Triglyceride glucose index and Atherogenic index of plasma for predicting colorectal neoplasms in patients without cardiovascular diseases

Diagnostic performance of the triglyceride-glucose index in predicting occurrence of cancer: a meta-analysis

Objective

This meta-analysis aimed to evaluate the diagnostic performance of the triglyceride-glucose (TyG) index in predicting cancer occurrence.

Method

A comprehensive literature search was conducted in Embase, Medline, Cochrane Library, and Google Scholar from inception to July 2024. Observational studies reporting the diagnostic efficacy of the TyG index in predicting cancer occurrence using ROC curve analysis were included. Pooled sensitivity, specificity, and area under the summary receiver operating characteristic (SROC) curve were calculated using a bivariate random-effects model.

Results

Eleven studies with 46,658 participants were included. Patients with cancer had a significantly higher TyG index than those without cancer (mean difference: 0.34, 95% CI: 0.23-0.45). The pooled sensitivity and specificity of the TyG index for predicting cancer occurrence were 0.68 (95% CI: 0.62-0.74) and 0.65 (95% CI: 0.54-0.74), respectively. The area under the SROC curve was 0.72 (95% CI: 0.68-0.75), indicating good discriminatory ability. Subgroup analysis of female participants yielded similar results, with an AUC of 0.73 (95% CI: 0.69-0.77).

Conclusion

The TyG index demonstrates good discriminatory ability and may have potential as an adjunct screening tool to help identify individuals at a higher risk of developing cancer. However, this should be interpreted alongside other established risk factors, as many confounding factors (including cancer type, genetic predisposition, and other malignancy risk factors) must be considered. Further research is needed to establish optimal cut-off values, which likely vary across different cancer types, and to investigate their diagnostic accuracy in diverse populations.

Systematic review registration

https://www.crd.york.ac.uk/prospero/, identifier CRD42024573712.

Relationships of triglyceride-glucose-related indices with colorectal cancer incidence and mortality in an American population: a dose-response meta-analysis and cohort study

BACKGROUND

The degree to which the triglyceride-glucose (TyG) index might interact with colorectal cancer (CRC) incidence and mortality is undefined. This systematic analysis was conducted through meta-analyses and large-scale databases.

METHODS

A meta-analysis was conducted through database search up to April 1, 2025, and articles investigating the incidence of CRC with clearly reported TyG index values, focusing on their dose-response relationship, were included. To validate the findings, data from the 1999-2018 National Health and Nutrition Examination Survey (NHANES) were utilized to explore links of TyG levels with CRC-linked mortality. Analyses involving restricted cubic splines (RCSs), weighted logistic regression (WLR), and multivariate Cox proportional hazards models were performed. Receiver operating characteristic (ROC) analyses explored predictive potential. Subgroup evaluation was subsequently conducted for detecting the susceptible populations.

RESULTS

Multivariate logistic regression showcased a greater CRC incidence among individuals in quartiles two, three, and four of TyG and TyG-body mass index (TyG-BMI) (95% confidence intervals (CIs): 1.14-1.5, 1.07-1.45; 1.39-1.83, 1.11-1.64; and 1.60-2.12, 1.19-1.93, respectively; P < 0.001). In contrast, multivariate Cox regression indicated a significant increase in CRC-related mortality only in the second quartile of TyG (95% CI: 1.22-7.47; P < 0.05). Analysis of the RCS curves demonstrated that the incidence of CRC displayed a nonlinear association with TyG (P = 0.045 for nonlinearity) but a positive linear association with TyG-BMI (P = 0.385 for nonlinearity). The TyG and associated indices did not exhibit any obvious dose-response association with CRC-related mortality (P > 0.05). ROC analyses exploring CRC risk revealed that TyG-BMI outperformed all indicators (area under the curve (AUC) = 0.71). Subgroup analysis revealed statistically significant links of CRC incidence with both TyG-BMI and female sex.

CONCLUSION

TyG and TyG-BMI may function as dependable markers for predicting CRC likelihood, and TyG-BMI outperformed all other predictors considered herein. However, TyG and associated indices showed no significant interrelationships with the mortality of CRC.

