{
  "abstract": "Background and objective: Prediabetes defined by glycated haemoglobin (HbA1c) can occur despite fasting plasma glucose (FPG) below 100 mg/dL, leaving a discordant glycaemic phenotype that FPG-based pathways may miss. We investigated whether triglyceride–glucose (TyG)-related indices identify this phenotype and whether their comparative performance is maintained across populations.\n\nMethods: We analysed fasting-subsample data from seven US National Health and Nutrition Examination Survey (NHANES 2005–2018) cycles and an independent health-examination cohort from Pu’er Hospital of Traditional Chinese Medicine (2020–2026). The primary index was TyG–waist-to-height ratio (TyG–WHtR). Survey-weighted and local regression models quantified adjusted associations. Candidate prediction models were benchmarked against related metabolic indices and a model retaining FPG, triglycerides and WHtR as separate terms. Repeated cross-validation was performed in NHANES, after which all fitted models, transformations and thresholds were frozen for external validation.\n\nResults and conclusion: Among 6,930 eligible NHANES participants, 1,206 had HbA1c-defined prediabetes, corresponding to a weighted prevalence of 12.7% [95% confidence interval (CI), 11.7%–13.7%]. The local cohort included 10,791 participants and 1,139 outcomes. Each cohort-specific standard deviation increase in TyG–WHtR was associated with higher outcome prevalence in NHANES (prevalence ratio, 1.239; 95% CI, 1.158–1.326) and locally (1.482; 1.407–1.561). The raw-component model showed repeated internal validation (area under the receiver operating characteristic curve, 0.746), whereas the metabolic score for insulin resistance led to frozen external validation (0.710; 0.693–0.727). TyG–WHtR was reproducibly associated with the outcome but was not the strongest discriminator in either setting. The gains in discrimination were modest, and this cross-sectional validation does not establish clinical utility.",
  "abstract_shown": true,
  "affiliations": [
    "Laboratory Department, Pu’er Hospital of Traditional Chinese Medicine"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 8,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Fen Li"
    },
    {
      "affs": [
        0
      ],
      "name": "Yingjing Xie"
    },
    {
      "affs": [
        0
      ],
      "name": "Yu Chen"
    },
    {
      "affs": [
        0
      ],
      "name": "Zexiu Wang"
    },
    {
      "affs": [
        0
      ],
      "name": "Chunmei Rao"
    },
    {
      "affs": [
        0
      ],
      "name": "Jinliu Cheng"
    },
    {
      "affs": [
        0
      ],
      "name": "Tianwu Zhang"
    },
    {
      "affs": [
        0
      ],
      "name": "Jin Yuan"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/361nm7p5ef6pt.bib",
  "cited_by": 0,
  "doi": "10.3389/fendo.2026.1961688",
  "fulltext_url": "https://europepmc.org/articles/PMC13686893",
  "id": "361nm7p5ef6pt",
  "issns": [
    "1664-2392"
  ],
  "landing_url": "https://www.frontiersin.org/articles/10.3389/fendo.2026.1961688/full",
  "language": "eng",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2712|Diabetes, Cardiovascular Risks, and Lipoproteins"
    ]
  ],
  "openalex": "W7221043647",
  "pdf_url": "https://europepmc.org/articles/PMC13686893?pdf=render",
  "pmcid": "PMC13686893",
  "pmid": "42922879",
  "published": "2026-10-08",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/361nm7p5ef6pt.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:20Z",
      "native_id": "10.3389/fendo.2026.1961688",
      "source": "crossref",
      "url": "https://www.frontiersin.org/articles/10.3389/fendo.2026.1961688/full"
    },
    {
      "first_seen": "2026-10-30T12:20:36Z",
      "native_id": "MED:42922879",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42922879"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2712|Diabetes, Cardiovascular Risks, and Lipoproteins",
      "subfield": "endocrinology-metabolism"
    }
  ],
  "title": "External validation reveals setting-dependent performance of TyG-related indices for HbA1c-defined prediabetes",
  "title_text": "External validation reveals setting-dependent performance of TyG-related indices for HbA1c-defined prediabetes",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:20:36Z",
  "url": "https://research.draconitic.com/paper/361nm7p5ef6pt",
  "venue": "Frontiers in Endocrinology",
  "versions": []
}