The Triglyceride-Glucose Index as a Biomarker for Insulin Resistance Following Hepatitis C Virus Eradication: A Prospective Cohort Study

Shen, Shih-Hsiung; Tsai, Hsin-Ju; Li, Yu-Hsuan; Chen, Chia-Chang; Lin, Ying-Cheng; Lee, Shou-Wu; Yang, Sheng-Shun; Huang, Yi-Hsiang; Lee, Teng-Yu

doi:10.3390/jcm14092963

Open AccessArticle

The Triglyceride-Glucose Index as a Biomarker for Insulin Resistance Following Hepatitis C Virus Eradication: A Prospective Cohort Study

by

Shih-Hsiung Shen

^1,†

,

Hsin-Ju Tsai

^1,2,†,

Yu-Hsuan Li

^3,4,

Chia-Chang Chen

^1,2,

Ying-Cheng Lin

^1,2,

Shou-Wu Lee

^1,5

,

Sheng-Shun Yang

^1,6,7

,

Yi-Hsiang Huang

^8,9

and

Teng-Yu Lee

^1,5,*

¹

Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung 407219, Taiwan

²

Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung 40227, Taiwan

³

Department of Computer Science & Information Engineering, National Taiwan University, Taipei 10617, Taiwan

⁴

Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung 407219, Taiwan

⁵

School of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan

⁶

Ph.D. Program in Translational Medicine, National Chung Hsing University, Taichung 40227, Taiwan

⁷

Institute of Biomedical Sciences, National Chung Hsing University, Taichung 40227, Taiwan

⁸

Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan

⁹

Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei 11230, Taiwan

^*

Author to whom correspondence should be addressed.

^†

These authors contributed equally to this work.

J. Clin. Med. 2025, 14(9), 2963; https://doi.org/10.3390/jcm14092963

Submission received: 17 March 2025 / Revised: 15 April 2025 / Accepted: 22 April 2025 / Published: 25 April 2025

(This article belongs to the Section Gastroenterology & Hepatopancreatobiliary Medicine)

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Abstract

Background: The triglyceride-glucose (TyG) index has emerged as a novel surrogate marker of insulin resistance, but its changes after hepatitis C virus (HCV) eradication remain unclear. This study aimed to evaluate changes in the TyG index following direct-acting antiviral (DAA) treatment. Methods: HCV-infected patients achieving sustained virological response 12 weeks post-treatment (SVR12) were prospectively enrolled from May 2015 to June 2023. Exclusion criteria included the following: (1) failure to achieve SVR12; (2) use of anti-diabetes or anti-hyperlipidemia medications; and (3) hepatitis B virus or human immunodeficiency virus co-infection. Changes in lipid profiles, TyG index, and homeostasis model assessment of insulin resistance (HOMA-IR) were evaluated from baseline to SVR12. Insulin resistance was defined as HOMA-IR ≥ 2.5. The optimal TyG index cut-off for predicting insulin resistance was determined using the Youden Index. Results: A total of 111 patients (median age: 61.0 years; 45.9% male) were included. The TyG index correlated positively with HOMA-IR (Pearson’s r = 0.32, p < 0.001). Among patients with pre-existing insulin resistance, significant improvements were observed at SVR12 in both HOMA-IR (4.0 [IQR: 3.1–5.4] vs. 2.5 [IQR: 2.0–3.9]; p < 0.001) and TyG index (8.47 [IQR: 8.08–8.68] vs. 8.36 [IQR: 8.00–8.71]; p = 0.028). Using 8.27 as the optimal TyG index cut-off, similar improvements were noted in HOMA-IR (2.8 [IQR: 2.0–4.3] vs. 2.3 [IQR: 1.5–3.8]; p = 0.031) and TyG index (8.62 [IQR: 8.46–8.83] vs. 8.52 [IQR: 8.27–8.89]; p = 0.003). Conclusions: The TyG index is a valuable tool for monitoring changes in insulin resistance after HCV eradication, particularly in patients with baseline insulin resistance.

Keywords: hepatitis C virus; direct-acting antivirals; HOMA-IR; insulin resistance; TyG index

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MDPI and ACS Style

Shen, S.-H.; Tsai, H.-J.; Li, Y.-H.; Chen, C.-C.; Lin, Y.-C.; Lee, S.-W.; Yang, S.-S.; Huang, Y.-H.; Lee, T.-Y. The Triglyceride-Glucose Index as a Biomarker for Insulin Resistance Following Hepatitis C Virus Eradication: A Prospective Cohort Study. J. Clin. Med. 2025, 14, 2963. https://doi.org/10.3390/jcm14092963

AMA Style

Shen S-H, Tsai H-J, Li Y-H, Chen C-C, Lin Y-C, Lee S-W, Yang S-S, Huang Y-H, Lee T-Y. The Triglyceride-Glucose Index as a Biomarker for Insulin Resistance Following Hepatitis C Virus Eradication: A Prospective Cohort Study. Journal of Clinical Medicine. 2025; 14(9):2963. https://doi.org/10.3390/jcm14092963

Chicago/Turabian Style

Shen, Shih-Hsiung, Hsin-Ju Tsai, Yu-Hsuan Li, Chia-Chang Chen, Ying-Cheng Lin, Shou-Wu Lee, Sheng-Shun Yang, Yi-Hsiang Huang, and Teng-Yu Lee. 2025. "The Triglyceride-Glucose Index as a Biomarker for Insulin Resistance Following Hepatitis C Virus Eradication: A Prospective Cohort Study" Journal of Clinical Medicine 14, no. 9: 2963. https://doi.org/10.3390/jcm14092963

APA Style

Shen, S.-H., Tsai, H.-J., Li, Y.-H., Chen, C.-C., Lin, Y.-C., Lee, S.-W., Yang, S.-S., Huang, Y.-H., & Lee, T.-Y. (2025). The Triglyceride-Glucose Index as a Biomarker for Insulin Resistance Following Hepatitis C Virus Eradication: A Prospective Cohort Study. Journal of Clinical Medicine, 14(9), 2963. https://doi.org/10.3390/jcm14092963

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The Triglyceride-Glucose Index as a Biomarker for Insulin Resistance Following Hepatitis C Virus Eradication: A Prospective Cohort Study

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