Loading...
Printed on 7/19/2026
For informational purposes only. This is not medical advice.
The TyG index is a simple surrogate marker of insulin resistance derived from fasting triglycerides and fasting plasma glucose. It correlates with clamp-derived insulin resistance and is commonly used in cardiometabolic research and risk stratification.
Formula: TyG = ln((Triglycerides [mg/dL] × Fasting Glucose [mg/dL]) / 2)
Save your results with a free account
Keep a history of calculations, favorite tools, and access your dashboard anytime.
Collect fasting blood samples (patient fasted for at least 8-12 hours) and measure serum triglycerides in mg/dL and fasting plasma glucose in mg/dL. These are standard components of a basic metabolic panel and lipid panel, available from routine outpatient labs without any additional tests.
Apply the formula: TyG = ln (natural logarithm) of [(triglycerides mg/dL × fasting glucose mg/dL) / 2]. For example: TG = 150 mg/dL, glucose = 100 mg/dL: TyG = ln(150 × 100 / 2) = ln(7500) = 8.92. Higher TyG values indicate greater insulin resistance. The natural log transformation normalizes the skewed distribution of triglycerides and glucose.
Higher TyG = greater insulin resistance. Proposed cutoffs vary by population and study: TyG >8.5-9.0 is commonly cited as elevated (insulin resistant), though no universally validated threshold exists. TyG is most useful as a relative comparator and research tool rather than a definitive clinical diagnostic threshold. Compare to population-specific reference values and interpret alongside BMI, waist circumference, HbA1c, and blood pressure.
Primary care physicians, endocrinologists, cardiologists
TyG provides an insulin resistance estimate using only standard fasting labs (TG and glucose) — eliminating the need for fasting insulin assay, which is not standardized across labs and not widely available. This makes TyG practical for metabolic syndrome screening in routine outpatient settings.
Gynecologists, endocrinologists, reproductive medicine specialists
Polycystic ovary syndrome (PCOS) is strongly associated with insulin resistance. TyG index can quantify the degree of insulin resistance in PCOS patients using readily available labs, guiding decisions about lifestyle intervention intensity and metformin therapy.
Hepatologists, gastroenterologists, primary care physicians
Elevated TyG correlates with non-alcoholic fatty liver disease (NAFLD/MASLD) risk and severity. TyG can serve as a non-invasive proxy for identifying patients who may benefit from liver imaging or elastography, particularly in patients with metabolic risk factors and elevated transaminases.
Cardiologists, preventive medicine physicians
TyG captures atherogenic insulin resistance not reflected by standard LDL-C measurement. Elevated TyG is associated with increased risk of atherosclerosis progression, PAD, and cardiovascular events, providing supplementary information to the ASCVD risk score in patients with metabolic syndrome or diabetes.
Epidemiologists, population health researchers, public health clinicians
TyG enables large-scale insulin resistance epidemiology studies using routinely collected metabolic data without requiring specialized insulin assays. It is widely used in observational studies examining cardiometabolic risk in diverse populations worldwide.
Unlike HOMA-IR (which requires fasting insulin measurement), TyG uses only fasting triglycerides and fasting glucose — both available from standard lipid panel and basic metabolic panel. Fasting insulin assays are not standardized across laboratories and vary in reference ranges. TyG provides comparable insulin resistance information to HOMA-IR (correlation r=0.62-0.92) without this limitation.
Triglycerides increase substantially after a meal (by 50-300 mg/dL above fasting levels), and glucose rises postprandially. Using non-fasting values will significantly inflate the TyG index. Always confirm the patient fasted for at least 8-12 hours before sample collection. Non-fasting samples are invalid for TyG calculation.
Published TyG cutoffs vary from 8.0 to 9.5 depending on the study, population, ethnicity, sex, and age group. There is no single universally accepted threshold for 'insulin resistant' equivalent to HOMA-IR >2.5. TyG is best interpreted in the context of population-specific reference data and in conjunction with other metabolic markers (waist circumference, HbA1c, BP). Avoid using a single cutoff as a clinical decision threshold.
Multiple meta-analyses have confirmed TyG associations beyond insulin resistance: TyG predicts NAFLD/MASLD risk (Wu et al., J Hepatol 2020), peripheral artery disease, coronary artery calcium progression, new-onset type 2 diabetes, and major adverse cardiovascular events. These associations support TyG as a clinically relevant cardiometabolic marker.
