Triglyceride-glucose index and cancer risk: a prospective cohort study in Taiwan

Abstract Background 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 cance...

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Main Authors: Hsiao-Yun Yeh, Mei-Hung Pan, Chih-Jen Huang, Shiao-Ya Hong, Hwai-I Yang, Ying-Ying Yang, Chia-Chang Huang, Hung-Cheng Tsai, Tzu-Hao Li, Chien-Wei Su, Ming-Chih Hou
Format: Article
Language:English
Published: BMC 2025-07-01
Series:Diabetology & Metabolic Syndrome
Online Access:https://doi.org/10.1186/s13098-025-01768-8
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author Hsiao-Yun Yeh
Mei-Hung Pan
Chih-Jen Huang
Shiao-Ya Hong
Hwai-I Yang
Ying-Ying Yang
Chia-Chang Huang
Hung-Cheng Tsai
Tzu-Hao Li
Chien-Wei Su
Ming-Chih Hou
author_facet Hsiao-Yun Yeh
Mei-Hung Pan
Chih-Jen Huang
Shiao-Ya Hong
Hwai-I Yang
Ying-Ying Yang
Chia-Chang Huang
Hung-Cheng Tsai
Tzu-Hao Li
Chien-Wei Su
Ming-Chih Hou
author_sort Hsiao-Yun Yeh
collection DOAJ
description Abstract Background 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. Methods 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. Results 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). Conclusions 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.
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spelling doaj-art-22e7e46b34984473a9f849b71e04ebca2025-08-20T03:46:23ZengBMCDiabetology & Metabolic Syndrome1758-59962025-07-0117111310.1186/s13098-025-01768-8Triglyceride-glucose index and cancer risk: a prospective cohort study in TaiwanHsiao-Yun Yeh0Mei-Hung Pan1Chih-Jen Huang2Shiao-Ya Hong3Hwai-I Yang4Ying-Ying Yang5Chia-Chang Huang6Hung-Cheng Tsai7Tzu-Hao Li8Chien-Wei Su9Ming-Chih Hou10Department of Medical Education, Taipei Veterans General HospitalGenomics Research Center, Academia SinicaGenomics Research Center, Academia SinicaDepartment of Biotechnology and Laboratory Science in Medicine, National Yang Ming Chiao Tung UniversityGenomics Research Center, Academia SinicaDepartment of Medical Education, Taipei Veterans General HospitalDepartment of Medical Education, Taipei Veterans General HospitalSchool of medicine, National Yang Ming Chiao Tung UniversityDivision of Allergy and Immunology, Department of Internal Medicine, Shin Kong Wu Ho-Su Memorial HospitalSchool of medicine, National Yang Ming Chiao Tung UniversitySchool of medicine, National Yang Ming Chiao Tung UniversityAbstract Background 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. Methods 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. Results 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). Conclusions 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.https://doi.org/10.1186/s13098-025-01768-8
spellingShingle Hsiao-Yun Yeh
Mei-Hung Pan
Chih-Jen Huang
Shiao-Ya Hong
Hwai-I Yang
Ying-Ying Yang
Chia-Chang Huang
Hung-Cheng Tsai
Tzu-Hao Li
Chien-Wei Su
Ming-Chih Hou
Triglyceride-glucose index and cancer risk: a prospective cohort study in Taiwan
Diabetology & Metabolic Syndrome
title Triglyceride-glucose index and cancer risk: a prospective cohort study in Taiwan
title_full Triglyceride-glucose index and cancer risk: a prospective cohort study in Taiwan
title_fullStr Triglyceride-glucose index and cancer risk: a prospective cohort study in Taiwan
title_full_unstemmed Triglyceride-glucose index and cancer risk: a prospective cohort study in Taiwan
title_short Triglyceride-glucose index and cancer risk: a prospective cohort study in Taiwan
title_sort triglyceride glucose index and cancer risk a prospective cohort study in taiwan
url https://doi.org/10.1186/s13098-025-01768-8
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