Association of the triglyceride-glucose index with inflammatory markers and dysregulation of adipokines in patients with metabolic syndrome

BACKGROUND: Triglyceride-glucose (TyG) index has emerged as a reliable surrogate marker for insulin resistance and an early indicator of metabolic dysfunction. However, its association with inflammatory markers and adipokine dysregulation in patients with metabolic syndrome (MetS) remains poorly understood. This study aimed to investigate the association of the TyG index with inflammatory biomarkers and adipokine profiles in adults diagnosed with MetS. METHODS: This cross-sectional study included 190 adults (aged 20-50 years) with metabolic syndrome (MetS), recruited from primary healthcare centers in Iran. We collected anthropometric and biochemical data, and calculated the TyG index, classifying participants into quartiles based on their TyG values. Fasting serum glucose (FSG), insulin, and lipid profiles were measured. Insulin resistance was assessed using the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR). In addition, inflammatory markers including tumor necrosis factor alpha (TNF-α), Interleukin-6 (IL-6), and high-sensitivity C-reactive protein (hs-CRP) long with serum levels of adipokines including leptin, adiponectin, resistin, visfatin, vaspin, and omentin-1 were measured using standardized assays. RESULTS: Higher TyG quartiles were associated with increased levels of insulin, HOMA-IR, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-c), TNF-α, leptin, and resistin, and decreased levels of adiponectin (all p < 0.05). There were no significant differences in high-density lipoprotein cholesterol (HDL-c), IL-6, hs-CRP, visfatin, vaspin, or omentin-1. These associations remained significant even after adjusting for age, sex, body mass index (BMI), smoking status, and physical activity. CONCLUSION: Our findings suggest that the TyG index reflects not only insulin resistance and atherogenic dyslipidemia, but also low-grade inflammation and adipokine imbalance in patients with MetS. Due to its simplicity and cost-effectiveness, the TyG index could be a useful tool for early metabolic risk assessment and identifying adipose tissue dysfunction.