Utility of Surrogate Markers for Insulin Resistance: Homeostasis Model Assessment for Insulin Resistance (HOMA-IR) and Triglyceride–Glucose (TyG) Index in Identifying Metabolic Syndrome Among Adults from Resource-limited Settings

Background: Insulin resistance (IR) is a central feature of metabolic syndrome (MetS). While the homeostasis model assessment for insulin resistance (HOMA-IR) is widely used, it has limitations in resource-constrained settings. The triglyceride-glucose (TyG) index offers a simpler alternative, but comparative data from Indian adults are limited. This study aimed to evaluate and compare the performance of the two indices as surrogate markers for IR among adults. Methods: A hospital-based cross-sectional study was conducted among 312 adults (217 without MetS and 95 with MetS), selected using stratified random sampling. Participants underwent standardized anthropometric measurements and fasting biochemical tests. MetS was defined according to the International Diabetes Federation (IDF) criteria. HOMA-IR and TyG indices were calculated and compared across demographic and clinical subgroups. Diagnostic performance was assessed using receiver operating characteristic (ROC) curve analysis. Results: Participants with MetS had significantly higher HOMA-IR and TyG index values compared with those without MetS (p