Comments on “Evaluation of the Triglyceride-Glucose Index with Different Generations of Beta-Adrenergic Blockers”

Q: What is the clinical evidence from this study?

Study design: Letter. Population: Insulin resistance and metabolic effects of beta-blocker therapy (n=712). Intervention: Third-generation beta-adrenergic blockers vs. Earlier-generation (e.g., second-generation such as bisoprolol and atenolol) beta-adrenergic blockers. Primary outcome: Triglyceride-glucose (TyG) index as an indicator of insulin resistance.

İsmail Engin

doi:10.4274/hamidiyemedj.galenos.2026.19327

October 30, 2026Hamidiye Medical JournalOpen Access

Comments on “Evaluation of the Triglyceride-Glucose Index with Different Generations of Beta-Adrenergic Blockers”

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Key result

Third-generation beta-adrenergic blockers are associated with a better triglyceride-glucose index metabolic profile in 712 non-diabetic patients, though prospective randomized confirmation is needed.

Key Points

To discuss methodological considerations and clinical implications regarding the evaluation of the triglyceride-glucose (TyG) index across different beta-blocker generations.
Commentary analyzing a retrospective study (n = 712) that evaluated the TyG index across different generations of beta-blockers.
Evaluation of cohort selection, specifically the exclusion of individuals with diabetes mellitus, and unmeasured lifestyle confounders such as diet and physical activity.
Third-generation beta-blockers were associated with a more favorable metabolic profile, although intra-class variations also occurred within second-generation agents (such as bisoprolol versus atenolol).
Excluding patients with diabetes created a homogeneous cohort free from antidiabetic drug confounding, but limited applicability to patients at the greatest risk for adverse metabolic outcomes.
The sensitivity of the TyG index to pharmacological changes compared to the hyperinsulinemic-euglycemic clamp remains debated, highlighting the need for prospective randomized trials with hard endpoints.

PICO

P

Population

Commented retrospective study of 712 non-diabetic patients treated with different generations of beta-adrenergic blockers.

E

Exposure / Comparator

Third-generation beta-adrenergic blockers vs Earlier-generation (e.g., second-generation such as bisoprolol and atenolol) beta-adrenergic blockers

O

Primary Outcome

Triglyceride-glucose (TyG) index as an indicator of insulin resistance

Limitations

Exclusion of patients with diabetes mellitus limits applicability to diabetic populations
Retrospective design limits reliable capture of lifestyle factors such as diet and physical activity
Potential unmeasured confounding from anthropometric parameters such as body mass index and waist circumference
Debated sensitivity of the triglyceride-glucose index to pharmacological treatments compared with the gold-standard hyperinsulinemic-euglycemic clamp test
Lack of detailed comparison of drug-specific pharmacological differences within the same generation (e.g., bisoprolol vs. metoprolol)
Absence of prospective randomized design with hard clinical endpoints such as new-onset diabetes

Implication

This letter to the editor discusses methodological considerations regarding a prior retrospective study on the triglyceride-glucose (TyG) index across different beta-blocker generations, emphasizing the need for prospective randomized trials with hard clinical endpoints.

Abstract

Comments on "evaluation of the triglyceride-glucose

Discussion

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Cite This Study

İsmail Engin (2026) conducted a letter in Insulin resistance and metabolic effects of beta-blocker therapy (n=712). Third-generation beta-adrenergic blockers vs. Earlier-generation (e.g., second-generation such as bisoprolol and atenolol) beta-adrenergic blockers was evaluated on Triglyceride-glucose (TyG) index as an indicator of insulin resistance. Third-generation beta-adrenergic blockers are associated with a better triglyceride-glucose index metabolic profile in 712 non-diabetic patients, though prospective randomized confirmation is needed.

synapsesocial.com/papers/6ae7d421edffb4962941045b https://doi.org/10.4274/hamidiyemedj.galenos.2026.19327

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Comments on “Evaluation of the Triglyceride-Glucose Index with Different Generations of Beta-Adrenergic Blockers”

Key Points

PICO

Limitations

Implication

Abstract

Discussion

Cite This Study

Comments on “Evaluation of the Triglyceride-Glucose Index with Different Generations of Beta-Adrenergic Blockers”

Key Points

PICO

Limitations

Implication

Abstract

Discussion

Cite This Study

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