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Peer-reviewedCC BY 4.0Journal of Clinical Medicine

Prevalence of Triglyceride–Glucose Index-Defined Insulin Resistance and Its Association with Recorded Cardiovascular Disease Among Adults in the Municipality of Naples: A Cross-Sectional Primary-Care Study

  • Serafino Fazio1
  • Vincenzo Santagada2
  • Gaetano Piccinocchi3
  • Giuseppe Signoriello4
  • Rosanna Ortolani5
  • Ilaria Loperto5
  • Flora Affuso6
  • Roberto Piccinocchi7
  • Ilenia Lorenza Calcaterra1
  • Matteo Di Minno1
7 affiliations
  1. 1School of Medicine, Federico II University, via S. Pansini 5, 80131 Naples, Italy
  2. 2Dipartimento di Farmacia, Università Federico II, Assessorato alla Salute e Verde, Comune di Napoli, 80133 Naples, Italy
  3. 3Società Italiana di Medicina Generale, Via del Sansovino, 50142 Florence, Italy
  4. 4University of Campania “Luigi Vanvitelli”, 80100 Naples, Italy
  5. 5Epidemiology, Prevention and Cancer Registry Unit, ASL Napoli 1 Centro, Via Comunale del Principe, 80125 Naples, Italy
  6. 6Independent Researcher, 80129 Nalles, Italy
  7. 7AOU-Azienda Ospedaliera Universitaria “Luigi Vanvitelli”, 80100 Naples, Italy
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Abstract

Objectives: Assess the prevalence of insulin resistance (IR) in the adult population of the municipality of Naples in Italy and its association with cardiovascular diseases. Methods: We performed a cross-sectional analysis of adults aged 18–60 years without recorded diabetes who were followed by general practitioners affiliated with the COMEGEN cooperative, ASL Napoli 1 Centro. Participants were included if concurrent fasting glucose and triglyceride values from the preceding six months were available to calculate the triglyceride–glucose index (TyG), as a surrogate index of IR. IR was defined using an operational cut-off of TyG ≥ 8.5. Results: Of 17,510 selected records, 17,481 had calculable TyG; 5707 met the IR criterion (32.65%; 95% CI 31.96–33.35%). Recorded cardiovascular conditions were present in 44.98% with IR and 28.90% without IR. The adjusted odds ratio (OR) for IR was 1.252 (95% CI 1.137–1.379; n = 9866), and the adjusted prevalence ratio (PR) was 1.133 (95% CI 1.079–1.190). Adding IR to a model containing age, sex, and BMI increased the ROC AUC from 0.7438 to 0.7452 (p = 0.0477), a negligible absolute gain. Conclusions: TyG-defined IR was common and associated with recorded cardiovascular conditions, but offered little incremental discrimination; causality cannot be inferred from these cross-sectional data. However, the high prevalence of IR, associated with cardiometabolic risk, should prompt health institutions to inform the public about the existence of IR, a condition associated with an increased cardiometabolic risk that could be counteracted through healthier lifestyles, and encourage the scientific community to conduct prospective randomized controlled trials to determine whether early screening for IR, and subsequent intervention to counteract it, can yield benefits for cardiovascular outcomes.

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Cite

BibTeXRIS
BibTeX
@article{fazio2026prevalence,
  title = {{Prevalence of Triglyceride–Glucose Index-Defined Insulin Resistance and Its Association with Recorded Cardiovascular Disease Among Adults in the Municipality of Naples: A Cross-Sectional Primary-Care Study}},
  author = {Serafino Fazio and Vincenzo Santagada and Gaetano Piccinocchi and Giuseppe Signoriello and Rosanna Ortolani and Ilaria Loperto and Flora Affuso and Roberto Piccinocchi and Ilenia Lorenza Calcaterra and Matteo Di Minno},
  journal = {Journal of Clinical Medicine},
  year = {2026},
  month = oct,
  doi = {10.3390/jcm15218244},
  url = {https://www.mdpi.com/2077-0383/15/21/8244},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Prevalence of Triglyceride–Glucose Index-Defined Insulin Resistance and Its Association with Recorded Cardiovascular Disease Among Adults in the Municipality of Naples: A Cross-Sectional Primary-Care Study
AU  - Serafino Fazio
AU  - Vincenzo Santagada
AU  - Gaetano Piccinocchi
AU  - Giuseppe Signoriello
AU  - Rosanna Ortolani
AU  - Ilaria Loperto
AU  - Flora Affuso
AU  - Roberto Piccinocchi
AU  - Ilenia Lorenza Calcaterra
AU  - Matteo Di Minno
PY  - 2026
DA  - 2026/10/23
JO  - Journal of Clinical Medicine
DO  - 10.3390/jcm15218244
UR  - https://www.mdpi.com/2077-0383/15/21/8244
AB  - Objectives: Assess the prevalence of insulin resistance (IR) in the adult population of the municipality of Naples in Italy and its association with cardiovascular diseases. Methods: We performed a cross-sectional analysis of adults aged 18–60 years without recorded diabetes who were followed by general practitioners affiliated with the COMEGEN cooperative, ASL Napoli 1 Centro. Participants were included if concurrent fasting glucose and triglyceride values from the preceding six months were available to calculate the triglyceride–glucose index (TyG), as a surrogate index of IR. IR was defined using an operational cut-off of TyG ≥ 8.5. Results: Of 17,510 selected records, 17,481 had calculable TyG; 5707 met the IR criterion (32.65%; 95% CI 31.96–33.35%). Recorded cardiovascular conditions were present in 44.98% with IR and 28.90% without IR. The adjusted odds ratio (OR) for IR was 1.252 (95% CI 1.137–1.379; n = 9866), and the adjusted prevalence ratio (PR) was 1.133 (95% CI 1.079–1.190). Adding IR to a model containing age, sex, and BMI increased the ROC AUC from 0.7438 to 0.7452 (p = 0.0477), a negligible absolute gain. Conclusions: TyG-defined IR was common and associated with recorded cardiovascular conditions, but offered little incremental discrimination; causality cannot be inferred from these cross-sectional data. However, the high prevalence of IR, associated with cardiometabolic risk, should prompt health institutions to inform the public about the existence of IR, a condition associated with an increased cardiometabolic risk that could be counteracted through healthier lifestyles, and encourage the scientific community to conduct prospective randomized controlled trials to determine whether early screening for IR, and subsequent intervention to counteract it, can yield benefits for cardiovascular outcomes.
SN  - 2077-0383
ER  -