Role of the triglyceride-glucose index in predicting parathyroidectomy in primary hyperparathyroidism

The triglyceride-glucose (TyG) index is an easily accessible novel indicator of insulin resistance. This study aimed to investigate the relationship between the TyG index and the homeostatic model assessment of insulin resistance (HOMA-IR) in patients with primary hyperparathyroidism (PHPT), compare these parameters with healthy controls, and evaluate whether the TyG index could serve as a potential new parameter in patients undergoing parathyroidectomy.

We retrospectively analyzed PHPT patients diagnosed between October 2023 and May 2024 in a tertiary endocrinology clinic. TyG index and HOMA-IR were compared with age- and sex-matched healthy controls, and subgroup analyses were performed for parathyroidectomy status. Statistical tests included correlation analysis and ROC curves.

HOMA-IR, TyG index and HbA1c were higher in patients with hyperparathyroidism compared to the control group (p < 0.001). The area under the curve (AUC) of each curve was calculated. It was found that serum calcium (AUC: 0.910, 95% CI: 0.849-0.971), fasting serum insulin (AUC: 0.876, 95% CI: 0.799-0.953), HOMA (AUC: 0.877, 95% CI: 0.799-0.956) and TyG index (AUC: 0.859, 95% CI: 0.777-0.941) demonstrated a satisfactory diagnostic capacity, with serum calcium achieving the highest score. ROC analysis demonstrated high diagnostic performance of TyG index (AUC = 0.859, cut-off = 9.6, sensitivity 82.9%, specificity 73.0%) and HOMA-IR (AUC = 0.877, cut-off = 2.69, sensitivity 84.2%, specificity 76.3%).

The TyG index (cut-off = 9.6) reliably identified PHPT patients requiring parathyroidectomy and may serve as a simple surrogate marker of insulin resistance.

Not applicable.