TyG Index a Strong Predictor of Glaucoma in Hypertensive Adults

Adding TyG-based risk stratification may serve as a practical, cost-effective adjunct to current screening guidelines and facilitate earlier detection of glaucoma in metabolically vulnerable populations, study suggests. This graph from the study shows the predictive ability of triglyceride-glucose index and related indices derived from it (TyG-WHtR, TyG-WC, TyG-BMI), along with traditional obesity measures (WC, BMI, WHtR). Photo: Kang K, et al. Exp Gerontol. October 15, 2025. Click image to enlarge. The triglyceride-glucose (TyG) index—which combines fasting blood glucose and triglyceride levels—and its obesity-related derivatives have emerged as surrogate markers for metabolic dysfunction. Previous studies have shown that elevated fasting glucose is associated with increased glaucoma risk. In a recent study, researchers aimed to explore the associations between TyG index and glaucoma in hypertensive adults. They found that the index demonstrates a strong diagnostic accuracy for glaucoma, outperforming traditional obesity measures in predicting disease development in this patient population.Data from 2,458 hypertensive participants aged 40 years or older in the National Health and Nutrition Examination Survey were evaluated. The findings indicated that hypertensive adults with higher TyG values—as well as related metrics that also factored in BMI, waist circumference and height—face markedly greater odds of having glaucoma. The TyG index delivered the strongest discrimination, the researchers noted in their paper for Experimental Gerontology, underscoring its promise as a simple, noninvasive screening tool.There was a strong correlation between TyG and insulin resistance, suggesting that TyG may be a useful alternative marker in evaluating metabolic dysfunction's role in glaucoma. “Elevated fasting glucose and insulin resistance can cause endothelial dysfunction, impair retinal blood flow and increase oxidative stress, all of which contribute to glaucomatous optic nerve damage, independent of intraocular pressure (IOP),” the authors wrote.The association between insulin resistance and glaucoma risk is further supported by various population-based studies, the paper explains, which have found higher glaucoma prevalence among individuals with insulin resistance or diabetes. “These findings underscore the importance of metabolic factors, such as fasting glucose and insulin resistance, in the pathophysiology of glaucoma,” the team wrote, proposing that interconnected pathophysiological pathways may connect insulin levels with increased glaucoma risk. TyG index reflects underlying metabolic disturbances that play a pivotal role in endothelial dysfunction, oxidative stress and chronic low-grade inflammation—key mechanisms implicated in glaucoma pathogenesis, they explained.“Insulin resistance impairs nitric oxide synthesis and disrupts endothelial function, which can lead to dysregulation of ocular perfusion and heightened vulnerability of the optic nerve head to ischemic damage. This vascular impairment hampers the autoregulation of retinal and optic nerve blood flow, especially under conditions of fluctuating IOP, a characteristic feature of glaucomatous injury,” the authors wrote.Based on these findings, TyG-related markers hold considerable promise for improving glaucoma risk prediction in clinical and public health contexts. “Their superior discriminative ability, clinical accessibility and demonstrated utility across diverse metabolic conditions position them as valuable additions to integrated strategies addressing the complex interplay between metabolic dysfunction and ocular disease,” the authors concluded in their paper.From a clinical perspective, the integration of TyG indices into routine screening protocols for hypertensive individuals may be feasible and beneficial, the team proposes. “As the TyG index is calculated from fasting glucose and triglyceride levels—tests that are already part of standard metabolic evaluations in primary care—it requires no additional testing burden,” the authors wrote in their paper. “Hypertensive patients with elevated TyG values could be flagged as high-risk for glaucoma and prioritized for ophthalmologic referral, especially when traditional risk factors (e.g., older age, family history, or poor glycemic control) are also present.”In this way, TyG-based risk stratification may serve as a practical, cost-effective adjunct to current screening guidelines and facilitate earlier detection of glaucoma in metabolically vulnerable populations, the authors concluded in their paper.Click here for the journal source. Kang K, Wang Q, Li Y, et al. Associations between triglyceride-glucose index and glaucoma risk in hypertensive adults: evidence from a nationally representative cohort. Exp Gerontol. October 15, 2025. [Epub ahead of print.] This article was developed by the editorial staff in conjunction with experts in the field. In the process, AI may have been among the editorial tools used to meet the goals of human editors, who approved all content.