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Meta-Analysis
. 2023 Sep 7;22(1):244.
doi: 10.1186/s12933-023-01973-7.

Triglyceride-glucose index and heart failure: a systematic review and meta-analysis

Amirmohammad Khalaji  1   2   3 , Amir Hossein Behnoush  4   5   6 , Shaghayegh Khanmohammadi  1   2 , Kimiya Ghanbari Mardasi  7 , Sourena Sharifkashani  1 , Amirhossein Sahebkar  8   9   10   11 , Caterina Vinciguerra  12 , Alessandro Cannavo  12
Affiliations
Meta-Analysis

Triglyceride-glucose index and heart failure: a systematic review and meta-analysis

Amirmohammad Khalaji et al. Cardiovasc Diabetol. .

Abstract

Background: Insulin resistance (IR) is a major metabolic disorder observed in heart failure (HF) and is tightly associated with patients' poor prognosis. The triglyceride-glucose index (TyG) has been proposed as a surrogate marker of IR in HF. Yet, whether TyG is a reliable clinical marker is still under debate. Hence, we aimed to respond to this relevant question via a systematic review and meta-analysis of existing studies.

Methods: A systematic search was conducted in PubMed, Embase, Scopus, and Web of Science to find studies investigating the TyG index in patients with HF or its association with the incidence of HF. Adjusted hazard ratios (HR) and 95% confidence intervals (CI) were pooled through random-effect meta-analysis. HRs were calculated using TyG as a continuous variable (1 unit increase) and by comparing the group with the highest TyG to the lowest TyG group.

Results: Thirty studies, involving 772,809 participants, were included in this systematic review. Meta-analysis of seven studies comparing the highest-TyG to the lowest-TyG group showed a significantly increased risk of HF in the former group (HR 1.21, 95% CI 1.14 to 1.29, P < 0.01). The same result was found when pooling the HRs for a one-unit increase in the TyG index (HR 1.17, 95% CI 1.08 to 1.26). Similarly, a more elevated TyG index was associated with a higher incidence of HF in patients with type 2 diabetes or coronary artery disease. Additionally, the incidence of adverse events (readmission and mortality) in patients with HF was associated with TyG.

Conclusion: Our findings support the TyG index as a valuable marker to assess the risk of HF incidence in different populations and as a prognostic marker in patients with HF. Further studies should be conducted to confirm these associations and investigate the clinical utility of the TyG index.

Keywords: Blood glucose; Heart failure; Insulin resistance; Meta-analysis; Systematic review; Triglycerides.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA flowchart representing the study selection process and reasons for exclusion
Fig. 2
Fig. 2
Forest plot showing the random-effect meta-analysis of HF incidence in comparison of the highest TyG group vs. lowest TyG group
Fig. 3
Fig. 3
Forest plot showing the random-effect meta-analysis of HF incidence using the TyG index as a continuous variable (1-unit increase)
See this image and copyright information in PMC

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