Association of Triglyceride-Glucose (TyG) Index With Severe Acute Pancreatitis: A Systematic Review and Meta-Analysis

The triglyceride-glucose (TyG) index has emerged as a surrogate marker for insulin resistance and has been implicated in various metabolic and inflammatory diseases. Its potential role in predicting the severity of acute pancreatitis (AP), particularly severe acute pancreatitis (SAP), remains underexplored. This study aims to evaluate the association between the TyG index and SAP through a systematic review and meta-analysis. We systematically searched PubMed, Scopus, and Europe PMC databases from inception to March 26, 2025. Eligible studies included adult patients with AP stratified by severity (SAP vs. non-SAP) and reported TyG index values. Data extraction and quality assessment using the Newcastle-Ottawa Scale were conducted independently by two reviewers. A random-effects model was used to compute pooled mean differences (MD), with subgroup and sensitivity analyses to explore heterogeneity. Ten studies comprising 2262 patients were included. The TyG index was significantly higher in SAP patients compared to non-SAP patients (MD = 0.61; 95% CI: 0.46-0.76; p < 0.0001; I² = 79.1%). The index also predicted ICU admission (MD = 0.52) and mortality (MD = 0.71) in AP patients. Subgroup analyses showed consistent findings across study designs and sample sizes, though geographic variability was observed. The TyG index is significantly associated with the severity of AP and may serve as a reliable, accessible prognostic biomarker for identifying patients at risk of SAP.