ANALYSIS OF THE TRIGLYCERIDE-GLUCOSE (TYG) INDEX IN RELATION TO THE HOMEOSTATIC MODEL ASSESSMENT (HOMA-IR) IN CARDIAC BYPASS PATIENTS WITH METABOLIC RISK FACTORS
ANALYSIS OF THE TRIGLYCERIDE-GLUCOSE (TYG) INDEX IN RELATION TO THE HOMEOSTATIC MODEL ASSESSMENT (HOMA-IR) IN CARDIAC BYPASS PATIENTS WITH METABOLIC RISK FACTORS

Summary/Abstract: Insulin resistance (IR) plays a central role in the development of both diabetes and cardiovascular diseases. The Triglyceride-Glucose (TyG) index has emerged as a promising alternative to the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) for determining insulin sensitivity. The primary aim of this study was to evaluate the predictive value of the TyG index compared to HOMA-IR in cardiac surgery patients presenting with metabolic risk factors. Between February and October 2025, 170 cardiac bypass surgeries were performed on patients with metabolic risk factors at the Zan Mitrev Clinic. Preoperative fasting insulin, blood glucose, and triglyceride levels were determined for all patients. These values were used to calculate the insulin resistance indices: the Triglyceride-Glucose (TyG) index and the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR). The values of these indices were compared with the postoperative course and surgical outcomes. The mean TyG index value among the patients was 9.07, while the mean HOMA-IR value was 3.23. The analysis of the postoperative outcomes demonstrated that HOMA-IR is a more robust and superior predictor of postoperative complications compared to the TyG index. Patients with a HOMA-IR score above 2.5 exhibited the highest atrial fibrillation frequency (n=41) and neurological deficits (n=16). The TyG index showed relatively uniform and low predictive power across all groups; this was further confirmed by linear regression (R²=0.180), suggesting that 82% of its variability is independent of insulin resistance. Furthermore, ROC analysis indicated that the TyG index and HOMA-IR measure significantly different metabolic risk aspects. The HOMA-IR index is clinically superior in predicting the early postoperative course in cardiac surgery patients. The low efficacy of the TyG index is likely a consequence of widespread statin therapy among these patients. Statins may mask the true metabolic risk by artificially lowering triglyceride levels, thus making HOMA-IR a more reliable diagnostic choice for perioperative assessment

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