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Published on: March 5, 2022
Deconstructing triglyceride glucose-body mass index in normal-weight women with polyendocrine metabolic ovarian
Daniel A Dumesic1, Tristan R Grogan2, Michelle M Song1
1Department of Obstetrics and Gynecology, University of California, Los Angeles, California.
Objective:
To study the biological pathways underlying the triglyceride glucose-body mass index (TyG-BMI), calculated as natural logarithm (plasma triglyceride [mg/dL] × fasting blood glucose [mg/dL]/2) × body mass index (BMI), in normal-weight women with polyendocrine metabolic ovarian syndrome (PMOS) and age-/BMI-matched normoandrogenic ovulatory (control) women, and to determine whether the TyG-BMI in such women is a useful clinical predictor of reduced in vitro fertilization (IVF) pregnancy outcome.
Design:
Retrospective cohort study SUBJECTS: Twenty-one normal-weight women with PMOS and 19 age- and BMI-matched controls.
Exposure:
All women underwent fasting circulating metabolic/androgenic determinations.
Main Outcome Measures:
The TyG-BMI was compared between women with PMOS and age-/BMI-matched controls and correlated with metabolic/androgenic outcomes.
Results:
Serum luteinizing hormone/androgen levels and fasting serum triglyceride/insulin levels were significantly greater in women with PMOS than controls. Adipose insulin resistance (adipose-IR) was also increased in women with PMOS vs. controls. The TyG-BMI and homeostasis model assessment of insulin resistance, however, were not significantly different by female type. In multivariable linear regression, TyG-BMI was unassociated with PMOS, serum free testosterone or fasting serum insulin levels. Instead, in all women combined, higher TyG-BMI levels were associated with greater adipose-IR, higher serum non-high-density lipoprotein cholesterol, and lower serum high-density lipoprotein cholesterol levels.
Conclusion:
Adipose-IR accompanying altered lipid metabolism underlies the TyG-BMI of normal-weight women with PMOS and age-/BMI-matched controls. The TyG-BMI, however, may have limited utility in predicting reduced IVF pregnancy outcome in normal-weight women with PMOS, although confirmation in similar cohorts undergoing IVF is needed.
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