Comparison of triglyceride-glucose index and HOMA-IR in assessing insulin resistance in acromegaly: a case-control study

The objective was to assess the triglyceride-glucose (TyG) index and the homeostatic model assessment for insulin resistance (HOMA-IR) in the evaluation of insulin resistance in patients with acromegaly and to compare results with healthy controls. A retrospective case-control study was conducted at the Department of Endocrinology, Necmettin Erbakan University, Meram Faculty of Medicine. The study included 50 acromegalic patients and 50 age- and sex-matched healthy controls. The median age and sex distribution were similar between the acromegaly and control groups (p > 0.05). Compared to the control group, acromegalic patients had significantly higher fasting glucose, HbA1c, total cholesterol, triglyceride, TyG index, and AST levels (p < 0.05 for all), while hemoglobin and platelet counts were significantly lower (p < 0.05). Diabetes mellitus (DM) was present in 24.0% of acromegalic patients. Compared to those without DM, acromegalic patients with DM were significantly older, had greater frequency of cardiovascular disease, and higher glucose, HbA1c, and neutrophil levels (p < 0.05). The TyG index showed a significant correlation with fasting glucose in both groups, but it correlated with insulin and HOMA-IR only in controls. Acromegalic patients exhibit significant metabolic alterations, including higher TyG index levels and increased DM prevalence, despite having similar HOMA-IR values to healthy controls.