DOI: 10.1097/ms9.0000000000005559 ISSN: 2049-0801

The triglyceride-glucose index as a predictor of cardiovascular disease: an umbrella review of meta-analyses

Shahriar Ghodous, Herby Jeanty, Saisree Reddy Adla Jala, Kavya Priya Somu, Nikitha Chellapuram, Shika M Jain, Pegah Rashidian, Abinash Mahapatro, Maryam Jafari, Seyedsina Moghimnejadhosseini, Hoda Safa, Mohammad Hashemi, Arezoo Ghazalgoo
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Background:

The triglyceride-glucose (TyG) index has gained recognition as a tool for assessing cardiovascular disease risk. This umbrella review synthesized findings from multiple meta-analyses examining the association between the TyG index and cardiovascular outcomes.

Methods:

In this umbrella review of meta-analyses, we followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

Results:

A higher TyG index was associated with increased odds of arterial stiffness [categorical: odds ratio (OR) = 1.83, 95% confidence interval (CI): 1.55–2.17, P < 0.01; I 2  = 68%; per 1-unit increase: OR = 1.51, 95% CI: 1.35–1.69, P < 0.01; I 2  = 82%]; coronary artery stenosis (OR = 3.49, 95% CI: 1.71–7.12, P < 0.01; I 2  = 0%); coronary artery calcification (CAC) (highest vs. lowest: OR = 1.66, 95% CI: 1.51–1.82, P < 0.01; I 2  = 0%; continuous: OR = 1.73, 95% CI: 1.36–2.20, P < 0.01; I 2  = 51%); CAC progression (categorical: OR = 1.66, 95% CI: 1.21–2.27, P < 0.01; I 2  = 0%; continuous: OR = 1.47, 95% CI: 1.29–1.68, P < 0.01; I 2  = 41%); and atrial fibrillation (AF) (categorical: OR = 1.98, 95% CI: 1.35–2.91, P < 0.01; I 2  = 92%; continuous: OR = 1.80, 95% CI: 1.50–2.17, P < 0.01; I 2  = 88%).

Conclusion:

Current meta-analytic evidence suggests that higher TyG index values are associated with several adverse cardiovascular outcomes. However, substantial heterogeneity and the generally low methodological quality of the included meta-analyses limit confidence in the magnitude and clinical applicability of these associations. The TyG index may serve as an adjunctive cardiovascular risk marker, but further high-quality prospective validation is required before routine clinical implementation.

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