In people living with HIV, a higher TyG index was independently associated with an increased risk of both T2DM and CVEs over long-term follow-up, representing a practical, low-cost tool for early metabolic risk stratification in this population.
The TyG index demonstrated fair discrimination for incident type 2 diabetes mellitus in people living with HIV, with an optimal threshold of 4.78.
People living with HIV with a TyG index at or above 4.78 had nearly three times higher odds of developing type 2 diabetes compared to those below the threshold.
People living with HIV in the highest TyG tertile had significantly higher risk of cardiovascular events compared to those in the lowest tertile.
The study cohort consisted of 477 people living with HIV-1 without baseline type 2 diabetes, followed for a median of 14.2 years.
People living with HIV are at increased risk for metabolic and cardiovascular diseases, and no structured prevention strategy currently exists for this population.
This research followed 477 people living with HIV (PWH) for about 14 years to see whether a simple blood test score — the triglyceride-glucose (TyG) index, calculated from routine fasting triglyceride and blood sugar measurements — could predict who would go on to develop type 2 diabetes or have a cardiovascular event such as a heart attack or stroke. Over the follow-up period, 38 participants developed type 2 diabetes and 45 had a cardiovascular event. People with a TyG index of 4.78 or higher were nearly three times more likely to develop diabetes, and those in the top third of TyG scores were more than three times more likely to experience a cardiovascular event compared to those in the lowest third. This research suggests that the TyG index — a simple, inexpensive calculation using blood tests that are already routinely collected — could serve as a useful early warning tool to identify people living with HIV who are at higher risk for serious metabolic and cardiovascular problems. This is particularly relevant because people living with HIV face elevated risks of these conditions, potentially due to both the virus itself and the medications used to treat it, yet there is currently no standardized approach for identifying who is most at risk. The practical implication of this finding is that clinicians caring for people with HIV might consider incorporating the TyG index into routine monitoring to help stratify metabolic and cardiovascular risk without requiring additional expensive tests. The study was retrospective and observational, meaning it looked back at existing data, so future prospective studies would be needed to confirm these findings and evaluate whether acting on TyG-based risk scores leads to improved health outcomes.
Pastori D, Gazzaniga G, Brogi T, Rivano Capparuccia M, Fimiani C, Mastroianni C, et al.. (2026). The Triglyceride-Glucose (TyG) Index and Incident Diabetes and Cardiovascular Events in People Living With HIV-1 Infection. A 14-Year Observational Cohort Study.. European journal of clinical investigation. https://doi.org/10.1111/eci.70258