Association of the Triglyceride–Glucose Index With Gallstone Disease: A Systematic Review and Meta‐Analysis of Observational Studies

TL;DR

This study finds that higher triglyceride-glucose index values are linked to a greater risk of gallstone disease, suggesting it could be a useful and low-cost screening tool.

Contribution

The study provides the first meta-analysis linking the TyG index, a marker of insulin resistance, to an increased risk of gallstone disease.

Findings

Each one-unit increase in the TyG index was associated with a 33.2% higher odds of gallstone disease.

Participants with gallstone disease had significantly higher TyG index values compared to those without.

The pooled prevalence of gallstone disease was 10.51%, with high heterogeneity across studies.

Abstract

Gallstone disease (GSD) is a common hepatobiliary condition closely associated with metabolic disturbances. The triglyceride–glucose index (TyG index), a widely used surrogate marker of insulin resistance, has gained attention as a potential indicator of gallstone risk. This systematic review and meta‐analysis aimed to synthesize observational evidence evaluating the association between TyG index and GSD in adults.

Web of Science, Embase, and PubMed were searched from inception to December 2025 for relevant observational studies. Study quality was assessed using the Newcastle–Ottawa Scale (NOS). Adjusted odds ratios (aORs), standardized mean differences (SMDs), adjusted hazard ratios (aHRs), and prevalence estimates were pooled using a random‐effects model (REM). Sensitivity analyses, subgroup analyses, and assessment of publication bias were conducted.

Nine studies including more than 430 000 participants were included. For each one‐unit increase in the TyG index, the pooled odds ratio for GSD was 1.332 (95% CI: 1.213–1.462; I
2 = 0%). When comparing the highest versus lowest TyG categories, the summary OR was 1.678 (95% CI: 1.150–2.448). Participants with GSD had higher TyG values than those without GSD (pooled SMD: 0.29; 95% CI: 0.26–0.32). The pooled prevalence of GSD was 10.51% (95% CI: 5.40–19.44), with heterogeneity (I
2 = 99.8%). Subgroup analyses were performed according to body mass index (BMI), sex, diabetes, and race.

Higher TyG index values are consistently linked to elevated risk of GSD. Given that TyG is inexpensive and routinely available, it may be useful for identifying individuals at a heightened risk of GSD. More longitudinal studies are needed to determine causation and to assess whether TyG‐based screening can improve GSD risk prediction or prevention.

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