Background: Thyroid hormones play a key role in glucose metabolism, and hypothyroidism is frequently associated with impaired insulin secretion, altered glucose disposal, and insulin resistance (IR). Aim: This study aimed to assess insulin resistance in patients with hypothyroidism using the triglyceride–glucose (TyG) index in comparison with the homeostasis model assessment of insulin resistance (HOMA-IR). Methods: This case-control study was conducted on 100 participants (50 hypothyroid patients and 50 euthyroid controls), aged 18–60 years. All subjects underwent detailed clinical evaluation, anthropometric measurements, and fasting laboratory investigations including glucose, lipid profile, insulin, TSH, and free T4. Insulin resistance was assessed using TyG index and HOMA-IR. Statistical analysis was performed using SPSS version 26, with p < 0.05 considered significant. Results: Hypothyroid patients showed significantly higher body weight, BMI, waist circumference, fasting glucose, fasting insulin, and HOMA-IR compared with controls (p < 0.05). The TyG index demonstrated strong positive correlations with fasting glucose (r=0.702), insulin (r=0.527), triglycerides (r=0.800), cholesterol (r=0.422), and HOMA-IR (r=0.415) (p < 0.01), but no correlation with thyroid profile. ROC curve analysis demonstrated that the TyG index had acceptable performance for predicting insulin resistance (AUC = 0.724, sensitivity 74.1%, specificity 69.9% at a cutoff of 8.51). Conclusion: HOMA-IR is more sensitive than the triglyceride-glucose (TyG) index to predict insulin resistance in hypothyroidism patients.
El-Nakeeb et al. (2026) studied this question.