The Associations Between the TyG Index and the Risk of Cancer—A Systematic Review and Meta-Analysis

IF 3.1 2区医学 Q2 ONCOLOGY

Cancer Medicine Pub Date : 2025-10-02 DOI:10.1002/cam4.71232

Hongyu Li, Zijie Chen, Guoheng Jiang, Wenqian Yu, Jing Luo, Shiyi Li, Linjun Xie, Xuan Bai, Yiting Xu, Yi Jiang, Menglin He, Min Mao, Xin Wang

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Abstract

Background

The triglyceride glucose (TyG) index, a simple and reliable surrogate marker of insulin resistance (IR), has garnered increasing attention in metabolic research. Although IR is mechanistically linked to carcinogenesis through multiple pathways, including chronic inflammation, hyperinsulinemia-driven pro-mitogenic signaling, and altered adipokine secretion, the specific utility of the TyG index for cancer risk assessment remains unclear. This systematic review examines whether the TyG index shows consistent associations across cancer types and holds value as an independent risk predictor beyond established metabolic syndrome components.

Methods

We systematically searched PubMed, Embase, and Web of Science databases from 2008 (the year the TyG index was established as an IR marker) to December 31, 2024, for studies on the TyG index-cancer association. Cohort, cross-sectional, and case–control studies were included. Using meta-analysis, we pooled effect sizes and conducted subgroup analyses by gender, region, population source, and study design. Trial sequential analysis (TSA) evaluated evidence reliability.

Results

This meta-analysis incorporated a total of 20 eligible studies. Our findings demonstrated that elevated TyG index levels were significantly associated with increased risks of various malignancies, including digestive system cancers (OR: 1.22, 95% CI 1.13–1.31), urogenital system cancers (OR: 2.04, 95% CI 1.53–2.71), and breast cancer (OR: 1.64, 95% CI 1.49–1.80) when compared to lower TyG index levels. These associations remained consistent across all pre-specified subgroup analyses stratified by study characteristics. Furthermore, TSA confirmed sufficient statistical power for definitive conclusions.

Conclusions

The consistent observed association between elevated TyG index and increased cancer risk highlights its potential as a candidate biomarker for further investigation. While these findings support the biological plausibility of insulin resistance in oncogenesis, current evidence—partially derived from observational studies—cannot establish causality or direct clinical utility. Future research should prioritize: (1) prospective validation of TyG index thresholds for cancer risk prediction, (2) mechanistic studies elucidating its role in tumor biology, and (3) assessment of its incremental value to existing risk stratification tools.

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TyG指数与癌症风险的关系——系统评价与荟萃分析。

背景：甘油三酯葡萄糖（TyG）指数作为一种简单可靠的胰岛素抵抗（IR）替代指标，在代谢研究中越来越受到重视。虽然IR通过多种途径与癌症发生机制相关，包括慢性炎症、高胰岛素驱动的促有丝分裂信号传导和脂肪因子分泌改变，但TyG指数在癌症风险评估中的具体效用尚不清楚。本系统综述探讨了TyG指数在不同癌症类型之间是否显示出一致的相关性，并在已建立的代谢综合征成分之外，作为一种独立的风险预测因子具有价值。方法：系统检索PubMed、Embase和Web of Science数据库，从2008年（TyG指数作为IR标记物建立之年）到2024年12月31日，进行TyG指数与癌症关联的研究。包括队列研究、横断面研究和病例对照研究。通过荟萃分析，我们汇总了效应量，并按性别、地区、人口来源和研究设计进行了亚组分析。试验序列分析（TSA）评估证据的可靠性。结果：本荟萃分析共纳入了20项符合条件的研究。我们的研究结果表明，与较低的TyG指数水平相比，TyG指数水平升高与各种恶性肿瘤的风险增加显著相关，包括消化系统癌症（OR: 1.22, 95% CI 1.13-1.31）、泌尿生殖系统癌症（OR: 2.04, 95% CI 1.53-2.71）和乳腺癌（OR: 1.64, 95% CI 1.49-1.80）。这些关联在所有预先指定的按研究特征分层的亚组分析中保持一致。此外，运输安全管理局证实有足够的统计能力得出明确的结论。结论：TyG指数升高与癌症风险增加之间一致观察到的相关性突出了其作为进一步研究的候选生物标志物的潜力。虽然这些发现支持胰岛素抵抗在肿瘤发生中的生物学合理性，但目前的证据（部分来自观察性研究）不能建立因果关系或直接的临床应用。未来的研究应优先考虑：(1)对TyG指数阈值进行癌症风险预测的前瞻性验证；(2)阐明其在肿瘤生物学中的作用的机制研究；(3)评估其对现有风险分层工具的增量价值。

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来源期刊

Cancer Medicine ONCOLOGY-

CiteScore

5.50

自引率

2.50%

发文量

907

审稿时长

19 weeks

期刊介绍： Cancer Medicine is a peer-reviewed, open access, interdisciplinary journal providing rapid publication of research from global biomedical researchers across the cancer sciences. The journal will consider submissions from all oncologic specialties, including, but not limited to, the following areas: Clinical Cancer Research Translational research ∙ clinical trials ∙ chemotherapy ∙ radiation therapy ∙ surgical therapy ∙ clinical observations ∙ clinical guidelines ∙ genetic consultation ∙ ethical considerations Cancer Biology: Molecular biology ∙ cellular biology ∙ molecular genetics ∙ genomics ∙ immunology ∙ epigenetics ∙ metabolic studies ∙ proteomics ∙ cytopathology ∙ carcinogenesis ∙ drug discovery and delivery. Cancer Prevention: Behavioral science ∙ psychosocial studies ∙ screening ∙ nutrition ∙ epidemiology and prevention ∙ community outreach. Bioinformatics: Gene expressions profiles ∙ gene regulation networks ∙ genome bioinformatics ∙ pathwayanalysis ∙ prognostic biomarkers. Cancer Medicine publishes original research articles, systematic reviews, meta-analyses, and research methods papers, along with invited editorials and commentaries. Original research papers must report well-conducted research with conclusions supported by the data presented in the paper.