Predicting colorectal adenoma recurrence: the role of systemic inflammatory markers and insulin resistance

BACKGROUND

Colorectal adenomas (CRA) exhibit high recurrence rates following endoscopic resection. Insulin resistance (IR) and chronic inflammation, increasingly prevalent due to unhealthy lifestyles, are key factors in CRA development. This study aimed to evaluate the predictive power of combining the inflammation score with the triglyceride-glucose (TyG) index for CRA recurrence.

METHODS

We conducted a comprehensive analysis of the clinical characteristics of 847 CRA patients who underwent endoscopic resection. Postoperative recurrence of CRA was assessed using logistic regression analyses to determine odds ratios (ORs) and 95% confidence intervals (CIs). The receiver operating characteristic (ROC) curve analysis was utilized to predict the risk of CRA recurrence based on the inflammation score and TyG index.

RESULTS

Among the 847 CRA included in the study, 126 experienced recurrences. Logistic regression analysis identified NLR (OR 2.641, 95% CI 1.982-3.549), TyG (OR 1.494, 95% CI 1.146-1.956), three or more adenomas (OR 2.182, 95% CI 1.431-3.322) and CRA larger than 10 mm (OR 1.917, 95% CI 1.267-2.921) as independent risk factors for CRA recurrence. ROC curves demonstrated the efficacy of NLR (AUC 0.701, 95% CI 0.652-0.750) and TyG (AUC 0.607, 95% CI 0.553-0.660) in predicting CRA recurrence. The combination of NLR, TyG and adenoma characteristics showed improved performance in predicting CRA recurrence (AUC 0.762, 95% CI 0.718-0.805).

CONCLUSIONS

Elevated NLR and TyG were associated with an increased risk of CRA recurrence. The integration of NLR and TyG with CRA characteristics significantly enhanced the predictive power for CRA recurrence.

Combined effect of triglyceride-glucose index and atherogenic index of plasma on cardiovascular disease: a national cohort study

The triglyceride-glucose (TyG) index and the Atherogenic Index of Plasma (AIP) are both predictors of cardiovascular diseases (CVD). However, their combined and individual contributions to CVD risk are not well understood. This study evaluate the joint and individual associations of the TyG index and AIP with CVD events in middle-aged and older Chinese adults. This nationwide, retrospective cohort study utilized data from CHARLS. The diagnosis of CVD in this study was determined based on self-reported information provided by participants regarding their medical history( heart disease and/or stroke). Cross-sectional analyses in 2011 and longitudinal analyses over a 9-year follow-up were conducted to assess these associations. In the cross-sectional analysis, 8,531 participants were included at baseline. The odds ratio (OR) for TyG alone was 1.06 (95% CI 0.96-1.22) for CVD, while the OR for AIP alone was 1.16 (95% CI 1.02-1.33). Combined analysis showed that compared to the low TyG & low AIP group, the OR for the high TyG & high AIP group was 1.23 (95% CI 1.07-1.42) for CVD. In the survival Analysis, the hazard ratio (HR) for TyG alone was 1.19 (95% CI 1.04-1.35) for CVD, while the HR for AIP alone was 1.25 (95% CI 1.09-1.43). Combined analysis showed that compared to the low TyG & low AIP group, the HR for the high TyG & high AIP group was 1.27 (95% CI 1.10-1.43) for CVD. The findings underscore the significant coexposure effects of the TyG index and AIP on CVD, particularly in middle-aged adults.

Association of the atherogenic index of plasma and modified triglyceride-glucose indices with digestive diseases among middle-aged and older population in China

BACKGROUND

Previous studies have shown that metabolic imbalances contribute to digestive diseases. This study aimed to investigate the relationship of the atherogenic index of plasma (AIP) and modified triglyceride-glucose (TyG) indices with digestive diseases.

METHODS

We recruited participants aged 45 years or older from the China Health and Retirement Longitudinal Study (CHARLS, 2011 - 2020). The indices assessed included AIP, TyG, triacylglycerol glucose-waist circumference (TyG-WC), the triacylglycerol glucose-waist-to-height ratio (TyG-WHtR), and the triacylglycerol glucose-body mass index (TyG-BMI). We used logistic regression and restricted cubic spline (RCS) analyses to examine the associations between these indices and the incidence of digestive diseases.

