Association between triglyceride glucose index and atrial fibrillation: A systematic review and meta-analysis.

Background and objectives: Previous studies have demonstrated that insulin resistance (IR) is associated with atrial fibrillation (AF). As a reliable indicator of IR, the triglyceride glucose (TyG) index has been extensively studied in relation to AF. We aimed to investigate the relationship between the TyG index and AF through a systematic review and meta-analysis.

Methods and study design: We systematically searched studies published up to August 2024 in online databases including PubMed, Embase, Web of Science, Wan-fang, and the China National Knowledge Internet database. Seventeen studies involving 57,213 patients were included in the analysis. A random-effects model and exposure-effect analysis were used to calculate the pooled effect estimate and compute the linear trend.

Results: A significantly higher TyG index was observed in AF patients (standardized mean difference [SMD]: 0.78; 95% CI: 0.43- 1.13; p<0.001). The TyG index was associated with the risk of AF in both continuous analysis (odds ratio [OR]: 1.80; 95% CI: 1.50-2.17; p<0.001) and category analysis (odds ratio [OR]: 1.98; 95% CI: 1.35-2.91]; p<0.001). Exposure-effect analysis confirmed a linear positive relationship between the TyG index and the risk of AF (plinearity = 0.006).

Conclusions: The TyG index is associated with an increased risk of AF, including pure AF, post-operative AF and AF recurrence after ablation. Further studies are needed to confirm the causal relationship between the TyG index and AF.