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High triglyceride-glucose index increases major adverse cardiocerebrovascular events in patients with CKM syndromeHigh triglyceride and glucose levels linked to heart and brain risks

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Key Takeaway
Note that a higher TyG index is associated with increased MACCE risk in patients with CKM syndrome.

This meta-analysis evaluated the association between the triglyceride-glucose (TyG) index and major adverse cardiocerebrovascular events (MACCE) in a large cohort of over 2 million individuals with cardiovascular-kidney-metabolic (CKM) syndrome. The study analyzed both categorical and continuous measures of the TyG index to determine its relationship with cardiovascular outcomes.

The analysis found that the highest TyG index category was associated with a 1.20 risk of MACCE compared to the lowest category (95% CI [1.11-1.30], p < 0.001). Additionally, a nonlinear positive association was observed for every 1-unit increment in the TyG index, showing a 1.05 risk (95% CI [1.02-1.08], p < 0.001).

Authors noted that the predictive power of the TyG index is not confirmed and causality cannot be established from these data. While the TyG index may contribute to adverse MACCE in individuals with CKM syndrome, further studies are required to confirm these findings. The results should be interpreted as observational evidence regarding risk association rather than a confirmed causal link.

How this fits prior evidence

This meta-analysis extends the existing evidence regarding risk stratification tools for cardiovascular-kidney-metabolic (CKM) syndrome. It adds to the evidence regarding the modified cardiometabolic index as a risk stratification tool and the body roundness index as a marker for metabolic syndrome. While the TyG index shows a significant association with MACCE, it is an observational finding and causality is not confirmed.

Managing heart health is complicated when multiple conditions like high blood pressure, kidney issues, and metabolic problems happen at once. This combination is known as cardiovascular-kidney-metabolic syndrome. Researchers looked at a specific measurement called the triglyceride-glucose index, which tracks both blood fats and sugar levels, to see if it could help identify people at higher risk for serious heart and brain events.

The study looked at over 2 million people. They found that those with the highest levels of this marker had a significantly higher risk of major heart and brain events compared to those with the lowest levels. Even small increases in this marker were linked to higher risks. This suggests that the triglyceride-glucose index might be a useful tool for identifying risk in patients with complex health profiles.

While these results are striking, it is important to remember that the study did not prove that the high levels directly cause the heart problems. Because the data comes from a large group of people rather than a controlled trial, we cannot be certain of the exact cause. More research is needed to confirm if this marker can be used as a reliable predictor for future health events.

What this means for you:
Higher levels of triglycerides and glucose are linked to increased risk of heart and brain events in certain patients.

Common questions

What is the triglyceride-glucose index?

The triglyceride-glucose index, or TyG index, is a measurement that looks at both your blood fats (triglycerides) and your blood sugar (glucose). It is used to help identify risks in people who have a combination of heart, kidney, and metabolic issues.

Who is affected by these findings?

These findings specifically involve individuals with cardiovascular-kidney-metabolic syndrome. This means people who deal with a mix of heart, kidney, and metabolic problems. The study included over 2 million participants to find these patterns.

Does this mean high levels cause heart problems?

The study shows a strong link between high levels and heart or brain events, but it does not confirm that the high levels are the direct cause. More research is needed to prove causality before it can be used as a definitive predictor.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedSep 2026
View Original Abstract ↓
BackgroundEpidemiological research has indicated a potential association between the triglyceride-glucose (TyG) index and the risk of major adverse cardiocerebrovascular events (MACCE). Nevertheless, the precise nature and magnitude of this relationship remain to be fully elucidated.ObjectivesThis study aims to assess the dose–response relationship between the TyG index and MACCE among individuals with cardiovascular-kidney-metabolic (CKM) syndrome.MethodsA comprehensive literature search was conducted using the PubMed and Web of Science databases to identify relevant studies on the TyG-MACCE relationship up to 16 June 2026. Data were synthesized using both random- and fixed-effects models, and nonlinear dose–response meta-analyses were performed using restricted cubic spline models.ResultsThe analysis incorporated eight cohort studies, encompassing over two million participants and 179 thousand MACCE cases. The aggregated risk estimate for MACCE, comparing the highest to the lowest categories of TyG index exposure, was 1.20 (95% confidence interval [CI] = 1.11–1.30, I2 = 77.2%, pheterogeneity < 0.001). The dose–response analysis revealed a nonlinear positive association between the TyG index and MACCE risk (pnonlinear < 0.001), with summary risk estimates calculated for each 1-unit increment in the TyG index being 1.05 (95% CI = 1.02–1.08, I2 = 81.1%, pheterogeneity < 0.001). Subgroup and sensitivity analyses yielded similar results.ConclusionsThis suggests that the TyG index may contribute to adverse MACCE in individuals with CKM syndrome. Further studies are needed to confirm causality and the predictive power of the TyG index. The research was prospectively registered in the Prospective Register for Systematic Reviews (registration number: CRD420261278535).Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD420261278535, identifier CRD420261278535.
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