Triglyceride-glucose index predicts severity of COVID-19

Correction: The formula should include the Logarithm of the product of triglyceride and the fasting glucose level divided by 2. You can go to MDApp for the TyG Index calculator at this LINK.

A new way to know the risk for developing severe COVID-19 was published in the Journal of Infection and Public Health in June 2022.

The study found that those with a Triglyceride-Glucose index of 8.81 are more likely to be on mechanical ventilation, require intensive care, high-flow oxygen therapy, and die within two months after the diagnosis of COVID-19. [1]

The Triglyceride-glucose (TyG) index is calculated by multiplying triglyceride by half of the fasting glucose level.

(Triglyceride Glucose (TyG )Index = Logarithm [Triglyceride (mg/dL) × Fasting glucose level (mg/dL)/2]

Example: Logarithm [Triglyceride 150 mg/dl x Fasting glucose 100mg/dl/2]

Triglyceride glucose index = 4.81

Triglyceride and fasting blood sugar are standard blood work. The triglyceride level is part of the Lipid Profile, and fasting glucose is the same as Fasting Blood Sugar.

In the study, those with severe complications in the COVID-19 group had a higher TyG index than those without severe complications. (8.81 ± 0.61 vs. 8.51 ± 0.61, p < 0.001).

The sicker group also has a higher fasting glucose level and triglycerides.

Additionally, those with severe complications in the COVID-19 group were older and had a higher Body Mass Index (BMI) (24.79 ± 3.43 vs. 23.91 ± 3.27 kg/m², p < 0.001). Normal BMI is 18.5 to 24.9.

This study which involved a nationwide COVID-19 cohort, was done in South Korea. They have a lower rate of obesity at 32.6% than in the US at 41.9%.

Comorbidities such as hypertension, diabetes mellitus, stroke, coronary artery disease, chronic kidney disease, asthma, and malignancy were more commonly noted in severe complications of the COVID-19 group.

The findings are consistent with another study from China. In that study, a TyG level of 9.2 was found in those who had died or had severe COVID-19.[2]

Insulin resistance is the common cause of Type 2 diabetes, hypertension, cardiovascular disease, and many others.

Insulin Resistance

Insulin resistance is when the liver and skeletal muscle cells do not readily respond to insulin. The body then produces higher insulin levels, or hyperinsulinemia, leading to several chronic diseases like cardiovascular disease, hypertension, diabetes, and obesity.

High triglyceride and fasting glucose levels indicate insulin resistance and metabolic syndrome.

The early signs of insulin resistance are high triglycerides, wide abdominal circumference, low HDL, and elevated blood sugar.

How to lower COVID-19 risk

Using what we know from this study, lowering the triglyceride and fasting blood sugar.

Fish oil, niacin, fibrates, and omega-3 fatty acids can lower triglycerides. [3] Diabetes medications reduce blood sugar. But something more effective and inflation-proof takes care of both- intermittent fasting.

Intermittent fasting melts away the triglycerides and lower blood sugar. Caution should be observed by people taking anti-hypertensives and diabetes medications since blood pressure, and sugar improvements will necessitate lowering the doses.

Intermittent fasting also decreases the inflammation levels commonly found in hypertension, atherosclerosis, and diabetes. Research showed that once a month fasting lowers the risk of COVID-19 hospitalization and death.

Learn more about intermittent fasting at:

1. Yogurt and Intermittent Fasting Reduced Body Toxins
2. Intermittent Fasting Grows New Liver Cells Faster
3. Intermittent Fasting while on Diabetes Medications
4. The Fasting Experience of 1422 Subjects at the Buchinger Wilhelmi Clinic
5. The Effects of Three-Week Fasting on the Extremely Obese
6. The Effects of Intermittent Fasting on Asthma
7. How to Do Intermittent Fasting
8. The Kaizen Way of Fasting
9. Early Time-Restricted Feeding is Intermittent Fasting In Sync with the Circadian Rhythm
10. Will Fasting Make My Muscles Shrink?
11. A Case Report of 3 Diabetic Patients that are Weaned Off Insulin

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Related:

• The Triglyceride/HDL ratio detects insulin resistance and predicts diseases.
• Triglyceride/LDL Cholesterol ratio predicts small dense LDL, the best predictor of atherosclerosis.

References:

1. Chang Y, Jeon J, Song TJ, Kim J. Association of triglyceride-glucose index with prognosis of COVID-19: A population-based study. J Infect Public Health. 2022 Jun 24;15(8):837-844. doi: 10.1016/j.jiph.2022.06.014. Epub ahead of print. PMID: 35779467; PMCID: PMC9225941.
2. Ren H, Yang Y, Wang F, Yan Y, Shi X, Dong K, Yu X, Zhang S. Association of the insulin resistance marker TyG index with the severity and mortality of COVID-19. Cardiovasc Diabetol. 2020 May 11;19(1):58. doi: 10.1186/s12933-020-01035-2. PMID: 32393351; PMCID: PMC7213552.
3. Feingold KR. Triglyceride Lowering Drugs. [Updated 2021 Apr 1]. In: Feingold KR, Anawalt B, Boyce A, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK425699/

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