Associations of triglyceride–glucose-related composite obesity indices with cardiovascular diseases and mortality: a systematic review and meta-analysis
Authors' conclusion
TyG-based composite obesity indices are associated with various cardiovascular outcomes and mortality risk, suggesting they may serve as a supplement to traditional risk assessment for risk stratification and early identification in primary prevention. Future multicenter prospective studies are still needed to further validate their causal associations and generalizability across diverse populations.
Study context
- Population
- Observational studies of triglyceride-glucose (TyG)-based composite adiposity indices and major cardiovascular and mortality outcomes; PubMed, EMBASE, Web of Science through October 8, 202585 studies
- Comparison
- TyG-based composite adiposity indices (TyG-BMI, TyG-WC, TyG-WHtR, TyG-ABSI, TyG-BRI), per 1-SD increase and highest vs lowest quantile
- Outcome
- CVD, stroke, CAD, cardiovascular and all-cause mortality per 1-SD increase
Methodological detailsrandom-effects models, linear and non-linear dose-response meta-analyses
- Random-effects models
- Linear and non-linear dose-response meta-analyses
Pooled result
As reported in the abstract
- Cardiovascular disease (CVD) risk increase per 1-SD, TyG-BMI, TyG-WC, TyG-WHtR (28 studies)
- 17%, 20%, and 19%
- Stroke risk increase per 1-SD, TyG-BMI, TyG-WC, TyG-WHtR, TyG-BRI (19 studies)
- 18%, 18%, 37%, and 17%
- Coronary artery disease (CAD) risk increase per 1-SD, TyG-BMI, TyG-WC, TyG-WHtR (11 studies)
- 17%, 18%, and 22%
- Cardiovascular mortality increase per 1-SD, TyG-BMI, TyG-WC, TyG-WHtR, TyG-ABSI (24 studies)
- 22%, 24%, 32%, and 31%
- All-cause mortality increase per 1-SD (37 studies)
- 5%, 18%, 21%, and 23%
Further pooled results
Categorical analyses (highest vs lowest quantile)
- Higher risk for most indices; TyG-BMI not significantly associated with all-cause mortality
Between-index comparisons
- Slightly greater risk increments for TyG-WHtR and TyG-WC than TyG-BMI for some outcomes
Dose-response
- Non-linear increasing associations of TyG-BMI, TyG-WC, TyG-WHtR with incident CVD and cardiovascular mortality; U-shaped TyG-BMI association with all-cause mortality
- TyG-BRI linearly associated with CVD; TyG-ABSI linearly associated with cardiovascular mortality
Heterogeneity
- Region, population type and sample size potential sources of heterogeneity
Original publication
Associations of triglyceride–glucose-related composite obesity indices with cardiovascular diseases and mortality: a systematic review and meta-analysis. Cardiovasc Diabetol. Published 26 March 2026. doi:10.
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