Triglyceride-glucose index and dysglycaemia in adults from the Aral Sea region of Uzbekistan: a cross-sectional study

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The Aral Sea region of Uzbekistan represents an environmentally vulnerable setting where historically reported iodine deficiency in the region, thyroid dysfunction and metabolic disorders may coexist. Urinary iodine was not directly measured in this study; references to iodine deficiency reflect regional contextual documentation only. Biochemical data linking thyroid status, aminotransferase elevation and dysglycaemia in this population remain scarce. A cross-sectional study enrolled 98 adults from Muinak, Kanlykul, and Takhtakupir, Karakalpakstan (2024–2025). Anthropometry, fasting and 2-h postprandial glucose, HbA1c, thyroid hormones, aminotransferases and fasting lipid profile were assessed. Fasting triglycerides (TG) were available for 64/98 participants (65.3%); all TyG-based analyses were performed on this complete-case subset of n = 64. Sex was recorded directly and retained as a covariate in all adjusted models. Logistic regression, ROC analysis and Monte Carlo cross-validation were performed. Women comprised 73/98 (74.5%). Dysglycaemia was present in 50/98 (51.0%) and hypothyroidism in 27/98 (27.6%). Among the 64 participants with complete TG data, TyG showed a significant association with dysglycaemia (OR 2.33; 95% CI 1.31–4.15; p = 0.004), remaining significant after adjustment for BMI, sex, TSH and ALT. ROC analysis demonstrated moderate discrimination (AUC 0.77; 95% CI 0.64–0.87). The Youden-derived threshold was 8.70, with sensitivity 43.2%, specificity 96.2%, PPV 94.1% and LR + 10.9. METS-IR yielded a comparable AUC (0.79 [0.67–0.89]); confidence intervals overlapped substantially with TyG, indicating no statistically significant superiority. Hypothyroidism was not independently associated with dysglycaemia (aOR 0.75). Participants with and without TG data did not differ significantly in most characteristics except BMI (32.7 vs. 29.3 kg/m²; p = 0.036). TyG is a practical marker associated with dysglycaemia in adults from the Aral Sea region. The sensitivity of 43.2% at threshold 8.70 means this threshold cannot replace comprehensive screening and should be used for high-confidence rule-in only. These findings are hypothesis-generating; external validation in a larger cohort is required before recommending clinical implementation. Not applicable.