Assessing the Diagnostic Performance of Triglyceride–Glucose–Based Indices for Early Detection of Metabolic Syndrome in Paediatric Down Syndrome

BACKGROUND: Down syndrome (DS) youth have an increased risk of metabolic syndrome (MetS). This study assessed the diagnostic performance of the triglyceride-glucose index (TyG) and its derivatives-TyG-BMI, TyG-waist circumference (WC) and TyG-waist-to-height ratio (WHtR) in detecting MetS compared with traditional markers. METHODS: We retrospectively analysed data from 60 DS patients and 40 controls; IR was estimated using HOMA-IR, TyG, TyG-BMI, TyG-WC and TyG-WHtR indices. MetS was defined by the presence of at least three of the following criteria: BMI z-score ≥ 2 SD and/or WC/H ratio ≥ 0.5; fasting glucose > 100 mg/dL and/or pathological HOMA-IR; dyslipidaemia; hypertension. RESULTS: MetS prevalence was 15% in DS. HOMA-IR showed the highest sensitivity (0.667) and specificity (0.80) to detect MetS, while TyG demonstrated similar performance (sensitivity 0.667; specificity 0.843) and the best overall accuracy (0.817). Composite indices showed moderate accuracy but high specificity. CONCLUSIONS: TyG, being simple and cost-effective, may be a valuable alternative for early MetS detection in DS.