Triglyceride–glucose Index Reveals High Insulin-Resistance Burden in Indian Rheumatoid-Arthritis Patients

Background: Insulin resistance (IR) is a recognised, inflammation-driven comorbidity that amplifies cardiovascular risk in rheumatoid arthritis (RA). Routine assessment is hampered by the cost of insulin assays. The triglyceride–glucose (TyG) index is an inexpensive surrogate that correlates strongly with clamp-derived insulin sensitivity. Methods: In this cross-sectional study, 82 non-diabetic adults fulfilling 2020 ACR/EULAR RAcriteria were enrolled over twelve months at a tertiary hospital in Gorakhpur, North India. Fasting glucose, triglycerides, HbA1c, ESR, high-sensitivity CRP, rheumatoid-factor, anti-CCP titres, and DAS28-CRP were recorded. TyG was calculated as ln[TG × FBS / 2]; IR was predefined as TyG ≥ 4.68. Group differences were analysed with t tests, χ² or Mann–Whitney U, and associations with Spearman correlation. Results: Mean age was 48 ± 11 years; 88 % were female. TyG-defined IR was present in 39 participants (47.6 %). Fasting glucose and triglycerides were significantly higher in the IR group, whereas HbA1c, ESR and CRP were similar. TyG displayed strong positive correlations with triglycerides (r = 0.90) and fasting glucose (r = 0.53) but was not associated with DAS28-CRP (r = –0.13) or inflammatory markers. IR frequency did not differ across DMARD monotherapy, dual, triple or biologic regimens. Conclusions: Nearly one-half of Indian RApatients without overt diabetes harbour TyG-defined IR, independent of disease activity or acute-phase reactants. Incorporating the TyG index into routine rheumatology practice could trigger timely lifestyle or pharmacological interventions that mitigate long-term cardiometabolic risk in resource-limited settings.