Elevated triglyceride-glucose index and risk of thymoma-associated myasthenia gravis: a prospective analysis from the UK Biobank
Authors' conclusion
Elevated TyG index and TG/HDL-C ratio were independently associated with higher thymoma-associated MG risk in this large prospective cohort, with evidence of non-linear relationships and BMI-related heterogeneity. These findings provide novel epidemiologic evidence linking metabolic markers of insulin resistance with thymoma-associated MG, but clinical translation requires further validation.
Study context
- Population
- UK Biobank participants422,397 analysed (triglyceride-glucose (TyG))
- Participants
- 501,954 participants
- Exposure
- TyG index and TG/HDL-C ratio quartiles and per unit increase
- Outcome
- Incident thymoma-associated MG
Methodological detailsUK Biobank, Cox proportional hazards models, restricted cubic splines
- UK Biobank
- Cox proportional hazards models
- Restricted cubic splines
Main finding
As reported in the abstract
Thymoma-associated MG by TyG index
Hazard ratio (95% CI)P value
Q4vs Q1
1.66(1.20–2.31)
P = 0.003Per unit increase
1.42(1.17–1.73)
P = 0.0005Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| Thymoma-associated MG by TG/HDL-C ratioQ4vs Q1TG/HDL-C ratio | 1.54 (1.11–2.15) | P = 0.01 | |
| Thymoma-associated MG by TG/HDL-C ratioPer unit increase · TG/HDL-C ratio | 1.06 (1.02–1.10) | P = 0.002 | |
| 0.512Hazard ratio (log scale) |
- Thymoma-associated myasthenia gravis (MG) by TG/HDL-C ratio: 422,691 analysed (314 cases)
Non-linear associations (restricted cubic splines (RCS))
- Suggested inflection point, TyG index
- 8.7
- Suggested inflection point, TG/HDL-C ratio
- 2.8
- Rather than strict thresholds
Subgroups by body mass index (BMI)
- Stronger associations in normal-weight and obese participants; tests for interaction not statistically significant
Sensitivity analyses: TyG index and MG alone
- Consistent associations between TyG index and MG risk, including isolated MG
Original publication
Elevated triglyceride-glucose index and risk of thymoma-associated myasthenia gravis: a prospective analysis from the UK Biobank. Cardiovasc Diabetol. Published 19 November 2025. doi:10.
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