.lastname: Wang
authors.affiliation: The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Liu
authors.affiliation: The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China.
authors.forename: Xizhuo
authors.initials: X
authors.lastname: Sun
authors.affiliation: Department of Preventive Medicine, Shenzhen University Health Sciences Center, 3688 Nanhai Avenue, Nanshan District, Shenzhen, 518060, Guangdong, People's Republic of China.
authors.forename: Xinping
authors.initials: X
authors.lastname: Luo
authors.affiliation: Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China.
authors.forename: Chongjian
authors.initials: C
authors.lastname: Wang
authors.affiliation: Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China.
authors.forename: Linlin
authors.initials: L
authors.lastname: Li
authors.affiliation: Department of Preventive Medicine, Shenzhen University Health Sciences Center, 3688 Nanhai Avenue, Nanshan District, Shenzhen, 518060, Guangdong, People's Republic of China.|The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China.|Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China.
authors.forename: Lu
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Department of Preventive Medicine, Shenzhen University Health Sciences Center, 3688 Nanhai Avenue, Nanshan District, Shenzhen, 518060, Guangdong, People's Republic of China.|The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China.|Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China.
authors.forename: Yongcheng
authors.initials: Y
authors.lastname: Ren
authors.affiliation: Department of Preventive Medicine, Shenzhen University Health Sciences Center, 3688 Nanhai Avenue, Nanshan District, Shenzhen, 518060, Guangdong, People's Republic of China.|The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China.|Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Zhao
authors.affiliation: Department of Preventive Medicine, Shenzhen University Health Sciences Center, 3688 Nanhai Avenue, Nanshan District, Shenzhen, 518060, Guangdong, People's Republic of China.|The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China.
authors.forename: Junmei
authors.initials: J
authors.lastname: Zhou
authors.affiliation: Department of Preventive Medicine, Shenzhen University Health Sciences Center, 3688 Nanhai Avenue, Nanshan District, Shenzhen, 518060, Guangdong, People's Republic of China.|The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China.|Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China.
authors.forename: Chengyi
authors.initials: C
authors.lastname: Han
authors.affiliation: Department of Prevention and Health Care, Military Hospital of Henan Province, Zhengzhou, Henan, People's Republic of China.
authors.forename: Jingzhi
authors.initials: J
authors.lastname: Zhao
authors.affiliation: Department of Preventive Medicine, Shenzhen University Health Sciences Center, 3688 Nanhai Avenue, Nanshan District, Shenzhen, 518060, Guangdong, People's Republic of China. hud@szu.edu.cn.
authors.forename: Dongsheng
authors.initials: D
authors.lastname: Hu
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D015992:Body Mass Index; D001835:Body Weight / Q000502:physiology*; D002681:China / Q000208:ethnology; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000175:diagnosis / Q000208:ethnology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D012424:Rural Population; D014280:Triglycerides / Q000097:blood*
chemical_list: D001786:Blood Glucose; D014280:Triglycerides
keywords: Cohort study; Insulin resistance; Normal weight; Triglyceride glucose index; Type 2 diabetes mellitus