Yeh Hsiao-Yun, Pan Mei-Hung, Huang Chih-Jen, Hong Shiao-Ya, Yang Hwai-I, Yang Ying-Ying, Huang Chia-Chang, Tsai Hung-Cheng, Li Tzu-Hao, Su Chien-Wei, Hou Ming-Chih
Department of Medical Education, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, 11217, Taipei, Taiwan.
School of medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Diabetol Metab Syndr. 2025 Jul 18;17(1):283. doi: 10.1186/s13098-025-01768-8.
Insulin resistance (IR) is a key metabolic abnormality associated with adverse health outcomes, including increased cancer risk. The triglyceride-glucose (TyG) index, a validated surrogate marker of IR, has been linked to metabolic dysfunction; however, its association with cancer risk in large population-based cohorts remains unclear. This study aimed to evaluate the relationship between TyG index and cancer risk in Taiwanese population.
We analyzed 150,592 participants from the Taiwan Biobank, among whom 148,809 were linked to the Taiwan Cancer Registry (2011-2022) for cancer incidence tracking. Cancer risk was assessed across TyG quartiles over a median follow-up of 5.7 years (IQR: 3.4-7.6). Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards models, adjusting for key covariates.
Higher TyG index levels were associated with increased risks of digestive system cancer (adjusted HR [aHR]: 1.17, 95% CI: 1.05-1.29), colorectal cancer (aHR: 1.25, 95% CI: 1.08-1.44), and urinary tract cancer (aHR: 1.47, 95% CI: 1.18-1.85). While subgroup trends suggested numerically higher risks in males, individuals aged ≥ 50 years, and those with overweight or obesity for these cancer types, formal interaction tests did not support statistically significant effect modification in these groups. Significant interactions were observed for overall cancers by age (P < 0.001) and BMI (P = 0.012), and for urinary tract cancer by drinking status (P = 0.047). In a subset of 19,808 participants with follow-up data, higher TyG quartiles were also linked to fatty liver, carotid plaques, and persistent IR over time (r = 0.75).
Higher TyG index levels, indicative of greater IR, are associated with an elevated risk of digestive system, colorectal, and urinary tract cancers. Evaluating TyG index levels could assist in risk stratification for these cancers among individuals with persistent IR, supporting targeted prevention strategies.
胰岛素抵抗（IR）是一种关键的代谢异常，与不良健康结局相关，包括癌症风险增加。甘油三酯-葡萄糖（TyG）指数是一种经过验证的IR替代标志物，已与代谢功能障碍相关；然而，其在基于人群的大型队列中与癌症风险的关联仍不明确。本研究旨在评估台湾人群中TyG指数与癌症风险之间的关系。
我们分析了台湾生物银行的150,592名参与者，其中148,809人与台湾癌症登记处（2011 - 2022年）关联以追踪癌症发病率。在中位随访5.7年（四分位间距：3.4 - 7.6年）期间，评估了各TyG四分位数组的癌症风险。使用Cox比例风险模型估计风险比（HR）和95%置信区间（CI），并对关键协变量进行了调整。
较高的TyG指数水平与消化系统癌症（调整后HR [aHR]：1.17，95% CI：1.05 - 1.29）、结直肠癌（aHR：1.25，95% CI：1.08 - 1.44）和泌尿系统癌症（aHR：1.47，95% CI：1.18 - 1.85）风险增加相关。虽然亚组趋势表明这些癌症类型在男性、年龄≥50岁以及超重或肥胖个体中的风险在数值上更高，但正式的交互作用检验并不支持这些组中有统计学显著的效应修饰。观察到总体癌症在年龄（P < 0.001）和BMI（P = 0.012）方面以及泌尿系统癌症在饮酒状况（P = 0.047）方面存在显著交互作用。在19,808名有随访数据的参与者子集中，较高的TyG四分位数也与随时间推移的脂肪肝、颈动脉斑块和持续性IR相关（r = 0.75）。
较高的TyG指数水平表明IR程度更高，与消化系统、结直肠癌和泌尿系统癌症风险升高相关。评估TyG指数水平可有助于对持续性IR个体中的这些癌症进行风险分层，支持针对性的预防策略。
