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Meta-Analysis
. 2025 Oct;14(19):e71232.
doi: 10.1002/cam4.71232.

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

Hongyu Li  1   2 , Zijie Chen  1   2 , Guoheng Jiang  1   2 , Wenqian Yu  1   2 , Jing Luo  1   2 , Shiyi Li  1   2 , Linjun Xie  1   2 , Xuan Bai  1   2 , Yiting Xu  1   2 , Yi Jiang  1   2 , Menglin He  1   2 , Min Mao  3   4   5 , Xin Wang  1   2
Affiliations
Meta-Analysis

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

Hongyu Li et al. Cancer Med. 2025 Oct.

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.

Keywords: cancer; insulin resistance; meta‐analysis; systematic review; triglyceride‐glucose index.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Flow chart of this study.
FIGURE 2
FIGURE 2
Forest plot of the association between the TyG index and cancer. (A) The association between the continuous triglyceride glucose (TyG) index and cancer risk reflects the change in cancer risk associated with each unit or standard deviation increase in the TyG index. (B) The association between the categorical TyG index and cancer risk reflects changes in cancer risk at higher levels of TyG compared to lower levels of TyG. *p value for publish bias.
FIGURE 3
FIGURE 3
Trial sequential analysis (TSA) for evaluating the reliability of the association between the TyG index and cancer. (A) Continuous TyG index and the cancer of digestive system. (B) Categorical TyG index and the cancer of digestive system. (C) Categorical TyG index and the cancer of urogenital system. (D) Categorical TyG index and breast cancer. Monitoring boundaries calculated based on *observed effect size*. Does not preclude *residual confounding*.
See this image and copyright information in PMC

References

    1. Bray F., Laversanne M., Sung H., et al., “Global Cancer Statistics 2022: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries,” CA: A Cancer Journal for Clinicians 74, no. 3 (2024): 229–263, 10.3322/caac.21834. - DOI - PubMed
    1. Gyamfi J., Kim J., and Choi J., “Cancer as a Metabolic Disorder,” International Journal of Molecular Sciences 23, no. 3 (2022): 35163079, 10.3390/ijms23031155. - DOI - PMC - PubMed
    1. Chiefari E., Mirabelli M., La Vignera S., et al., “Insulin Resistance and Cancer: In Search for a Causal Link,” International Journal of Molecular Sciences 22, no. 20 (2021): 11137, 10.3390/ijms222011137. - DOI - PMC - PubMed
    1. Tahapary D. L., Pratisthita L. B., Fitri N. A., et al., “Challenges in the Diagnosis of Insulin Resistance: Focusing on the Role of HOMA‐IR and Tryglyceride/Glucose Index,” Diabetes and Metabolic Syndrome 16, no. 8 (2022): 102581, 10.1016/j.dsx.2022.102581. - DOI - PubMed
    1. Tao L. C., Xu J. N., Wang T. T., Hua F., and Li J. J., “Triglyceride‐Glucose Index as a Marker in Cardiovascular Diseases: Landscape and Limitations,” Cardiovascular Diabetology 21, no. 1 (2022): 68, 10.1186/s12933-022-01511-x. - DOI - PMC - PubMed