RESULTS

A total of 4,453 participants were included in our analysis, 53.3% of whom were female, with an average age of 60 years. The incidence of digestive diseases in middle-aged and older adults was 6.18%. Compared with those in the lowest tertile group, the odds ratios (ORs) with 95% confidence intervals (CIs) for digestive diseases in the highest tertile for AIP, TyG, TyG-WC, TyG-WHtR, and TyG-BMI were 1.452 (1.07-1.972), 1.193 (0.873-1.631), 1.349 (1.044-1.743), 1.5 (1.089-2.068), and 1.312 (0.956-1.799), respectively. Sensitivity analyses confirmed the robustness of the correlations between these indices and digestive diseases.

CONCLUSION

Our study revealed that the AIP, TyG-WC, and TyG-WHtR were independently associated with the incidence of digestive diseases. These findings highlight the importance of considering and optimizing metabolic factors in management strategies for digestive diseases.

Triglyceride-Glucose Index, Modifiable Lifestyle, and Risk of Colorectal Cancer: A Prospective Analysis of the Korean Genome and Epidemiology Study

BACKGROUND

Insulin-mediated pathways plausibly explain the pathogenesis of colorectal cancer (CRC). The triglyceride-glucose index (TyG) is a surrogate of insulin resistance (IR), but its association with CRC in the Korean population has not been evaluated.

METHODS

From the 2004-2013 Korean Genome and Epidemiology Study, 98,800 participants aged 40-69 years were followed through 2020. Data on CRC incidence were obtained from the Korean National Cancer Center registry. Cox regression models and restricted cubic splines were fitted to examine the association between the TyG; In [(triglycerides) × (fasting glucose)/2] and CRC incidence. Joint effects of modifiable lifestyle factors and TyG on CRC risk were also investigated.

RESULTS

Median follow-up time was 10.6 years, and 699 CRC cases were observed. A unit-increment in TyG was associated with increased risk of CRC combined (hazard ratio, HR: 1.28, and 95% confidence interval, CI: 1.12-1.46), colon (1.29, 1.10-1.54), and rectal cancer (1.24, 1.01-1.52). Associations were dose-dependent, with linear associations observed for CRC and colon, but non-linear associations were observed for rectal cancer. A high TyG index (above 8.4) combined with overweight/obesity was linked to an increased risk of CRC (1.31, 1.07-1.61) and colon cancer (1.33, 1.03-1.72). When combined with low fruit and vegetable intake, the risks were higher for CRC (1.40, 1.12-1.74) and colon cancer (1.57, 1.18-2.09). Combined with high red meat consumption, the risks were elevated for CRC (1.32, 1.05-1.65) and colon cancer (1.52, 1.15-2.02).

CONCLUSIONS

A high TyG index was associated with a higher risk of colorectal cancer, and the risk was highest among participants with a high BMI, low fruit and vegetable intake, and high intake of red meat, suggesting a role of both insulin resistance and modifiable lifestyle in colorectal cancer development.

Association of the triglyceride-glucose index with the occurrence and recurrence of colorectal adenomas: a retrospective study from China

BACKGROUND

Resection of colorectal adenoma (CRA) prevents colorectal cancer; however, recurrence is common. We aimed to assess the association of the triglyceride-glucose (TyG) index with CRA occurrence and recurrence.

METHODS

Data from 3392 participants at a hospital in China from 2020 to 2022 were analyzed. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). A restricted cubic spline was used to fit TyG index dose‒response curves to recurrent adenomas. The discriminatory power of TyG index for predicting later recurrence was assessed with the area under the receiver operating characteristic (ROC) curve in 170 patients with a TyG index at initial adenoma diagnosis.

RESULTS

One thousand five hundred ninety-six adenoma and 1465 normal participants were included in the occurrence analysis, and 179 recurrent and 152 nonrecurrent participants were included in the recurrence analysis. The TyG mutation was an independent risk factor for CRA occurrence and recurrence. After adjusting for confounders, the risk of adenoma in the participants in Q2, Q3, and Q4 groups of TyG was 1.324 (95% CI 1.020-1.718), 1.349 (95% CI 1.030-1.765), and 1.445 (95% CI 1.055-1.980) times higher than that of the Q1, respectively, and the risk of recurrence in the Q3 and Q4 groups was 2.267 (95% CI 1.096-4.691) and 2.824 (95% CI 1.199-6.648) times in Q1 group. Multiple logistic regression showed that the highest quartile of the TyG index was associated with a greater risk of advanced adenoma recurrence (OR 4.456, 95% CI 1.157-17.164), two or more adenomas (OR 5.079, 95% CI 1.136-22.714 [after removal of TyG index extreme values]), and proximal colon or both adenomas (OR 3.043, 95% CI 1.186-7.810). Subgroup analysis revealed that the association was found to be present only in participants of all age groups who were either male or without obesity, hyperglycemia, hypertension, or dyslipidemia (p < 0.05). ROC curves illustrated that the TyG index had good predictive efficacy for identifying recurrence, especially for patients with two or more adenomas (AUC 0.777, 95% CI 0.648-0.907).

