甘油三酯-葡萄糖指数与乳腺癌的关系：一项系统综述和荟萃分析

IF 1.5 Q4 ONCOLOGY

Cancer reports Pub Date : 2025-04-07 DOI:10.1002/cnr2.70194

Diar Zooravar, Hanieh Radkhah, Bahareh Shateri Amiri, Pedram Soltani

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引用次数: 0

摘要

背景和目的甘油三酯-葡萄糖（TyG）指数是胰岛素抵抗和代谢综合征的替代标志物，与乳腺癌（BC）风险有关。然而，其预测价值仍存在争议。本系统综述和荟萃分析评估了TyG指数与乳腺癌风险之间的关系、TyG在鉴别乳腺良恶性病变中的作用及其潜在的预后意义。方法综合检索截至2025年1月的PubMed、Scopus、Web of Science、Embase、谷歌Scholar等数据库。符合以下标准的研究被纳入：(1)评估有关BC风险、进展或预后的TyG指数；(2)纳入比较组（健康个体、乳腺良性病变患者或内部对照）；(3)报告的效应大小（优势比[OR]或风险比[HR]）， 95%置信区间（CI）；(4)提供足够的TyG指数统计数据。排除的研究包括体外或动物研究、综述、病例报告和缺乏相关定量数据的研究。使用随机效应模型汇总效应大小；通过I2统计评估异质性，并进行敏感性分析。限制三次样条模型评估剂量-反应关系。结果共分析了13项研究，包括回顾性、病例对照、队列和横断面设计。病例对照和横断面研究显示，较高的TyG指数与BC风险增加之间存在显著关联（OR: 1.87, 95% CI: 1.45-2.41, p < 0.01）。然而，队列研究没有证实这种关系（HR: 1.04, 95% CI: 0.97-1.11, p = 0.23）。TyG指数能有效区分乳腺良恶性病变（WMD: 0.23, 95% CI: 0.18-0.27, p < 0.01），合并AUC为0.64。剂量-反应分析显示TyG指数与BC风险之间存在非线性关系（p < 0.001）。结论：虽然TyG指数可能不能强烈预测BC的发病，但它反映了与癌症进展相关的代谢改变。其区分良恶性病变的能力突出了其临床应用价值。未来的研究应规范TyG指数阈值，并通过纵向研究验证其预后价值。试验注册号：CRD42024547997

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Association Between Triglyceride-Glucose Index and Breast Cancer: A Systematic Review and Meta-Analysis

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Association Between Triglyceride-Glucose Index and Breast Cancer: A Systematic Review and Meta-Analysis

Background and Aims

The triglyceride-glucose (TyG) index, a surrogate marker for insulin resistance and metabolic syndrome, has been implicated in breast cancer (BC) risk. However, its predictive value remains controversial. This systematic review and meta-analysis assessed the association between the TyG index and BC risk, its role in differentiating malignant from benign breast lesions, and its potential prognostic significance.

Methods

A comprehensive search of PubMed, Scopus, Web of Science, Embase, and Google Scholar was conducted up to January 2025. Studies were included if they met the following criteria: (1) assessed the TyG index about BC risk, progression, or prognosis; (2) included a comparator group (healthy individuals, benign breast lesion patients, or internal controls); (3) reported effect sizes (odds ratio [OR] or hazard ratio [HR]) with 95% confidence intervals (CI); and (4) provided sufficient statistical data on the TyG index. Excluded studies included in vitro or animal research, reviews, case reports, and those lacking relevant quantitative data. Effect sizes were pooled using a random-effects model; heterogeneity was assessed via I² statistics, and sensitivity analyses were performed. A restricted cubic spline model evaluated dose–response relationships.

Results

Thirteen studies, including retrospective, case–control, cohort, and cross-sectional designs, were analyzed. Case–control and cross-sectional studies revealed a significant association between a higher TyG index and increased BC risk (OR: 1.87, 95% CI: 1.45–2.41, p < 0.01). However, cohort studies did not confirm this relationship (HR: 1.04, 95% CI: 0.97–1.11, p = 0.23). The TyG index effectively differentiated malignant from benign breast lesions (WMD: 0.23, 95% CI: 0.18–0.27, p < 0.01) with a pooled AUC of 0.64. Dose–response analysis suggested a non-linear relationship between the TyG index and BC risk (p < 0.001).

Conclusion

While the TyG index may not strongly predict BC onset, it reflects metabolic alterations linked to cancer progression. Its ability to distinguish benign from malignant lesions highlights its clinical utility. Future studies should standardize TyG index thresholds and validate their prognostic value through longitudinal research.