First Trimester Triglyceride-Glucose Index and Lipid Profile as Predictive Factors in the Diagnosis of Late-Onset Preeclampsia: Can We Prevent It?

Objectives: This study aimed to evaluate whether first-trimester metabolic markers-including the triglyceride-glucose (TyG) index and lipid-related ratios (TG/HDL-c, LDL-c/HDL-c, and TyG/BMI)-could predict the development of late-onset preeclampsia, and to assess their associations with birthweight and birth length. Methods: A retrospective cohort study was conducted on 306 pregnant women (153 with late-onset PE and 153 normotensive controls). Demographic and clinical data, including maternal lipid profiles, TyG index, and other biochemical markers, were collected during the first trimester. Statistical analyses, including Mann-Whitney, two-sided t-tests, and receiver operating characteristic curves (ROC), were performed to assess the predictive value of the TyG index and other ratios in predicting late-onset PE. Results: Significant differences between the PE and control groups were observed in delivery method, birthweight, and birthlength (p < 0.05). ROC analysis revealed that the TyG index had an area under the curve (AUC) of 0.79, with a sensitivity of 69.3% and specificity of 75.8%. The TyG index was inversely associated with birthweight (ρ = -0.288) and gestational age at delivery (ρ = -0.218), while positively correlating with systolic blood pressure (ρ = 0.441). Conclusions: The TyG index, along with TG/HDL and LDL-c/HDL ratios, demonstrated predictive value for late-onset PE. These findings suggest that elevated TyG index levels may contribute to adverse pregnancy outcomes such as intrauterine growth restriction and preterm delivery. First-trimester lipid profiles and the TyG index may serve as valuable markers for early prediction of late-onset PE.