When fasting TG >500 mg/dL, the primary concern shifts to severe hypertriglyceridemia (pancreatitis risk, chylomicronemia syndrome) rather than insulin resistance per se. TyG in this range is dominated by the extreme TG elevation. Investigate secondary causes (familial hypertriglyceridemia, hypothyroidism, severe diabetes, medications) and treat TG aggressively with fibrates or omega-3 fatty acids.
TyG combined with BMI (TyG-BMI = TyG × BMI) has been shown to improve discrimination for metabolic syndrome, insulin resistance, and NAFLD compared to TyG alone in several studies. This reflects the independent contribution of visceral adiposity to metabolic risk. TyG-BMI may be more informative than TyG in clinical assessments.
TyG has strong research validation as a population-level insulin resistance marker. However, it has not been prospectively validated in clinical trials as a treatment decision threshold — there are no clinical trials demonstrating that treating to a target TyG reduces cardiovascular events. Use TyG to identify patients who may benefit from metabolic intervention, but make treatment decisions based on established clinical criteria (diabetes diagnosis, HbA1c, waist circumference, BP, lipids).
TyG can be reduced through: (1) carbohydrate restriction — reduces both fasting TG and glucose; (2) regular aerobic exercise — improves insulin sensitivity and lowers TG; (3) Mediterranean diet — reduces TG and improves glucose; (4) weight loss — 5-10% body weight reduction significantly reduces TyG. SGLT2 inhibitors and GLP-1 agonists also improve TyG by reducing both TG and glucose, making them particularly beneficial for TyG-elevated patients with T2DM.
If fasting insulin is available, calculate HOMA-IR [fasting glucose (mg/dL) × fasting insulin (µU/mL) / 405] alongside TyG. High concordance between HOMA-IR and TyG validates the TyG estimate. Discordance (e.g., high TyG but normal HOMA-IR) may occur in familial hypertriglyceridemia without true insulin resistance — in this case, clinical context and other metabolic markers should guide interpretation.
TyG Index proposed by Simental-Mendía et al. (Eur J Clin Invest 2008) as surrogate for insulin resistance. Correlation with HOMA-IR confirmed in meta-analyses: Guerrero-Romero et al. (Eur J Endocrinol 2010). TyG and cardiovascular events: Sanchez-Garcia et al. (Cardiovasc Diabetol 2020), meta-analysis of 11 studies, n=30,132. TyG and NAFLD: Wu et al. (J Hepatol 2020), meta-analysis. TyG-BMI: Er et al. (J Clin Endocrinol Metab 2020). No universally validated clinical cutoff; individual use requires caution. Not yet validated as RCT-level treatment target.
The TyG index provides a practical insulin resistance signal based on routine fasting labs. Lower values tend to align with lower metabolic risk, while higher values are associated with insulin resistance, metabolic syndrome, and elevated cardiovascular risk in many cohorts.
Use this calculator when fasting triglyceride and fasting glucose values are available and you want a quick, low-cost proxy for insulin resistance in outpatient screening, preventive cardiology, or metabolic follow-up.
TyG thresholds are not universally standardized and vary across ethnicity, age, and study design. The index should not be used as a stand-alone diagnostic test for diabetes or metabolic syndrome.
For related assessments, see HOMA-IR, Cholesterol Ratio and ASCVD Risk Calculator.
Disclaimer: This tool is for educational and informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider with questions about your health.
April 21, 2026 · trust-baseline
Clinical trust metadata enabled for this tool page with structured review/version fields.
Estimate insulin resistance using fasting glucose and fasting insulin with the HOMA-IR equation.
OpenCardiologyCalculate total cholesterol/HDL ratio and triglyceride/HDL ratio from a standard lipid panel. A total/HDL ratio below 3.5 is optimal. For full cardiovascular risk assessment, use [ASCVD Risk Calculator](/tools/ascvd-risk) or [Framingham Risk Score](/tools/framingham-risk).
OpenCardiologyCalculate 10-year ASCVD risk using current 2026 ACC/AHA Pooled Cohort Equations. Statin thresholds: <5% low, 5–7.5% borderline, ≥7.5% intermediate, ≥20% high.
Open