CONCLUSIONS

An increase in the TyG index is associated with an increased risk of adenoma occurrence and recurrence, with a stronger association with the latter.

Relationship between TyG index and the degree of coronary artery lesions in patients with H-type hypertension

BACKGROUND

The TyG index, a prominent metric for assessing insulin resistance, has gained traction as a prognostic tool for cardiovascular disease. Nevertheless, the understanding of the prognostic significance of the extent of coronary artery stenosis in individuals afflicted with H-type hypertension remains limited.

METHODS

A retrospective study was conducted at Wuhan Third Hospital, including a cohort of 320 inpatients who were diagnosed with hypertension in combination with coronary artery disease. The study period spanned from January 1, 2021, to February 1, 2023. The study cohort was stratified based on the severity of stenosis into three distinct groups: low stenosis, medium stenosis, and high stenosis, as determined by the Gensini score derived from coronary angiography findings. The present study aimed to investigate the association between the severity of coronary stenosis and the number of lesion branches, utilizing the TyG index as a testing indicator. The predictive ability of TyG for coronary lesion severity was assessed using logistic regression analysis.

RESULTS

The results of our study indicate a positive correlation between elevated levels of TyG and an increased susceptibility to severe stenosis in individuals diagnosed with H-type hypertension. Upon careful consideration of potential confounding variables, it has been observed that the TyG index exhibits a robust association with the likelihood of severe stenosis in individuals with H-type hypertension (odds ratio [OR] = 4000, 95% confidence interval CI 2.411-6.635, p = 0.0001), as well as the prevalence of multivessel disease (OR = 1.862, 95% CI 1.036-3.348, p < 0.0001). The TyG index demonstrated superior predictive ability for severe coronary stenosis in patients with H-type hypertension compared to those without H-type hypertension (area under the curve [AUC] = 0.888, 95% confidence interval CI 0.838-0.939, p < 0.0001, versus AUC = 0.615, 95% CI 0.494-0.737, p < 0.05).

CONCLUSION

The TyG index is an independent risk factor for the degree of coronary stenosis and a better predictor in patients with H-type hypertension combined with coronary artery disease.

Diagnostic value of triglyceride-glucose index and related parameters in metabolism-associated fatty liver disease in a Chinese population: a cross-sectional study

OBJECTIVE

Our study aimed to explore the diagnostic value of triglyceride-glucose (TyG) and its related parameters in metabolism-associated fatty liver disease (MAFLD).

DESIGN

A cross-sectional study of residents who attended medical checkups at the First Hospital of Nanping City, Fujian Medical University, between 2015 and 2017.

SETTING

One participation centre.

PARTICIPANTS

2605 subjects met the inclusion-exclusion criteria and were grouped according to whether they had MAFLD.

RESULTS

The TyG index and its associated parameters are positively associated with the risk of developing MAFLD (p<0.001). Restriction cube spline analysis showed a significant dose-response relationship between the TyG index and MAFLD. The risk of developing MAFLD increases significantly with a higher TyG index. After adjusting for confounders, this relationship remains (OR: 4.89, 95% CI 3.98 to 6.00). The areas under the receiver operating characteristic curves of the TyG index for MAFLD detection were 0.793 (0.774 to 0.812). The areas under the curve (AUC) of TyG-related parameters were improved, among which TyG-waist circumference (TyG-WC) showed the largest AUC for MAFLD detection (0.873, 95% CI 0.860 to 0.887). In addition, the best cut-off value of the TyG-WC was 716.743, with a sensitivity and specificity of 88.7% and 71.4%, respectively.

CONCLUSION

The TyG index effectively identifies MAFLD, and the TyG-related parameters improved the identification and diagnosis of MAFLD, suggesting that TyG-related parameters, especially TyG-WC, may be a useful marker for diagnosing MAFLD.