Fasting triglyceride–glucose index and hypertensive disorders of pregnancy: an observational study of metabolic risk in singleton pregnancies

OBJECTIVES: To evaluate the association between the fasting TyG index and gestational hypertension/preeclampsia (GH/PE) in singleton pregnancies. METHODS: This observational study included 175 pregnant women with singleton pregnancies examined during routine antenatal care between 11 and 35 weeks of gestation from January 2023 to December 2024. Women with pre-existing hypertension, diabetes, renal disease, gestational diabetes mellitus or major systemic disorders were excluded. Clinical, anthropometric and fasting biochemical data were collected, and the TyG index was calculated as ln [fasting triglycerides (mg/dL) × fasting glucose (mg/dL)/2]. Group comparisons, correlation analyses, logistic regression and receiver operating characteristic (ROC) analysis were performed. RESULTS: Thirty-nine women (22.3 %) developed GH/PE. Compared with women with physiological pregnancies, women with GH/PE had higher pre-gestational BMI, gestational weight change, blood pressure, fasting glucose, triglycerides and TyG index values (all p≤0.018). The TyG index correlated positively with mean arterial pressure (r=0.20, p=0.027) and gestational week at assessment (r=0.35, p<0.001). Higher TyG index values were associated with increased odds of GH/PE (OR=3.75, 95 % CI 1.79-7.85). A TyG cut-off of 8.6 showed 58.97 % sensitivity and 69.85 % specificity, with an AUC of 0.69 (95 % CI 0.59-0.79). CONCLUSIONS: In this antenatal cohort, the fasting TyG index was associated with GH/PE and showed moderate discriminatory ability. The TyG index should not be used as a stand-alone diagnostic test, but it may complement BMI and routine clinical assessment in identifying women with increased metabolic susceptibility to hypertensive pregnancy disorders.