Elevated triglyceride-glucose index as a predictor of carotid plaque incidence: Insights from a comprehensive meta-analysis.

Background: Early detection of carotid plaque (CP) can help reduce the burden of ASCVD in the general population. CP and triglyceride-glucose index (TyGi) are associated with insulin resistance.

Objectives: We performed a meta-analysis exploring the association of TyGi levels with the incidence of CP.

Methods: A systematic search of PubMed, Scopus, and Google Scholar till September 2023 reporting TyGi and CP identified 67 studies, of which 13 met our study criteria. TyGi was assessed both categorically and continuously. Binary random-effects models used for pooled odds ratios (OR) with 95 % confidence intervals (CI) and I² statistic for heterogeneity.

Results: Analyzed data from 163,792 patients with a mean age of 53 ± 8.9 years, primarily female (51.5 %). Common comorbidities were hypertension (42.4 %) followed by dyslipidemia (24.3 %). Multivariable analysis showed that high vs. low TyGi quartile was associated with a higher risk of CP with unadjusted OR (1.82, 95 % CI [1.5 - 2.21], p < 0.01; I² = 95.77, p < 0.01) and adjusted OR (1.3, 95 % CI [1.16 - 1.46], p < 0.01; I² = 79.71, p < 0.01). Increasing TyGi also had a higher risk of CP with unadjusted OR (1.53, 95 % CI [1.15 - 2.03], p < 0.01; I² = 98.48, p < 0.01) and adjusted OR (1.23, 95 % CI [1.11 - 1.35], p < 0.01; I² = 89.82, p < 0.01). The association was validated by sensitivity analysis.

Conclusion: Our study indicates a higher risk of CP in patients with higher TyGi scores, underscoring its significance as a predictor for carotid atherosclerosis.