The use of HOMA-IR and the TyG index in identifying

The gap

Evidence profile

Sourced from the limitations and future-work section and future work of the source papers, classified as general, spanning 3 journals.

Supporting evidence — 3 representative gaps

• Triglyceride-glucose index as a marker of metabolic and inflammatory risk across different thyroid function states (2026) · Scientific Reports · doi

  Several limitations should be considered when interpreting the findings of this study. First, the cross-sectional design precludes causal inference regarding the relationship between thyroid function and the TyG index. Second, direct measures of insulin resistance, such as HOMA-IR or hyperinsulinemic– euglycemic clamp techniques, were not available. As a result, the TyG index was used both as a surrogate indicator of insulin resistance–related metabolic risk and as the primary outcome variable in association and ROC analyses, which limits the diagnostic and clinical interpretability of the findings. Accordingly, TyG-derived cut-off values should be interpreted as markers of increased metabolic risk rather than as validated diagnostic thresholds for insulin resistance. ARTICLE IN PRESSARTICLE IN PRESS ACCEPTED MANUSCRIPT In addition, a pooled multivariable regression model including thyroid function group as an independent predictor of the TyG index was not performed; instead, regression analyses were conducted separately within each thyroid function category. While this approach allowed identification of group-specific determinants of the TyG index, it may limit direct between-group comparisons. Furthermore, although the overall sample size was adequate for the primary analyses, subgroup analyses may have been underpowered for more detailed stratification by sex or body mass index. Behavioral factors such as dietary intake, physical activity, and alcohol consumption could not be systematically assessed due to the retrospective nature of data collection. Thyroid disease duration and medication status were also not fully captured, and undiagnosed dysglycemia could not be entirely excluded despite the exclusion of individuals with known diabetes. Finally, systemic inflammation was assessed using the CRP/albumin ratio; additional inflammatory biomarkers, such as interleukin-6 or tumor necrosis factor-α, were not measured and may have provided a more comprehensive characterization of inflammatory status. Future studies incorporating longitudinal designs, direct measures of insulin sensitivity, and broader panels of metabolic and inflammatory biomarkers are warranted to validate and extend these findings and to clarify the clinical utility of the TyG index across different thyroid function states.

  generallimitationsevidence 5/5
  Keywords: index thyroid function insulin analyses direct resistance metabolic group inflammatory measures risk primary diagnostic clinical
• Comparison of the homeostasis model assessment of insulin resistance (HOMA-IR) and the triglyceride-glucose index (TyG index) in non-diabetic young adults with obesity (2026) · Romanian Medical Journal · doi

  Future studies should investigate the use of HOMA-IR and the TyG index in identifying insulin resistance in other populations. Future studies should compare the effectiveness of different interventions for preventing and managing insulin resistance in young adults. Future studies should investigate the relationship between obesity indices and insulin resistance markers in different age groups.

  generalfuture-work sectionevidence 5/5
  Keywords: future studies investigate use homa-ir tyg index identifying
• Ethnicity-Specific Thyroid Hormone Sensitivity Indices and Their Association With Metabolic Syndrome in Euthyroid South Asian Adults (2026) · Cureus · doi

  Future research should build on these findings as follows. First, longitudinal cohort studies that include repeated measurements of thyroid hormone sensitivity indices are needed to determine whether these measures can predict the association with metabolic syndrome or cardiometabolic disease in the future. Second, community-based population studies would improve the generalizability of the findings by evaluating whether the associations hold in the general South Asian population. Third, molecular and physiological mechanisms of thyroid hormone resistance that lead to insulin resistance, dyslipidemia, and adiposity may be studied in mechanistic detail, clarifying the biological mechanisms underlying these relationships. Fourth, thyroid hormone sensitivity indices can be included in multivariate cardiometabolic risk discrimination to assess whether they improve risk stratification beyond traditional metabolic indices. Finally, future research must investigate the genetic and environmental factors influencing thyroid hormone sensitivity in South Asian populations, as ethnic differences in metabolic predisposition may influence endocrine-metabolic interactions.

  generalfuture workevidence 5/5
  Keywords: thyroid hormone metabolic future sensitivity indices whether cardiometabolic population improve south asian mechanisms resistance risk

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