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Meta-Analysis
. 2024 Sep 28;14(1):80.
doi: 10.1038/s41387-024-00341-y.

Investigating the association between the triglyceride-glucose index and peripheral artery disease: a systematic review and meta-analysis

Amirsaeed Samavarchitehrani #  1 , Alessandro Cannavo #  2 , Amir Hossein Behnoush #  3   4   5 , Ali Kazemi Abadi  1 , Zahra Shokri Varniab  6   7 , Amirmohammad Khalaji  8   6   9
Affiliations
Meta-Analysis

Investigating the association between the triglyceride-glucose index and peripheral artery disease: a systematic review and meta-analysis

Amirsaeed Samavarchitehrani et al. Nutr Diabetes. .

Abstract

Background: Peripheral artery disease (PAD) is a common disease associated with atherosclerosis, leading to significant mortality and morbidity worldwide. Our study focuses on the association between insulin resistance (IR) and PAD, specifically investigating the triglyceride-glucose index (TyG) as a potential surrogate marker of IR in the context of PAD by pooling the existing studies on this topic.

Methods: Online databases, including PubMed, Embase, Scopus, and the Web of Science, were searched to find the studies comparing the TyG index in PAD vs. control, reporting the TyG index among PAD severities, and assessing the association of increase in TyG with PAD prevalence. Random-effect meta-analysis was performed to calculate the standardized mean difference (SMD) and 95% confidence interval (CI) for TyG level comparison and to calculate pooled odds ratio (ORs) for a 1-unit increase in TyG and higher vs. lower quartile/tertile of TyG association with PAD.

Results: In the final review, 22 studies comprising 73,168 cases were included. Random-effect meta-analysis showed that patients with PAD had significantly higher levels of the TyG index compared with controls (SMD 0.76, 95%CI 0.65-0.88, P < 0.001). Also, higher severities of PAD were associated with higher TyG levels (SMD 0.48, 95%CI 0.22-0.74, P = 0.0003). Additionally, a 1-unit increase in TyG was associated with a 60% increase in odds of PAD (OR 1.60, 95%CI 1.41-1.80, P < 0.001). Finally, the highest quartile (Q4) of TyG had significantly higher odds of PAD compared to Q1 (OR 1.94, 95%CI 1.49-2.54, P < 0.001).

Conclusion: Our meta-analysis has identified a significant association between TyG levels and PAD and its severity. These findings not only contribute to our understanding of the role of IR in PAD pathology but also offer clinicians an exact index for evaluating PAD risk and its complications. This could potentially lead to more effective prevention and management strategies in the future.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA diagram flowchart representing the search and study selection process.
Fig. 2
Fig. 2
Forest plot for meta-analysis of TyG levels in patients with PAD vs. controls.
Fig. 3
Fig. 3
Forest plot for meta-analysis of TyG levels in patients with severe PAD vs. moderate PAD.
Fig. 4
Fig. 4
Forest plot for meta-analysis of one unit increase in TyG level association with high baPWV.
Fig. 5
Fig. 5
Forest plot for meta-analysis of tertile 3 vs. tertile 1 of TyG association with high baPWV.
Fig. 6
Fig. 6
Forest plot for meta-analysis of quartile 4 vs. quartile 1 of TyG association with high baPWV.
See this image and copyright information in PMC

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