Triglyceride Glucose Index as a Predictor of Cardiovascular and Metabolic Risk in an Urban Population in Kenya

Background Cardiovascular diseases (CVDs) and metabolic syndrome (MetS) are significant contributors to the global burden of non-communicable diseases (NCDs), with their prevalence rising in Sub-Saharan Africa (SSA). Insulin resistance (IR) plays a key role in the development of these conditions, but its assessment is often limited by resource constraints. The triglyceride glucose (TyG) index incorporates triglyceride and glucose measurements and has emerged as a simple and cost-effective surrogate marker for IR. This study evaluated the use of Tyg index as a predictor of cardiovascular and metabolic risk and determined the optimal cutoffs for predicting CVD risk and MetS in a Kenyan population. Methods Data were analyzed from 528 healthy Black African adults (255 males, 273 females) recruited for a global reference interval study. CVD risk was estimated using the Framingham Risk Score, while MetS was diagnosed using the 2009 harmonized criteria. The TyG index was calculated, and its ability to predict CVD risk and MetS was assessed using receiver operating characteristic (ROC) curve analysis. Results Males had significantly higher TyG index values, blood pressure, and waist circumference compared to females (p < 0.05). ROC analysis showed that the TyG index was a strong predictor of intermediate-to-high CVD risk (AUC = 0.840) and MetS (AUC = 0.858). The optimal TyG index cutoff for predicting CVD risk was 4.74 (sensitivity 74.1%, specificity 81.2%), while the best cutoff for MetS was 4.64 (sensitivity 74.8%, specificity 84.5%). Conclusion The TyG index demonstrates strong potential as a screening tool for cardiovascular and metabolic risk in seemingly healthy adults. Its ease of measurement and diagnostic accuracy make it particularly valuable in resource-limited settings. Further studies are needed to assess its real-world application in SSA and explore its role in early prevention strategies.